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Headache Help

A THREE-STEP PLAN TO STOP THE THROB ONCE AND FOR ALL

What does a migraine sufferer have in common with Al Roker? Both can predict an oncoming storm. M.D.s don't fully understand why, but changes in barometric pressure (a precursor to bad weather) can short-circuit the autonomic nervous system and set off a migraine. SELF can't do anything about wind and rain, but the guide below may help you head off migraines and other headaches before they hit—or soothe the pain once it strikes.

HEADACHE HELPER #1

Identify your ache. The two types of headaches most likely to affect women are tension headaches and migraines. About 95 percent of all women have at least one headache a year, and 75 percent of those are tension-related. The cause can usually be traced to muscle tightness (from stress or hunching over your computer, for instance); you'll feel a dull, pressing pain on both sides of your head.

Migraines strike nearly 20 million women at some time and tend to cause throbbing pain on one side of the head. Sufferers may have visual auras (such as a flashing light in the corner of the eye), nausea or sensitivity to light and sound. "Many people think they have a sinus headache when it's a migraine," says Anne Remmes, M.D., codirector of The Columbia Headache Center of Columbia University College of Physicians & Surgeons in New York City. Common triggers include red wine, chocolate and even hunger, which can throw off the brain's equilibrium; some experts think an imbalance in the brain chemical serotonin may also play a role.

HEADACHE HELPER #2

Turn off tension. First, sleuth out potential tension triggers, says Allan Bernstein, M.D., chief of neurology at Kaiser Permanente in Santa Rosa, California. See if any of these sound familiar: If your office gave out frequent flyer miles for hours logged, you'd get a free trip to Australia; you schlep a handbag heavier than most toddlers; you struggle through a blood-boiling highway commute every day. Easy fixes: "Take a break from your computer every 30 minutes," Dr. Bernstein says. Lighten your bag and, if possible, change the way you get to work (hop a train for a relaxing ride, or form a car pool). When you feel stressed, try some shower power. Warm showers (even a warm washcloth or heating pad) help ease tense muscles. Dr. Bernstein also suggests paying attention to timing. "If they occur at the end of the day, they are most likely related to an afternoon activity. Those that happen earlier in the day are probably related to your commute," he says.

Build little tension busters into your day. "When the phone rings, use that as a cue to inhale deeply, sit up straight and exhale slowly as you relax your shoulders," Dr. Remmes says. Try this before a big meeting, when your baby starts to cry—whatever stresses you out.

Got a headache anyway? "Ibuprofen or other over-the-counter pain relievers generally do the trick," Dr. Remmes says. (If you're taking them more than two times a day, twice a week, see a doctor for something stronger.) Surprisingly, your dentist may also be able to help. Some tension headaches are linked to stress-induced jaw clenching. Research shows that wearing a corrective bite guard while you sleep can reduce the pain and frequency of headaches.

HEADACHE HELPER #3

Master your migraines. Bright lights, the food additive MSG, oral contraceptives and more can set off migraines, Dr. Remmes says. Some herbs such as ginkgo biloba, ginseng and St. John's wort can also be culprits. "If you know your triggers, steer clear if you can," she says. "Also, keeping a consistent sleep schedule, even on weekends, has been shown to help prevent migraines." So does eating a magnesium-rich diet, because the mineral affects levels of serotonin and other migraine-related brain chemicals. Whole grains, peanut butter, spinach and almonds are all good sources.

Fortunately, migraines often announce their imminent arrival. One study in the journal Neurology found that 97 percent of sufferers have some sort of symptom, including fatigue, trouble concentrating or a stiff neck hours or even days before the headache's onset. Recognizing these signs and treating the migraine early may stop the pain in its tracks. OTC medication should be your first defense; triptans, which affect serotonin levels, are the best prescription migraine drugs. Acupuncture may also help, possibly because it releases pain-quelling endorphins in the body.

"When the phone rings, use that as a cue to inhale deeply, sit up straight and exhale slowly as you relax your shoulders," one expert says.

If you've tried nonprescription remedies to no avail, see an M.D. In fact, you may want to ask for a referral to a headache specialist; research shows doing so will likely improve your outcome. A report in the journal Headache, for example, found migraine sufferers experienced greater success after visiting a specialist. Compared with family docs, the specialists spent more time with their patients and were more likely to prescribe newer and more effective drugs.

Whatever ache attacks your head, you can beat the pain with the right kind of treatment. Experts say 90 percent of sufferers can eventually be helped. What a relief!

Leah Ingram lives in New Hope, Pennsylvania.