Q: Can headaches be prevented?
Dr. Donnica: There is no cure for most primary headache conditions; secondary headaches may be cured if the condition causing them is curable (e.g. sinus headache, benign tumor). In this section we'll address preventive steps for primary headache conditions.
Since stress is high on the list of headache causes and migraine triggers, stress management techniques are high on the list of headache prevention strategies. These include massage, meditation, biofeedback, and having a positive attitude.
Lifestyle modifications can also help: don't smoke, try to eat meals regularly while avoiding dietary triggers; get enough rest; and exercise.
Specific steps to prevent migraines: Figure out what triggers your migraines and then avoid those triggers as much as possible. These include:
Foods (e.g. chocolate, smoked fish, nuts, pickled foods, or aged cheese)
Beverages (e.g. red wine, other alcoholic beverages; caffeine withdrawal)
Food additives (e.g. nitrates, nitrites or MSG)
Environmental factors (e.g. bright or flashing lights; changes in weather; increased stress; missed meals; changes in altitude)
Significant changes in sleep (either too much or too little)
Hormonal changes: especially changes in estrogen levels (e.g. with pregnancy, premenstrual syndrome, and perimenopause)
Medications: starting or stopping many medications may increase or decrease migraine incidence (e.g. birth control pills, hormone replacement therapy, certain antidepressants, certain blood pressure medications). This is another reason never to stop taking a chronic medicine suddenly without first discussing it with your physician.
For patients who get frequent migraines or cluster headaches and for whom lifestyle changes do not bring sufficient relief, preventive prescription medicines are available. These medicines are prescribed to reduce the frequency and severity of attacks in patients who have more than two migraines per month, who have disabling migraines monthly, or chronic recurrent clusters. In general, these drugs act to prevent blood-vessel swelling; they don't treat the migraine-associated symptoms and most won't help a migraine or cluster headache once it has started. Your doctor may recommend one of many medicines from the following categories:
Beta-blockers (e.g. propranolol)
Antidepressants (e.g. Elavil or Zoloft)
Calcium channel blockers
Histamine acid phosphate
Specific steps to preventing tension headaches: For sufferers of tension headaches, the list of preventive strategies involves all the strategies to reduce stress, from exercise to meditation to yoga to massage. Figure out what works for you, then just do it. Getting sufficient and regular sleep should also help as will eating a well-balanced diet.
Created: 9/24/2000  - Donnica Moore, M.D.