Pain is your body’s way of alerting you that something is wrong, so if you’re not sure what is causing a headache, and it persists or recurs, it’s vital to see your health professional. "Successful treatment depends on an accurate diagnosis of the sources," says Dr Elliot Shevel of The Headache Clinic in Joburg. You may need only relaxation, massage, gentle neck stretches or compresses. But, severe pain like migraine may require a migraine specialist, or a multidisciplinary approach by a neurologist, a physiotherapist, a dentist and a psychologist.
An extremely severe headache can indicate a stroke, if it strikes suddenly with numbness, weakness or paralysis, dizziness and confusion. Get help immediately, says Benoni neurosurgeon Dr Johann Stegmann. "Clot-busting medication can limit the severity of strokes caused by clots and save lives, but needs to be administered within the first three hours."
Fortunately most headaches have less frightening causes, including:
You have eye strain
The headache pain is around or behind your eyes, which feel tired and sore.
The solution
"Have your eyes tested – you may need glasses or contact lenses, or a stronger prescription," says Dr Shaquir Salduker, director of the Durban Pain Clinic at St Augustine’s Hospital.
You haven't eaten or drunk enough
Skipping a meal can cause your blood sugar to drop, triggering a headache. Not drinking enough, especially when it’s hot and you’re exerting yourself, can also trigger one from dehydration. And if you’re a regular coffee drinker, missing your morning cup may trigger a caffeine withdrawal headache.
The solution
Eat regular meals and snack healthily between on a handful of raw nuts, raw veggies or fruit, and keep water on your desk or carry a refillable bottle, so you can drink whenever you feel thirsty. If you’re in caffeine withdrawal, a catch-up coffee or cube of dark chocolate can help your head. To kick a caffeine habit, do it slowly – cut your intake by around 25% a week, suggests Dr Shevel.
You've eaten a triggering food
If you’re prone to migraines, certain foods can set one off. Common culprits are aged cheese, alcohol, foods with nitrites (sausages, bacon), pickled or fermented foods and MSG.
The solution
Keep a food diary – then once you identify the source of your headaches, eliminate it. If your migraines persist, see a headache or pain specialist.
You have a hangover
Alcohol is a diuretic and too much can dehydrate your body, strain your liver and disturb your sleep, all contributing to a throbbing headache with nausea and tiredness.
The solution
Rehydrate by drinking plenty of water, and pop a painkiller like aspirin or ibuprofen. Avoid acetaminophen, which can be harsh on an alcohol-inflamed liver, advises Harvard Health. In a study in the Journal of Clinical Medicine, people who consumed more zinc and B vitamins 24 hours before drinking had less severe hangovers.
You ate or drank something cold
If you eat ice cream fast or toss back a freezing beverage, you can experience an ice cream headache or brain freeze. The reason is thought to be linked to the blood vessels in your mouth contracting from the cold, triggering pain signals to the brain, Dr Shevel says.
The solution
Eat or drink cold things slowly.
You have a rebound headache
"If you take more painkillers than prescribed and for longer than you should, especially those with caffeine or opioids, you can build resistance to them and need more to bring relief – then experience even worse headaches, in a vicious cycle," says Dr Salduker.
The solution
Ask your health professional about changing your medication or to refer you to a specialist who can look at alternative ways to deal with the pain, and wean you off painkillers. Injections can be used for tension headaches, and Botox for migraines, blocking pain signals between nerves and muscles.
"We detox rebound headache patients with alternative medication, exercise prescriptions, physiotherapy to help relax muscles, and have a psychologist who educates them on the nature of their pain and helps them reframe it using cognitive behavioural therapy and mindfulness therapy," says Dr Salduker.
Also read: Suffering from heartburn? Here's what you should know.
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