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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.

4. You're a Caffeine Fiend

There's a reason washing your pain reliever down with a cup of joe or a cola seems to vanquish pain: Caffeine shrinks swollen blood vessels that make migraines and even tension headaches throb. That's why it's a featured ingredient in migraine remedies. But as the caffeine wears off, your headache rebounds, maybe because blood vessels re-swell — irritating already sensitive nerve endings.

Real pain relief: If you are drinking coffee, limit the amount. "Stick to a cup or two and have it at the same time each day," advises Carolyn Bernstein, M.D., clinical director of the Harvard Medical Faculty Physicians Comprehensive Headache Center at Beth Israel Deaconess in Boston. "You don't need a caffeine-withdrawal headache on top of a migraine!"

5. You Ignore Triggers

When researchers at the Headache Center of Atlanta surveyed 1,207 women and men, 76 percent reported they had triggers. What set off their migraines? Eighty percent said stress, 65 percent of the women blamed hormone fluctuations, 50 percent named sleep disturbance, 44 percent had trouble with perfumes and other strong odors, 38 percent were bothered by bright lights and 32 percent by sleeping late, 30 percent mentioned heat, 27 percent were troubled by certain foods, and for an unlucky 5 percent, sex led to a headache.

If your brain is extremely sensitive, your triggers can be obvious, says Dr. Bernstein. "You may get a migraine every time you eat a pomegranate. But if you're less sensitive, something may bother you only when you're already vulnerable."

Real pain relief: Keep a headache diary. "Chart when you got a headache as well as weather changes, what you ate the previous day, whether you had alcohol (and what type), your stress level, if you exercised, and, for women, where you are in your menstrual cycle," Dr. Bernstein suggests. Include medications you're taking for other health issues; some antidepressants, bronchodilator drugs for asthma, contraceptives, and diet pills can trigger migraines, too.

Your next step? Eliminate avoidable triggers, and be vigilant when you're exposed to those you can't control — such as hormonal changes at menstruation, sudden weather shifts, or high-tension days. "If you've got a big deadline at work and you know stress triggers your headaches, this is the time to be sure you're getting enough sleep, not overdoing caffeine, and eating well," says neurologist Christina Peterson, M.D., of the Oregon Headache Clinic.

Your diary may point to certain foods and additives that are triggers for you. But since they're such a frequent cause of migraines, some headache specialists recommend that all patients cut out common offenders, including caffeine, monosodium glutamate, chocolate, nitrite-processed meat and fish (like cold cuts or lox), cheese (especially aged types like Cheddar and blue), nuts, and alcohol (particularly red wine, champagne, and dark-colored drinks like rum). Being alert to triggers can help you avoid milder headaches, too. Ones to watch include dehydration, skipping meals, skimping on sleep, and downing too much caffeine or chocolate.


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