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Head off the ache

Ow! My achin’ noggin!

Could it be a migraine? The difference between a garden-variety headache and the more intense ailment isn’t as clear as many of us think.

That hangover, for example? Likely a migraine. A throbbing noodle might also be a sign of something more ominous, so get it checked out.

Sure, pop an ibuprofen, but it might not always be effective, and not everyone wants to be pill-happy.

So what else can you do to quell the ache?

What the experts say

“Magnesium relaxes muscles and opens the blood vessels. Forty per cent of people with cluster [on one side] headaches and about 50 per cent with migraines have low magnesium levels. Small amounts of caffeine help big amounts make headaches worse. Magnesium is good for prevention of migraines. Also coenzyme Q10, butterbur, feverfew, riboflavin (vitamin B2). Take these daily to prevent headaches. The best preventive treatment for migraine is Botox injections. We think it works by affecting sensory nerve endings that feed information back to the brain. Acupuncture works. Biofeedback and relaxation techniques are scientifically proven. The number-one cure for headaches is regular aerobic exercise, 30 to 40 minutes, three or four days a week.”

ALEXANDER MAUSKOP, director, New York Headache Center, Manhattan

“We use behavioural therapy – relaxation therapy – and teach our patients meditation. Biofeedback technology assesses whether they are relaxed. We ask our patients to meditate twice a day for 15 minutes. Meditation gets the autonomic nervous system functioning at a lower, more stable level. Behavioural therapy reduces the frequency and duration of headaches, tension types as well as migraines. We used to think there were two types of headaches, but we now realize it’s messier than that. Everybody who has headaches has a unique equation. They can have as many as 15 [symptoms] or as few as two. The two always present are muscular-skeletal tension and autonomic nervous system dysfunction.”

JOSHUA WOOTTON, professor of anaesthesia, Harvard Medical School, Boston

“There’s a study showing that most patients who come to a doctor bothered by headache have migraines. Migraines have many triggers, like nitrates in cured meats. Alcohol is the other big trigger. The majority of people who have headaches with their hangovers have migraines. There’s a popular idea that if only you can identify which food triggers your migraine, everything will be fine and dandy. There’s no evidence to support that. Migrainers need regularity: regular sleep, regular meals, regular exercise.”

PETER GOADSBY, professor of neurology, headache program director, University of California San Francisco

“Primary headaches are built into the person’s biology, often genetically. Secondary headaches come from having something else wrong, like a wisdom tooth, tumour, sinus infection, herniated disc, among 300 different causes including infections, toxins and trauma. Migraine, on the other hand, is a biological event, usually genetically determined, in which your brain is overly sensitized. Migraine is often an illness of women cluster headache is principally in men. Tension headache is a term I don’t like to use because it’s really a subdued form of migraine.”

JOEL SAPER, clinical professor of neurology, Michigan State University, Ann Arbor

“Most of those with headaches who do not suffer from migraines probably have tension headaches. Among the neurological disorders, headache is one of the most costly for society. Migraine patients seem to have more anxiety and depression. Headache is linked to chronic pain in other parts of the body. Migraine, particularly with aura, is a risk factor for stroke in women. These women should avoid other risk factors for vascular diseases, such as smoking and oral contraceptives.”

LARS JACOB STOVNER, leader, Norwegian National Headache Centre, Trondheim

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