FINDING THE CAUSE OF PAINFUL HEADACHES

Headaches are a fact of life. You know your head hurts when you’ve got a cold or an allergy. But what about a headache that just doesn’t go away, or headaches so painful that you just can’t get through your day?

“When the frequency or severity of headaches impacts your ability to live your life – or when they affect your quality of life – it’s time to talk with your doctor or healthcare professional,” said Dr. Shaun Christenson, an Essentia Health neurologist in Fargo.

“The goal is to answer the question of why you’re having headaches,” Dr. Christenson said. “The first question to ask is ‘What’s new in your life that’s bringing out the headaches?’ ”

A good place to start is to try to identify what triggers your headache. Dr. Christenson begins with key lifestyle questions:

• Are you drinking enough water to avoid becoming dehydrated?

• Are you consuming too much caffeine, or too much alcohol?

• Are you skipping meals?

• Are you getting enough sleep?

• Do you have more stress in your life?

All of these factors can cause headaches, and making simple lifestyle changes can often resolve them, Dr. Christenson said. Another trigger for women can be hormonal changes during their menstrual cycle or during menopause. “Headaches and migraines like instability and women’s changing hormones levels are unstable during menstruation,” he explained.

Women are twice as likely as men to suffer from migraines and severe headaches lasting a day or longer regardless of their age or race, according to recently released statistics from the 2012 National Health Interview Survey. The survey, conducted for the Centers for Disease Control and Prevention, found 18.9 percent of women surveyed reported experiencing a severe headache or migraine within the past three months. The same was true of only nine percent of men. Younger women, ages 18-44, reported the highest number of headaches.

Getting a good night’s sleep can be a challenge but it can have a big impact on headaches, even migraines, said Dr. Christenson. He recommends getting at least 7 ½ hours of sleep each night, establishing a routine bedtime and not napping. “In our busy lives, everybody tries to do more and we end up being sleep-deprived,” the neurologist said. “But there are consequences from that lack of sleep.”

Occasional headaches can be treated with over-the-counter pain relievers, but Dr. Christenson cautions about their overuse. “Over-the-counter pain relievers were developed to be used two or three days in a week, not every day,” he explained. Overuse can lead to side effects, such as stomach ulcers or kidney damage, and even rebound headaches.

“Pain relievers can create a trap and cause a daily headache called a rebound headache,” Dr. Christenson said. “If you take a pain reliever every day and then don’t use a pain reliever for several hours, your headache will become temporarily worse. When you take the pain reliever, it simply takes the edge off the pain. You’re unlikely to get better unless you totally stop taking the pain reliever for weeks.”

When lifestyle changes and over-the-counter medicines don’t offer relief, prescription medications can help, Dr. Christenson said. Consulting with a neurologist can help diagnose other causes, such as a spinal fluid leak, chronic meningitis or an unexplained increase in pressure inside the brain called pseudotumor cerebri.

A common fear among headache sufferers is that their pain is a symptom of a brain tumor. But that’s highly unlikely, said Dr. Christenson. “With a brain tumor, you wouldn’t have a headache alone without other neurological symptoms,’’ he explained.

Dr. Christenson stressed that a sudden, severe headache warrants a trip to the emergency department at the nearest hospital. “If you are having the worst headache you’ve ever had in your life – a red flag headache – you need to call 911 and get immediate attention,” he said, explaining such a headache can be a symptom of a stroke or a brain hemorrhage. Other symptoms of these potentially life-threatening conditions are a change in vision, double vision, confusion, slurred speech, and weakness in the face, arm or leg.