Surprisingly common severe headaches, but treatment methods are improving

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Doctors cited hydration, getting enough sleep and exercise, avoiding processed foods, and managing stress as some of the most effective tools to avoid triggering both types of headaches.

“I often recommend magnesium and vitamin B2 as natural supplements for migraines as well,” Mays said.

Hammes said headache sufferers could also find relief from manually manipulating the muscles and joints around the shoulders and neck.

It works “particularly well in tension headaches,” according to Hammes, but can also help with migraines when there is a structural cause (i.e. trauma to the neck or head) related to the migraines.

“I usually tell my patients to try osteopathic manipulation three times before they say it didn’t help at all or there was no difference,” she said.

Mays advises against a heavy reliance on painkillers like ibuprofen, which can make the problem worse by causing “medication overuse” headaches.

“If you are using these medications twice a week or more to treat headaches, you should consult your doctor,” she said.

Doctors can prescribe specialized treatments that are taken at the onset of a migraine, for example, or try to prevent them altogether with blood pressure medications, anticonvulsants, antidepressants, and even Botox injections. Mays is particularly excited about CGRP antagonists, a new class of therapies that work by disrupting pain-inducing inflammation in the brain, having seen its positive impact firsthand.

“I had a patient who had been crippled by headaches for years. She limited what she would do. She never went to college, never had a family, and she’s seen incredible progress since we put her on one of these CGRP therapies,” Mays said. “But they are very expensive.”

Hammes tells his regular headache sufferers to start by recording their experience in a journal so they can isolate what may be contributing to the onset. If you wake up with a headache, your pillow may be too big or too small, or the straps on your CPAP machine are too tight. If it starts after a long day of school or work, maybe your briefcase or backpack is too heavy or your computer screen is too low.

Identifying patterns can help doctors assess the causes of your headaches and recommend possible interventions.

“If patients don’t have a very specific therapy designed for their type of headache, they can become really dissatisfied,” Mays said, “and so that’s where it’s worth looking for someone which you know has knowledge about managing the type of headache you are experiencing.

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