Why Your Head Hurts & How To Fix It

Illustrated by Sydney Hass.
Ugh, headaches. For something so universal, we know frustratingly little about them. But, researchers do know what works to ease the pain, and they're finding better treatments all the time. Below, we've rounded up the latest on how you can get rid of your horrible headache.

First off, the brain doesn't have its own set of pain receptors. So, when you get that familiar throbbing, that's your nerves and blood vessels responding to a certain trigger that's outside of your head, like a bright light or just plain ol' stress. When your nerves detect one of those triggers, the signal is sent up the trigeminal nerve into different areas of the brain.

So, the pain isn't necessarily indicating where the trigger is. In that way, headaches can be sort of enigmatic. Here's how to tell what's up with your particular brand of headache, and how you can get help.

Caffeine Headaches

"Too much caffeine at one time could easily trigger a headache," says Dawn Buse, PhD, of the Montefiore Headache Center. "Or, you could develop a headache because the body's expecting it and has basically been thrown off balance." 

Caffeine is also a common ingredient in many headache medications, such as Excedrin, because it helps the body absorb the other ingredients. But, if those medications are used with any type of frequency (even just more than once a week), Dr. Buse says the body can become dependent on them, leading to more caffeine-related headaches.

So, if you somehow went without your regular caffinated beverage, the short-term solution is to just drink the coffee. But, Dr. Buse says you should ideally wean yourself off of caffeine to prevent these headaches in the long-term. 

However, Sheena Aurora, MD, of the Headache Clinic At Stanford Health Care, says there isn't necessarily anything wrong with having caffeine — in moderation (sigh). So, she suggests stepping down from coffee to tea, or capping yourself at one caffeinated beverage per day, since it can be easy to lose track of how much you're actually having.
Advertisement
Illustrated by Sydney Hass.
Tension Headaches
Tension headaches are the most common type, affecting more than 38% of us in a year. Colloquially, we call them "stress headaches" because stress is a common trigger, says Dr. Buse. Other culprits include clenching your jaw, not getting enough sleep, and being dehydrated. These headaches usually come with mild-to-moderate pain felt on both sides of the head. They may cause a feeling of pressure in the neck and shoulders, too. 

So, what can you do about these little monsters? Well, over-the-counter pain medications can help here and there. But, taking too much medication — or taking it consistently for too long — can actually perpetuate the headache. "A lot of times, when someone goes to see a physician to talk about their frequent headaches, they may actually be tapered off the over-the-counter medication," says Dr. Buse, "and given either a prescription that's specific for their type of headache, or a preventive that doesn't contain caffeine."

Dr. Buse also suggests practicing relaxation — she even has guided-relaxation exercises on her site. "This will slow the heart rate, improve circulation...and take down all the other stress responses in our body," she says. Many chronic conditions (not just headaches) "can be triggered by this stress response," Dr. Buse adds, "so practicing on a regular basis to get the body into relaxation mode is very healthy." 
Cluster Headaches
Yikes — cluster headaches are notoriously painful, usually around one eye, and tend to come in waves (or "clusters"). "These are very intense, very severe headaches," says Dr. Buse, "and someone can have several attacks in one day."

But, they are also somewhat predictable. Dr. Buse says they may be related to the time of day or even the time of year. They're also "linked to the circadian rhythm," says Dr. Aurora. Current research suggests cluster headaches may be due to a dysfunction in the hypothalamus, a part of the brain that plays a huge role in our hormonal sleep-wake cycle.

If you're in the middle of an attack, Dr. Aurora says that inhaling oxygen is actually the treatment of choice due to its vasoconstrictive effects. Other options include a class of medications introduced in the '90s called triptans, which cause vasoconstriction by working on serotonin receptors in the brain. 

But, obviously, being able to avoid the attacks in the first place is ideal. There's some research to suggest that blocking the brain's occipital nerve or the sphenopalatine ganglion (SPG) could help prevent attacks, but trials are still underway. And, there's other research to suggest that our old friend melatonin could also be effective.
Illustrated by Sydney Hass.
Migraines
Ah, migraines. Just thinking about them makes us want to hide away in a dark room. Migraine pain tends to be on just one side of the head, but it can be on both. "The real hallmark of migraines is that people are very sensitive to light, sound, and odors," says Dr. Buse. "And, people may have nausea or even vomit during the headache phase." 

Dr. Aurora says there's a huge genetic component to getting migraines: "80% of those with migraines have a first-degree relative who also had migraines," she says. And, Dr. Buse says women are more likely to get them than men.

Essentially, there's something in the brain that's overreacting to environmental factors. Dr. Buse says some research suggests it could be the thalamus — a brain area that directs information between other areas. And, because some people get a visual "aura" before an attack, the brain's visual system is also affected. In the brain, some blood vessels end up constricting, while others widen to compensate. This inconsistency ends up causing that characteristic throbbing pain.

The good news is that we're seeing a surge in migraine research at the moment. Current treatments include those previously-mentioned triptans, caffeine-containing medications, and nerve blocks. But, Dr. Aurora says that treatment must be individualized, including keeping track of your particular triggers — which you can even do on an app now. 

And, the recently-identified CGRP (calcitonin gene-related peptide) antibodies may change the game. These little friends can act as vasodilators and are involved in pain signaling, making them a prime target for migraine research. So far, studies have shown promising results. Mindfulness meditation also seems to help prevent migraines, and Dr. Buse says her team is starting up their own study to investigate mindfulness-based cognitive therapy for migraine-sufferers in the next few months.
Advertisement