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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.

3. You Pop Pain Pills continued...

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.

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!"

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