Quick-start guide to headaches

Pain around the eye and throbbing on one side of the head — they’re common headache symptoms, but what do they mean? “Many times people assume a headache is due to sinusitis, and they put up with it for years,” says Dr. John ­Pettinato, a neurologist with ­Harvard-affiliated Beth Israel Deaconess Medical Center.

Understanding your pain can help you find the best approach to treatment.


The pain of migraine headaches begins (and sometimes remains) on one side of the head, with pain stretching from the front to the back of the head. “Most of the time it’s a throbbing, pounding pain,” says Dr. Pettinato. Migraines make people sensitive to light and sound, may cause nausea and vomiting, and can last a few hours or even days. Preventive treatment often includes prescription medication, such as topiramate (Topamax).

Tension headaches

A tension headache usually feels like a tight band around the head. It can start in the neck and back and may be associated with neck or shoulder tension. “This can be treated with something simple, like rest,” Dr. Pettinato says.

Cluster headaches

Cluster headaches are rare, with a terrible stabbing pain around the eye. “It lasts about 90 minutes, goes away, and comes right back,” Dr. Pettinato says. Other symptoms include redness or tears in one eye and nasal congestion. Treatment includes the calcium-channel blocker verapamil in a sustained-release formulation (Calan and others), the steroid prednisone, and the mood-stabilizing drug lithium.

Sinus headaches

Sinus headaches occur with sinusitis — nasal congestion, postnasal drip, and sometimes fever. “These headaches are usually behind the eyes and nose and feel more like pressure than pain,” explains Dr. Pettinato. “Migraine headaches can occur in the same area, and that leads to confusion with diagnosis.” Treating the sinusitis — sometimes with antibiotics — usually resolves sinus headaches.

Reporting symptoms

Severe headache symptoms that come on suddenly should be treated as emergencies, unless they are migraines that you have learned to recognize. “Go to an emergency room and get evaluated to make sure it’s not a stroke, a brain tumor, or a ruptured brain aneurysm,” Dr. Pettinato advises. An occasional headache is probably nothing to worry about. But when pain becomes chronic—more than once a week—or interferes with your life, it’s time to tell your doctor.

Pill-free treatment

Once underlying causes of headaches are ruled out, try some of these strategies to keep headaches from returning:

Manage stress. “Meditation and yoga are helpful,” suggests Dr. Pettinato.

Walk daily. Aim for 20 minutes.

Try acupuncture. Research suggests that acupuncture may help prevent migraines and occasional or chronic tension headaches.

Don’t skip meals. “That triggers headache in some people,” explains Dr. Pettinato. “Eat a protein snack in between meals, too.”

Stay hydrated. “Dehydration is a powerful headache trigger,” Dr. Pettinato says.

Using drugstore remedies for headache painIt’s tempting to reach for an over-the-counter painkiller to make headache pain go away. While this may be okay occasionally, it’s not a good solution for chronic headache pain (that is, headaches that occur more than once a week). Long-term use of ­either acetaminophen (Tylenol) or nonsteroidal ­antiinflammatory drugs (NSAIDs) — such as ibuprofen (Advil), naproxen (Aleve), or aspirin — is associated with numerous problems.Taking large doses of acetaminophen (more than 3,000 milligrams per day) can damage the liver, especially if you drink alcohol while taking the drug. Acetaminophen also may increase the risk of bleeding if you take warfarin (Coumadin). Long-term use of NSAIDs is associated with ulcers, stomach bleeding, kidney problems, high blood pressure, and increased risk of heart attack or stroke. Even short-term NSAID use appears to slightly raise the risk of heart attack and stroke.Ironically, regular use of these painkillers can actually make headaches more frequent. “Excessive use of any medication can cause overuse headaches. We’re not sure why. Maybe it lowers the threshold for a headache to start,” says Dr. John Pettinato, a neurologist with Harvard-affiliated Beth Israel Deaconess Medical Center.His advice for chronic headaches: “Try to avoid NSAIDs, and don’t take Tylenol more than twice a week.”

Bible verses for today’s meditation and inspiration: Matthew E. McLaren’

Then you will call on me and come and pray to me, and I will listen to you. Jeremiah 29:12 NIV

Be joyful in hope, patient in affliction, faithful in prayer. Romans 12:12 NIV

And when you pray, do not keep on babbling like pagans, for they think they will be heard because of their many words. Matthew 6:7 NIV

The Lord is near to all who call on him, to all who call on him in truth. Psalm 145:18 NIV

‘Call to me and I will answer you and tell you great and unsearchable things you do not know.’ Jeremiah 33:3 NIV

“For where two or three gather in my name, there am I with them.” Matthew 18:20 NIV

 Let us then approach God’s throne of grace with confidence, so that we may receive mercy and find grace to help us in our time of need. Hebrews 4:16 NIV

who is unseen. Then your Father, who sees what is done in secret, will reward you. Matthew 6:6 NIV

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