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Doctors say headache sufferers should trace cause

McClatchy-Tribune illustration (McClatchy-Tribune illustration / The Spokesman-Review)
McClatchy-Tribune illustration (McClatchy-Tribune illustration / The Spokesman-Review)
Lindsay Kalter Dallas Morning News

When it comes to fighting headaches, instant gratification is ideal. It’s easy to pop a couple of pain pills and move on with your daily activities.

But doctors say the most common remedy used by headache sufferers could actually be a major source of the problem.

Too many pain relievers can ultimately make headaches more painful and less manageable, headache experts say. Because of this, doctors encourage people to try eliminating potential causes – stress, eye-strain and certain food or drink – before reaching for the medicine.

“The headache is a unique type of pain,” says Dr. Anwarul Haq, a specialist at the Dallas Headache Association.

“The medicine that gives temporary relief today, it modifies pain control in the brain, and starts adding fuel to the fire, producing more pain.”

Taking pain medication more than two or three times a week can cause “rebound headaches,” Haq says.

The body adjusts to the medicine and goes through withdrawal once it wears off. The result is a more intense headache, which prompts the desire for more pain medication. And the cycle continues.

As many as one in 20 people get daily headaches, Haq says. Doctors say that being aware of potentially headache-causing activities could reveal the culprit.

What’s causing your headache?

Dr. Todd Clements, of the Clements Clinic in Plano, Texas, says certain lifestyle modifications can help reduce headaches without medication. He says one of the most common causes of headaches is too much caffeine, which can restrict blood flow to the brain.

“And it can lead to dehydration, too, which also causes headaches,” he says.

A caffeine-induced headache will usually occur immediately after the energizing effects wear off.

In moderation, caffeine can help headaches. Small amounts speed up the heart rate just enough to open the blood vessels in the brain. In fact, some headache medications contain small amounts of caffeine.

But it only has the desired effect if caffeine intake is limited to 200 milligrams, or two cups of coffee, in 24 hours. A large coffee from Starbucks contains more than 400 milligrams.

Haq says that cheese, chocolate and wine may also be problematic.

“Cheese, especially aged cheese, can lead to headaches,” he says. “It could be related to certain amino acids in the cheese that could trigger the effect.”

Aside from dietary habits, stress causes its fair share of headaches. Clements says tension-type headaches caused by stress tend to start in the middle or at the end of the day and are usually accompanied by tension in the neck.

The most effective antidote for these, he says, is exercise. It releases endorphins, the body’s natural painkiller.

And if exercise is out of the question, even taking 20 minutes each day to escape from external stressors can help.

“Have a time period where you can de-stress for a little bit,” says Clements. “Try breathing techniques that can increase your oxygen level.”

These breaks can also help reduce eyestrain, he says. With heavy reliance on computers in most workplaces, people often get headaches from staring at monitors all day.

“Also, iPods and loud music are common causes,” Clements says. “Any senses overstimulated can cause headaches.”

If these behavioral changes prove ineffective and headaches are no longer manageable with pain medication, further medical attention might be needed. The patient can be referred to a neurologist by a primary care physician; the neurologist may then suggest the attention of a headache specialist.

“If it’s something where you have other things with it, like dizziness, seeing double, that could be something more ominous,” Clements says.

Haq says that people who suffer frequent tension-type headaches or migraines can be treated with medications to keep headaches from starting. These include Elavil, Topamax and Pamelor.

Unlike pain relievers that are taken after the headache starts, preventive medications do not cause rebound headaches.

Migraines are debilitating headaches sometimes accompanied by other physical symptoms. Haq says that most are caused by a genetic component, but they can be heightened by environmental factors.

Rather than increasing pain medication when headaches become worse or more frequent, he says, it’s important to see a doctor and explore different options.

“If the patient feels they’re losing control over them, or if they are getting a different type of headache, they should definitely seek medical attention,” Haq says.

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