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Why You Still Get Headaches

Could it be your pain pills? That cheese sandwich? Learn about eight common headache causes and how to find relief from your migraine.

2. You Blame Your Sinuses

Head pain plus congestion, a runny nose, and facial pressure feels like sinus trouble. But don't swallow that decongestant just yet. In one multicenter study of 2,991 adults who thought they had sinus headaches, researchers discovered a whopping 88 percent really had migraines.

The confusion is understandable. When the trigeminal nerve — the brain's superhighway for migraine pain signals — is activated during a migraine, it can cause sinus symptoms like congestion, too, Dr. Buchholz explains. And weather changes that bring on sinus pain — shifts in temperature, humidity, and barometric pressure — also trigger migraines. "But sinus remedies containing decongestants just make things worse," warns Dr. Buchholz. "When the decongestant wears off, blood vessels in your head expand again, and your headache gets worse."

Real pain relief: If you have head pain and facial pressure — but no fever or greenish or yellow discharge — you may be having a migraine, not a sinus attack. Talk to your doctor. Lifestyle changes could prevent future headaches or, if that's not enough, you may need medication.

3. You Pop Pain Pills

Taken too often, pain meds, even over-the-counter varieties, can be setting you up for nonstop headaches. In one new German study of 7,417 women and men, half of those with chronic migraines had medication-overuse headaches. Other experts estimate that two out of three people who get frequent headaches (tension or migraine) are stuck in this pain-pills-pain cycle.

What happens in your body depends on the type of drug you're taking. Opioids, such as codeine, mute pain-sensing receptors on brain cells, but as a dose wears off, the receptors become exquisitely sensitive to the tiniest pain signals. Migraine-alleviating triptans, such as sumatriptan (Imitrex) and zolmitriptan (Zomig), work by helping the brain use more serotonin, a feel-good brain chemical that blocks pain signals in the trigeminal nerve. But — experts theorize — as each triptan dose wanes, serotonin levels plummet, leaving you extra-vulnerable to another headache.

You may be getting overuse headaches if you're taking over-the-counter remedies (especially those that contain a mix of aspirin, acetaminophen, and caffeine) or sinus headache formulas with a decongestant 15 days a month or more. Some experts think even plain aspirin or acetaminophen taken this often can spur headaches, possibly by sensitizing brain cells to pain signals. Popping prescription pain relievers at least 10 days per month may also set you up for medication-overuse pain. "Over time, these drugs lower the threshold: You wake up with headaches more often, have more headaches throughout the day, and your medications stop working," says Dr. Buchholz.

Real pain relief: Stop taking your pain drugs, with your doctor's help. Easy? No. But consider this: Studies show quitting pain pills significantly reduces migraine intensity and frequency. "None of the other strategies that prevent migraines will work until you do this," says Dr. Buchholz. Once you're free of rebound headaches, you can work out the best preventive and treatment strategies for you.


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