We have all had at least one in our lives – a headache. Sometimes it’s dull and slight and simply an annoyance. Sometimes it can be so bad that you need to go to the ER for immediate sedation. Why?

Ask that question 20 years ago and the answer would depend on the particular type of headache we’re talking about. We would have guessed that a migraine headache resulted from contraction and dilation of blood vessels running to the brain and that a tension headache was the result of tensed-up muscles.

Today we would say that most headaches, if not all, probably originate in the same area of the brain, and this is how they seem to work:

Headaches and Serotonin

Some event, we’re not sure what, triggers the trigeminal nerve (located in the brain stem, its branches run to your face) which releases a burst of chemicals signaling pain. Usually, these stimulate the a release of serotonin, a substance which counteracts the pain signals. The people who get headaches are those whose serotonin reaction is slow.

Two problems that trouble many headache sufferers are depression and sleep disorders which are also serotonin related. Frequently, when people diagnosed with depression begin treatment with medications called selective serotonin re-uptake inhibitors (SSRI’s), the frequency and severity of their headaches disappear.

Serotonin, however, does not provide a full explanation of where headaches come from. More research is needed before we will have a complete understanding of the underlying processes.

There is a possibility your headaches are an effect of an ailment in another part of your body. If you suffer from headaches regularly you should consult your doctor, who will probably prescribe a battery of tests before making a diagnosis.

Keep a Headache Log

The best way to deal with headaches is to prevent them, and you can do that by identifying and eliminating those things which trigger your headaches. To identify your headache triggers, keep a headache diary. Whenever you feel a headache coming on, record this data:

• The time of onset.
• Where you were.
• What you were doing.
• Who you were with.
• The location of the headache in your head.
• How you were feeling (hot, cold, angry, sad, happy, anxious, hungry, etc.).
• When and what you last ate.
• Any ideas about what you think may have triggered the headache.
• What you did/will do to relieve the pain, and how it worked.
• What medications you were on and the dosage.
• When the headache ended.

Estimate, on a scale of 1-to-10, the amount of pain you felt when the headache was at its worst.

From this diary, you should begin to see a pattern. Perhaps a certain type of food, a particular person in your life, or perhaps they occur at the same times every day. Any patterns you find may help you identify the problem. Share your diary with your doctor, who may also be able to discern patterns you cannot and identify the source.

What Types of Things Can Cause a Headache?

• Emotions: Chronic headache sufferers are more prone to stress and anxiety, emotions which seem to reduce immunity to pain.
• Diet: Certain substances such as nitrites, tyramine, MSG, alcohol, caffeine, high doses of vitamins, and lack of water can trigger headaches.
• Medications: Nitroglycerin, drugs for hypertension, blood thinners, ulcer treatments, antiseizure drugs, and oral contraceptives.
• Environmental factors: You may be living or working in a place that exposes you to odors, glare, noise, stress, or other factors that can trigger headaches.
• Eating and Sleeping Patterns: Missing meals, getting too much or too little sleep.
• Strains: Straining eye, neck, or shoulder muscles.
• Hormones
• Physical exertion

Laugh Your Headache Away

Once you have a better idea of what it is that triggers your headaches, take action. Here are some things that may reduce the number of headaches or even stop them in their tracks:

The Headache Remedy Varies With The Headache

• Tension headache. This feels like a tight band around your head with possible additional pain in the neck. It calls for an over-the-counter pain reliever like aspirin or acetaminophen.
• Migraine. Extreme pain on one side of the head may be accompanied by vomiting and sensitivity to light and sound. Prescription drugs may be needed.
• Cluster headache: Sharp, severe pain in one side of the head lasts 45 to 90 minutes. There will be several every day for a period that may be as long as 12 weeks. Calls for preventative medicine and the possible use of oxygen.
• Sex headache: Peaks with orgasm. Usually nothing to worry about, but if they recur often, see a doctor. They may be a sign of bleeding in the brain or stroke.
• Ice cream headache: Pain that goes through the roof of your mouth when you take a bite of ice cream. Don’t take such big bites.

Resources:

• If you get headaches, you may get migraines. Learn how to treat migraines
• "Headaches," Health Square.
• Zahid H Bajwa, MD, R Joshua Wootton, MDiv, PhD "Patient information: headache causes and diagnosis," UptoDate Patient Information.