There are five types of headaches: sinus, cluster, tension, migraine and hormonal. OB-GYN Dr. Lisa Masterson explains that headaches are much more common in women than men due to hormonal fluctuations, and many women report menstrual migraines right before their periods. Headaches also can be caused by neck pain that stems from injury, strain, sprain, herniated discs or insufficient support while sleeping.
ER physician Dr. Travis Stork explains that migraine headaches are thought to be caused by the dilation of blood vessels in the brain and tend to affect one side of the head. The dilated vessels pull on nerve receptors located near the blood vessels, causing pain signals to be sent to the brain. The result is a throbbing headache with a variety of symptoms.
Foods such as coffee, red wine, cheese, chocolate and those with monosodium glutamate or high levels of sodium can trigger migraines. Dr. Travis suggests headache sufferers keep a journal of when they have migraines to see what triggers them.
If you do get a migraine, relaxing in a dark, quiet room that is free of any strong smells can help reduce the symptoms. Non-surgical migraine remedies include practicing relaxation techniques, such as accupuncture, exercising at least three times per week and placing ice on the base of the neck.
"Acupuncture is an option for people who aren’t getting relief from over-the-counter medicines or prescription medicines,” Dr. Travis says.
Multiple treatments are recommended for patients with chronic pain.
“Acupuncture is great,” acupuncturist Dr. Michael Yang says. “We’re talking about increased endorphin response, which we know is the natural painkiller. We also know it’s a question of blood flow, so acupuncture does a great job of increasing the blood flow in the patient, and that is really critical when we’re talking about dealing with this kind of pain.”
Plastic surgeon Dr. Andrew Ordon explains that Botox injections are an increasingly popular treatment for migraines, because they can be injected into the sensory nerves that send pain impulses to the brain. Read Dr. Ordon's blog post about how Botox can help neutralize migraines.
For those who do not respond to medications or Botox, a surgical procedure pioneered by plastic surgeon Dr. Bahman Guyuron from the University Hospitals of Cleveland might help cure migraines. Dr. Guyuron discovered an unexpected side effect when performing a forehead lift, a cosmetic procedure that lifts the brow to create a younger appearance. He noticed that his patients who had migraines were no longer having headaches after the procedure.
"That led me to do a number of studies that were published in the Journal of Plastic and Reconstructive Surgery," Dr. Guyuron says. "We have discovered that there are common trigger sites, and I have developed surgical techniques for each one of them."
Trigger points in the brain initiate a cascade of events that lead to the dilation of blood vessels, causing migraine pain. Dr. Guyuron makes five incisions in the forehead, removing targeted muscles and nerves.
"The patients look naturally rejuvenated and more cheerful," Dr. Guyuron says. "We take the migraine headaches away and eliminate that irritation of the trigeminal [nerve] branches that cause migraine headaches."