The plain fact is that no one welcomes a headache. Or pain anywhere, for that matter. And why would we? Pain gets in the way of whatever we’re doing, or thinking, or thinking about doing. At the very best, a headache is downright inconvenient.
So why consider it a gift? Because, unsurprisingly, pain gets our attention. And a pain in the head gets our attention like nothing else. Of course, the very first idea we have is, “Get rid of it…”, followed by “as fast as possible.” This is perfectly normal, and there’s nothing wrong with it. I keep aspirin* in my bathroom cabinet, and so should you.
The obvious temptation is to dismiss the headache from our awareness as soon as it’s gone. Bad idea. Pain anywhere in your body is a friendly signal, alerting you that something is amiss. Sometimes it is more than a signal; sometimes it’s a screaming, last-ditch, about-to-go-over-the-cliff panic button that you ignore at your peril. So how do you tell when you getting a friendly “nudge” vs. an all-stations alarm?
What you need is a simple checklist that can help you determine why you developed that pesky headache. Then you have a reasonable basis for deciding whether it’s
a) a “one-off”, or
b) a trend you need to correct, or
c) potentially a serious situation you are going to need help with.
There are lots of variables and complexities to explore, but here’s a short form that’s practical and easy to use.
- Are you hungry?
- Are you thirsty?
- Are you sleepy?
- Are you unhappy or stressed?
- Are you over-working? or spending lots of time at a computer?
- Have you had your vision checked lately?
- Are you taking any medication?
- Have you been over-indulging with alcohol? or other mood-altering substance?
- Did you pull a muscle (especially in the neck) or over-strain during sports or other activity?
- Have you been in an accident, had any type of fall, or hit your head?
- Have you been exposed to any environmental irritants? or to any known allergen?
- Did you wake up with it? or did it come on during the day?
- Have you had this kind of headache before? Is there a pattern to it? Is it getting worse?
- Does it correspond to a change in barometric pressure? or to any hormonal fluctuation?
- Did you experience anything unusual before it started: ringing in your ears, or sensitivity to light?
- Does anyone in your family have a similar experience with a headache?
Some of the answers give you an immediate framework for thinking about the root cause of your headache. Dehydration is an almost pandemic problem, but easy to fix. Giving yourself the benefit of a regular and healthy diet is not as easy, but can certainly be done. Correcting ergonomics at your workstation is usually pretty simple; I ask patients to bring me pictures and we troubleshoot from there.
Other causes and linkages can be a little harder to tease out. A hormonal pattern is easier to chart than one that’s linked to barometric pressure. Migraine-type headaches don’t always have the classic presentation with a prodrome and light sensitivity. If you suspect a prescription may be the problem, talk to your medical practitioner about alternatives or interactions.
Awareness of head injuries has definitely increased, but still not enough people know that headaches can be caused by increasing intracranial pressure. This can be from a blood vessel leakage, a growing mass within the skull, or a disruption in cerebrospinal fluid flow. These are worse case scenarios, but I hope to convince you to take a headache seriously. Early warning is a gift worth having.
On a more positive note, I have seen many patients who now, I am happy to say, no longer have headaches. And that’s a wonderful thing – much better than a gift from even the best store.
*Preferably not acetaminophin, by the way; see Harvard Medical School’s 12 Things you Should Know about Paint Relievers.
Click here for a print-friendly version of the checklist.