Last week neuroscientist Professor Amanda Ellison discussed migraines and how sex can help to cure them. Today, in the second extract from her new book, she describes different types of headache and what can help to ease the pain…
We’ve all had that ‘uhoh’ feeling. Something doesn’t feel quite right. There’s a tightness, a fogginess. Thirty minutes later we might use other words: splitting, pounding, banging. Now it’s a headache.
Despite what we may think in that moment, we need pain. Pain not only tells us that something is wrong, it also protects us.
The brain works under tight parameters, and as you use bits of it, blood flow is diverted there to give it the energy and oxygen it needs to function.
Pain happens when there is a breakdown between what your brain needs and what your vascular system, which carries blood around, can bring it. If this happens, the blood vessels widen to bring more blood quickly, and this stretches their walls too much, tugging on the pain receptors that line them, setting them off.
Here’s what you can do about some of the common causes of headache…
‘There is danger here’, is their message, ‘stop what you are doing’. If, for example, your visual system needs to work harder because you forgot to wear your glasses, more blood will be diverted to the occipital regions (at the back of the brain) to help you cope.
(This is why, perversely, a headache caused by eye strain is most likely to be felt at the back of the head). Here’s what you can do about some of the common causes of headache…
Before you reach for the painkillers, water should be your first port of call, because the most common type of headache is a dehydration headache.
The amount of water we have in our system is controlled by the hypothalamus (a region at the base of the brain, which acts like a command centre for all our unconscious functions, such as sweating and hormone levels).
It drives our thirst and if we don’t have enough water in our bloodstream to dilute toxins in our kidneys, the kidneys will take water from wherever they can. Your brain contains a whopping 1.4 litres of water — waiting to be tapped in times of crisis.
So, if you haven’t been drinking enough, your brain literally shrinks. This activates pain receptors close to the brain. Taking a painkiller will help dull the pain, but doesn’t address the problem.
Before you reach for the painkillers, water should be your first port of call, because the most common type of headache is a dehydration headache
If it feels as though there’s an elastic band fitted around your skull and a weight sitting on top of your head, it’s probably a tension, or stress-induced, headache. Stress is our body’s response to events our brains perceive as a threat — whether that’s a bear running towards you or too many demands at work.
There are a number of ways stress gives us a headache. The first is because the release of stress hormone adrenaline constricts blood flow to your extremities (which is why you go pale when you get a fright, for example).
But adrenaline also increases the blood flow to your vital organs such as your brain, and vasodilation here can activate pain receptors. Second, because of the body’s ‘fight or flight’ response to stress, your muscles are tighter than they ordinarily would be, constantly using energy and oxygen.
Meanwhile, another bodily response to stress is to release nitric oxide to help relax blood vessels and it also makes us much more sensitive to pain in the tissue of the head and neck, including the signals from tense muscles.
Trying to lessen our response to stress is key to prevention. One way — albeit not very medical — is through meditation.
Sometimes called ‘ice cream headache’ or ‘brain freeze’, this stabbing pain in the temples triggered by eating something ice-cold is actually caused by sensory receptors in the roof of your mouth (the palate).
If you consume anything very cold too fast, this activates a nerve bundle behind the palate that then connects with the trigeminal nerve that brings pain signals from the head and face to the brain.
Also, your blood vessels dilate to restore normal body temperature and heal any damage the cold may have done, which in turn tugs on their pain receptors. But why is the pain felt up in the temple and not in the mouth?
Well, the message is carried by the trigeminal nerve up to the brain, where it is lumped together with signals from other areas of the face. Your sensory system can’t distinguish between these inputs and so we typically feel the pain in the temple. The good news is this kind of headache is short-lived.
Sometimes called ‘ice cream headache’ or ‘brain freeze’, this stabbing pain in the temples triggered by eating something ice-cold is actually caused by sensory receptors in the roof of your mouth (the palate)
A sinus headache might not be the most blinding, but it is dull and always there during an episode. It can be a symptom of sinusitis — inflammation of the air-filled cavities in the bones of the face — along with congestion and blockage of the nose; excess mucus; a bad taste in the mouth; an inability to smell properly; and a productive cough.
Some clinicians believe that up to 90 per cent of apparently sinusrelated headaches may in fact be a migraine. It can be difficult to tell the two apart — though, generally, the whole-body symptoms that come with migraine, such as nausea, tend to be more extreme than with a sinus-related headache.
This doesn’t mean headache as a result of sinus trouble isn’t a real phenomenon, however.
WHY TABLETS CAN MAKE THINGS WORSE
Over-the-counter medications such as paracetamol and ibuprofen help a headache by decreasing the inflammation and helping get blood vessels back to a normal width so that they stop tugging on the pain receptors embedded in their walls.
However, overusing these drugs for every ache and pain can lead to a headache itself.
They act to constrict all blood vessels, so if you use them for more than 15 days per month for three months, the system of blood vessels in the brain has to constantly readjust to keep blood flow consistent and this can break down, risking what is called a rebound headache.
Where you feel the pain can depend on which sinus is affected. Pain over the cheeks and just below the eyes accompanied by toothache and general headache indicates maxillary sinusitis (inflammation of the sinuses in the cheekbones).
Frontal sinusitis localises the headache to your forehead (where the frontal sinuses are found).
And pain behind and between the eyes could be inflammation of the ethmoid sinuses (located either side of the bridge of the nose). This is the headache most people describe as ‘splitting’.
Sinusitis can be caused by bacteria and viruses, allergies such as to dust mites or pet dander, an underactive thyroid or hormonal imbalances.
Then there are structural causes, such as nasal polyps — non-cancerous growths that block the sinuses.
With sinus headache, the nerve endings of the trigeminal nerve are activated by inflammatory substances such as prostaglandins, which are released by the immune system to deal with the threat to the sinuses, and these signals are carried up to the brain and interpreted as pain.
Accordingly, treatment must, in part, be related to its cause whether that’s antibiotics for a bacterial infection, or antihistamines for an allergy. If the cause is not obvious, keep a diary allowing you to identify and avoid your triggers.
If no trigger becomes apparent, it is time for an appointment with a specialist to investigate the causes.
WHEN IT’S A SIGN OF SOMETHING SERIOUS
Headache is not to be taken lightly, particularly if you play contact sports or if it comes on suddenly, or if it is accompanied by speech, vision or movement problems.
Any of these may indicate that a blood vessel has burst and has damaged brain tissue, or there is a blockage to a blood vessel that is starving the brain of nutrients (as in a stroke).
Sometimes — although it is rare — a headache can be a symptom of an aneurysm, which is a bulge in a blood vessel, usually in the brain or the abdomen. As the vessel wall that has bulged is weakened, there is a risk that the little balloon it has made will burst, causing a bleed on the brain.
If it does rupture, the headache that occurs as a result is described as sudden and agonising. It can also cause a stiff neck, a severe aversion to light and sickness or nausea. Some of these symptoms are shared with migraine — but either way, do not ignore this type of headache if you have never experienced it before; see a doctor, it could save your life.
- Extracted from Splitting, The Inside Story On Headaches, by Amanda Ellison, published by Green Tree on June 11 at £16.99. © Amanda Ellison 2020. To order a copy for £13.60, visit bloomsbury.com and quote the code DAILYMAIL (offer valid until June 23, 2020).