People with frequent headaches often suffer in silence. But working with their doctor, they might be able to keep headaches at bay.

"We see a lot of adults and children with headaches with a vast array of causes, including migraines, sinus-related and tension-related," says MetroHealth's Holly Perzy, MD. If headaches are occurring routinely, "it's important to have a comprehensive physical assessment."

That means documenting a health history and a headache history. That history might mean asking a patient to keep a log for several weeks, noting what they were doing or eating when a headache began, and what helped or didn't help relieve it. "Often we can find patterns," says Dr. Perzy. A log works especially well for children: "It gives them a sense of empowerment."

Triggers for headaches can include:

• An inconsistent sleep schedule and amount of sleep.
• Caffeine. Get a moderate and consistent amount of caffeine. Don't quit caffeine cold turkey. Avoid taking over-the-counter medications with caffeine.
• Too much stress.
• Alcohol use. Some types of alcohol - including red wine - are high in tyramine, which can trigger a headache.
• Foods, including aged cheeses, MSG and deli meats. Again, tyramine is often the culprit.
• Menstrual cycles. Headaches can be hormone-related.
• Not drinking enough fluids. Being dehydrated can give you a headache.
• Allergies.
• Poor posture, which puts pressure on the neck and upper back.

A lot of people self-medicate for headaches, and Dr. Perzy cautions that if you've been doing that for a long period of time and then stop, you can get a rebound headache.

If a patient has migraines, and has had more than two severe ones a month, Dr. Perzy says they may need to consider daily preventive measures. Sometimes migraines can be handled with medication; sometimes a patient has to be hospitalized. Regardless, "We are constantly looking at new technologies to help alleviate pain in patients."

Sometimes, headaches are a sign of something more serious. Dr. Perzy says a neurology workup or CT scan is called for when patients are:

• Waking up at night with a headache
• Experiencing the worst headache of their life
• Suffering visual abnormalities
• Suffering speech abnormalities
• Have limb tingling, weakness or loss of function.

 

MetroHealth's Ali S. Totonchi, MD, is trained to perform minimally invasive surgery for migraines. This works on all four of the main migraine trigger points on the head. The surgery is geared toward people who have at least two or three severe migraines a month and who may not respond to migraine medications or who are tired of taking them. The minimally invasive surgery is usually outpatient.