YOUR QUESTIONS ABOUT HEADACHES, ANSWERED
Do children experience headaches in the same way the adults do? Could this be related to the stress of adolescence?
Approximately 70% of children have experienced some degree of headache by the age of 15. The stresses of adolescence, such as peer pressure, developing sexuality, and conflicts with parents, are known contributors to headache development. The typical lifestyle of an adolescent, including irregular eating and sleeping habits, may also trigger headaches. In some young women, the onset of their menstrual cycle may be linked with the onset of headaches. To help your child deal with headaches, try to remove triggering factors where possible, encourage relaxation techniques or biofeedback, while providing comfort and counsel.
Occasional use of over-the-counter pain relievers may also be appropriate, but remember to exercise caution when using medications containing aspirin for children under the age of 15 due to the risk of Reye's syndrome. It is important to know when to seek medical attention, especially with young children. Some symptoms to be aware of are headaches accompanied by fever, drowsiness, rash, or vomiting, and those after head trauma. See a doctor when treating a child with a pain reliever for headache. See the dosing guidelines on the packaging of OTC medication to confirm the appropriate age range for use and dose.
What is biofeedback? Can it really reduce pain?
Biofeedback is one of the relaxation techniques commonly used in headache centers. Simply put, a machine is used to provide feedback to sufferers about muscle tension, which is associated with pain. Using that information patients learn to reduce the muscle tension in their bodies. With practice, this effect may be achieved without the machine. Studies have shown that people who learn biofeedback techniques can reduce pain by up to 50%-70%. For more information, contact The Biofeedback Certification Institute of America at (303) 420-2902.
I have heard that caffeine may not be safe. Is that true?
Caffeine has been an ingredient in both OTC and prescription drug products for many decades. Medical research has demonstrated that caffeine is a safe and effective addition to the combination of acetaminophen and aspirin in medications for relief of pain when used at the appropriate dose. The acetaminophen-aspirin-caffeine combination is approved and clinically proven to be effective and well-tolerated for the relief of both migraine and tension-type headache pain, but as always, you should follow package directions.
The recommended dose of this product contains about as much caffeine as a cup of coffee. Limit the use of caffeine-containing medications, foods, or beverages while taking this product because too much caffeine may cause nervousness, irritability, sleeplessness, and, occasionally, rapid heartbeat.
Why does Excedrin® contain caffeine?
Caffeine has been found to enhance the pain relieving function of aspirin and acetaminophen when used in combination as in Excedrin® Extra Strength.
I've heard that working in some office buildings can give you headaches. Is this true?
While it's not the office building itself that may be giving you the headache, the air within the building could be. The cause of your headache could be due to a lack of free flowing fresh air. Chemicals and pollutants such as asbestos, toxins from the heating or air conditioning systems, chemical cleaners, pesticides, and second hand cigarette smoke may become sealed in the building and are all possible headache triggers. If you believe your building's environment is the cause of your headaches, try using an electric air cleaner, an air ionizer, or simply opening the windows.
Can allergies cause headaches?
The relationship between allergies and headaches is generally related to allergy symptoms. Some headaches do occur at the same time as allergies, particularly when grass, pollen, or ragweed counts are high. Headache specialists tend to agree that allergies are usually not the cause of severe or recurrent headaches. Sinus headaches are more likely to occur as the result of the buildup of mucus in the sinus cavities. You should see a doctor to determine an appropriate treatment.
I get a headache when I read for long periods. Is there something I can do to prevent it?
Yes. Eyestrain headaches may be caused by reading in poor light or reading for long periods without a break. Technically, it's not your eyes you are straining but the muscles around them, which are used for squinting, blinking, or reacting to a glare or dim light. To help prevent eyestrain, read in good light and take a five-minute break at least once an hour, gaze around the room periodically, and change the focus of your eyes from close to long range. See an eye care specialist since you may need corrective lenses or a change in your current lens prescription. Whenever your eyes feel strained, try this exercise: remove any lenses or glasses and turn down the lights or go to a dim room, put your hands over your eyes so your palms block out the light, look into the blackness for 30 seconds, close your eyes again, lower your hands, and open your eyes slowly.
I have started to get headaches since beginning a job as a computer operator. Could eyestrain be a factor?
Possibly, yes. Eyestrain headaches can result from contraction of muscles in and around the eyes. They are common among computer workers. These headaches cause mild pain in the forehead or in the eyes themselves, which frequently improves after the eyes are rested. Taking five minute breaks every hour and shifting the focus of your eyes from close up to far away may help prevent eyestrain headaches. However, eyestrain is generally not a cause of recurrent or chronic headaches. If you suffer frequently, you should have your eyes checked to determine your need for glasses or a new lens prescription, and to rule out glaucoma, which can cause headache symptoms.
Can the foods I eat be causing my headaches?
It's possible. Certain foods — including those that contain tyramine (such as hard cheeses) or nitrites (such as processed meats) — commonly trigger migraine headaches. Chocolate and alcohol (particularly red wine and beer) are also common triggers in some people. So are some fruits, yogurt, MSG, and freshly-baked breads. However, there does not appear to be a causal link between food and tension headaches. So, if you find that giving up a particular food makes your headache go away, chances are you had a migraine.
Why do I get headaches from eating ice cream?
We don't understand completely what causes the throbbing head or face pain that some people feel when they take a bite of ice cream or swallowing other cold substances. It most likely has to do with the sudden cold shock sent to the warm tissues of the mouth and throat. Sensations of discomfort are then carried by various nerves from the front of the mouth and the back of the throat to other parts of the head, and lasts less than five minutes. Although there is no treatment for these types of headaches, you can avoid them. Eat more slowly and in smaller amounts. Allow ice cream to melt in your mouth before swallowing, this helps cool off the warm tissues in your mouth gradually.
I always get headaches right before my period. Is there a connection?
There could be. Headache activity is influenced by fluctuations in the menstrual-related hormones, particularly estrogen and progesterone. This can lead to headaches around the time of menstruation or mid-cycle, during ovulation. Premenstrual headaches, which may strike as migraines or tension-type, afflict 10 million American women.
What is a migraine headache?
A migraine headache is a recurring, throbbing pain that usually affects one side of the head, but may affect both sides. Migraine sufferers describe the pain ranging from mild to searing, excruciating, stabbing, and even debilitating. Typically, the pain begins in and around the eye or temple. A migraine attack is usually accompanied by nausea, sensitivity to light (photophobia) and sound (phonophobia), and sometimes vomiting. The pain is often worsened by physical activity, such as mild exercise, bending over, or even changing position suddenly. You should see a doctor for diagnosis.
What happens during a migraine attack?
Many scientists believe that migraine headaches occur when arteries to the brain constrict, then dilate, resulting in the throbbing pain of a migraine headache. It isn't known what causes the blood vessels to constrict and dilate, but abnormally low blood levels of a chemical substance called serotonin may trigger the contractions. Migraine attacks can be disabling. More than 80% of migraine sufferers report at least some headache-related disability: 50% or more report mild or moderate disability, such as being unable to work or engage in usual daily activities; and about 30% report severe disability, sometimes requiring bed rest.
Who gets migraine headaches?
Migraine headaches affect approximately 30 million people in the U.S. each year. The majority of them don't currently seek treatment for their migraine pain.
When do migraines first occur?
Migraine headaches may first occur at a relatively young age, with the peak onset between eight and 12 years of age among males and between 13 and 17 years of age among females. The peak age for incidence is between 30 and 39 years of age. Migraines may occur less frequently and with less severity after the age of 50.
How does migraine headache differ from tension headache?
Migraine headaches are usually characterized by throbbing or pulsing pain on one side of the head. The symptoms of migraine headache sometimes include sensitivity to light or sound, loss of vision, and nausea. Tension headaches typically cause a dull, steady ache above the eyes or in the back of the head. They are usually accompanied by a feeling of tight head pressure and occasional nausea.
What is a migraine "aura?"
The two most prevalent types of migraine headache are migraine without aura and migraine with aura. Approximately 20 percent of migraine sufferers experience aura during their migraine attacks. The aura is comprised of neurological symptoms that most often include visual disturbances, such as flashing lights or lines, and may also include dizziness, numbness, or tingling that usually precedes the headache.
How often do migraine headaches occur?
Attacks are typically occasional — one to three times per month — yet sometimes they occur two or three times per week and last from four to 48 hours, and sometimes as long as 72 hours if left untreated.
What causes migraine headaches?
Migraines can be triggered by a number of things. Triggers can be emotional, such as stress, anxiety, depression, or even mild excitement. They can also be triggered by certain foods, including alcohol, chocolate, or citrus fruits. Hormones are also common triggers — many women experience migraines with changes in their estrogen levels during menstruation, pregnancy, childbirth, and menopause.
How are migraine headaches treated?
Until recently, only prescription drugs were approved for the treatment of migraine headache pain in the U.S. Excedrin® Migraine, the first over-the-counter pain reliever to treat mild to moderate migraine headache, was approved for marketing by the FDA. The product contains the same formula as Excedrin® Extra Strength, a widely available and generally well-tolerated pain reliever.
What is the effect of migraine on our society?
Migraine headaches affect — and disrupt — millions of lives each year. While migraine attacks are responsible for missed family time, strained relationships, loneliness, sleep deprivation, and frustration, migraine also takes its toll on the workplace. According to the National Consumer League, migraine costs society at least $5 billion in lost productivity and 270 lost workdays for every 1,000 workers each year.
Is it true that the majority of migraine headache sufferers do not seek treatment from physicians?
Yes. Studies have shown that the majority of migraine patients do not currently seek professional treatment.
Where can patients get more information on managing migraine headache pain?
There are many resources available, including the National Headache Foundation (1-800-843-2256), The American Headache Society (1-800-255-ACHE).
What is the difference between Excedrin® Migraine and Excedrin® Extra Strength?
The product approved for migraine headache is the same Excedrin® Extra Strength formula that has been on the market for more than 30 years. The FDA required that new labeling be created to address important patient information, instructions, and warnings for use in treating migraine headache pain.
I'm already taking another drug for migraine; can I take Excedrin® Migraine too?
If you are taking a prescription medication, please consult your doctor before combining it with any over-the-counter medication, including Excedrin® Migraine.
Is it safe to take products containing acetaminophen?
The FDA has determined that acetaminophen is safe for most people to use, when taken as directed. Take acetaminophen and all other medications according to the package directions. For further information or to discuss personal health concerns, please consult your pharmacist or physician.
A friend told me that poor posture could be the cause of my frequent headaches. Is that true?
Definitely. Many people get headaches or make their headaches worse because of poor posture. If you hold your head up in proper alignment with your body, there's less strain on your muscles. But if it is held forward of its proper position, it places strain on the muscles of the neck and upper back. Certain positions can lead to muscle strain and headache if they're held for a time. If you hold a particular position such as bending over a typewriter, or holding the phone between your shoulder and your head, or doing any type of repetitive movement, you could be vulnerable to headache. One way to counteract these stresses is to change position frequently. Every 45 minutes or so, give yourself a three to five minute "break." Get up from your desk and walk to the copy machine or do some filing, anything as long as you change positions.
What Are the Sinuses and Sinus Headaches?
Sinuses are air-filled cavities (spaces) located in the forehead, cheekbones, and behind the bridge of the nose. The sinuses produce a thin mucus that drains out of the channels of the nose. When a sinus becomes inflamed, often as the result of an allergic reaction, the inflammation will prevent the outflow of mucus and cause a pain similar to that of a headache. See a doctor if you are experiencing sinus headaches to determine the cause.
What Are the Symptoms of Sinus Headaches?
Sinus headaches are associated with a deep and constant pain in the cheekbones, forehead or bridge of the nose. The pain usually intensifies with sudden head movement or straining. The pain is usually accompanied by other sinus symptoms, such as nasal discharge, feeling of fullness in the ears, fever, and facial swelling.
Whether your headache symptoms can actually be attributed to the sinuses will need to be determined by health care professionals. If your headache is caused by a sinus blockage, such as an infection, you will likely have a fever and require a prescription medication.
How Are Sinus Headaches Treated?
Treatment of sinus headaches is usually directed toward symptom relief and treating the infection. Treatment might include antibiotics for the infection, as well as a short period of pain and fever reliever (such as acetaminophen, aspirin), decongestants (such as phenylephrine, a vasoconstrictor to decrease nasal congestion), or antihistamines to treat the symptoms.
Can Allergies Cause Headaches?
It is generally a misconception that allergies cause headaches. However, allergies can cause symptoms such as sinus congestion, which can lead to headache pain. If you have allergies, the treatment for your allergy can relieve your allergy symptoms, but may not relieve your headache pain. The two conditions often must be treated separately. See your doctor to ensure proper treatment.
I seem to be waking up earlier and earlier. Is it normal to sleep fewer hours as you get older?
Yes. The amount of sleep needed is largely influenced by age. As we grow older, not only do we require less hours of sleep, but also less deep sleep. In fact, we need half as much deep sleep in our 60s as we did in our 20s. Also, the number of awakenings during the night increases as we age. If you find yourself waking too early and feeling tired by late afternoon, try going to sleep a bit later and getting up at the same time each morning. Avoid taking naps during the daytime. Keep in mind that the amount of sleep needed for each individual varies and changes, and feeling refreshed and alert after a good night's sleep may have nothing to do with quantity — just quality of the sleep you're getting.
Lately it seems that many people I know, like myself, are having trouble sleeping. How common is this problem?
It is widespread. Sleep disorders affect as many as one-third of American adults. This includes 40 million people with chronic sleep problems and another 20-30 million with intermittent difficulties. Millions more are sleep deprived due to the demands and stresses of everyday living, and may be at risk for sleep difficulties since stress is a leading cause of insomnia. In women, physiological factors such as the menstrual cycle, pregnancy and postpartum, and menopause commonly interfere with sleep throughout women's lives. A government commission recently reported that sleep difficulties may affect more than 40% of women over the age of 40!
I fall asleep easily but often wake up in the middle of the night with my mind racing. Do I have insomnia?
Possibly. Insomnia covers difficulty getting to sleep as well as waking up in the middle of the night and not being able to get back to sleep. While even good sleepers awaken five to 15 times each night, most fall asleep within a few seconds and forget that they have been awake. Studies show that at least half of all sleep problems are caused by such issues as marital stress, job stress, anxiety, or depression. If you are having trouble falling back to sleep, pay attention to the thoughts running through your mind. They may help you find the cause of your problem.
Can pain affect sleep?
People who experience pain may have difficulty falling asleep and staying asleep. This can reduce the duration and quality of sleep.
Why do I wake up with a headache on weekends or holidays when I sleep in longer?
Many people experience headaches on weekends and holidays. In fact, the "weekend" headache is a recognized occurrence. Altered sleep patterns may contribute to weekend headaches. If you use weekends to "sleep in," you may actually be oversleeping, and that may cause migraines in some people. Migraine headaches can begin during the stage of sleep called Rapid Eye Movement (REM). REM sleep accounts for about 25% of adult sleep time. Therefore, the more you sleep, the more REM sleep you experience, and the more likely you are to get a headache. Maintaining a consistent sleep schedule by getting up at the same time as you do during the week should help you avoid this problem.
My wife suffers from headaches, and she smokes. Could these two things be related?
Yes, they could. Research has shown that there is a relationship between headache activity and cigarette smoking. There is also an association between brands with higher nicotine and more frequent occurrence of headaches. If your wife would like to quit smoking, these findings may provide the incentive she needs.
Why do some people tend to get their headaches after a stressful situation has passed?
For some people, stress may be a function of everyday life. A demanding job or boss, financial, marital, or other interpersonal problems may be the rule rather than the exception. It is only during periods of relaxation such as after work or weekends when stresses are lessened that these individuals may experience headaches. These headaches are not psychological, but rather physical in nature. During times of prolonged stress, the blood vessels constrict and tighten. When the stress is gone and these people are finally able to relax, the blood vessels dilate and may result in headache. A good way to try to avoid this cycle is to attempt to minimize stressful times and try to keep busier during leisure times.
What is the stress response and is it helpful or harmful?
The stress response is your body's instinctive reaction to a dangerous or stressful situation. This reaction can be both helpful and harmful. For example, one of the instinctive responses to stress or danger is muscle contraction. This is helpful during times of physical stress, such as when muscles contract tightly around a broken bone to prevent further injury. But some people respond to emotional stress — such as an argument at work — with the same clenched muscles, which can lead to a painful muscle contraction headache. Look in the mirror the next time you're in a tense situation. If you see hunched shoulders, a clenched jaw and an angry look, you may be someone whose headaches are caused by a muscle contraction response to anger and worry.
Stress and TMJ (temporomandibular joint) syndrome — is there a connection?
There may be. TMJ syndrome is believed to be due to the misalignment of the teeth and the jaw, and the strain of the surrounding muscles used to compensate for this misalignment. In some cases, it may also be due to an arthritic condition of the joints. Some people respond to stress by clenching their jaw, or grinding their teeth both during the day as well as at night. If you suffer from TMJ syndrome and respond to stress in this way, you may actually be compounding the problem. Consider self-massage as a way to alleviate some of the stress, and see your doctor, dentist, or a TMJ specialist for further information.
What causes my headaches?
Some headaches are caused or "triggered" in a variety of ways. For some headache sufferers, changes in weather as well as odors, foods, alcoholic beverages, stress, and other factors may "trigger" headaches. Some triggers are more common than others — alcohol, sugar, chocolate, fatty foods, and citrus fruits are among them.
My husband gets really terrible headaches. What are the odds that he is suffering from something really serious?
Approximately 90% of all headaches are classified as tension-type (sometimes also referred to as muscle contraction headaches). Another 8% are migraine or cluster headaches. Only 2% are potentially more serious — that is, secondary to an underlying illness or other medical condition. He should see a doctor for an accurate diagnosis of his condition. See When To See a Professional for Your Headaches for tips on choosing a headache specialist.
Are all "bad" headaches migraines?
No. Tension-type headaches, which affect more than three-quarters of all headache sufferers and are five times as frequent as migraines, also can be very painful. They can interfere with job productivity, family life, and a general sense of well-being.
A friend told me she's been diagnosed as having "mixed" headaches. I've never heard of that. What are they?
Patients suffering from mixed headaches experience various combinations of tension-type headaches and migraines. Often a person who has suffered for years from one type of headache will begin to experience the other as well. This phenomenon, as well as other relationships between tension headaches and migraines that research has shown recently, has led many researchers to believe that the two forms of headache may share a common mechanism in the brain.
I often get a headache just as a big storm approaches. Is that more than a coincidence?
It may be. Changes in the weather, usually from good to bad, can trigger a migraine or other type of headache. Some migraine sufferers can actually predict their headaches by changes in the weather. Scientists theorize that as a storm front approaches, changes in the barometric pressure affect the headache sufferer, triggering a migraine attack.