How do I deal with these chronic headaches?

January 17, 2007 11:34 AM

How do I deal with these chronic headaches?

For the last 3 months, I've been suffering with chronic headaches. Just about every day, and often all day, my head has just been pounding. It's affecting every aspect of my life, and I really need to figure out how to deal with this in order to get my life back. It's affecting my personality (with a headache, I'm obviously much more irritable) my relationships (my bf, who although has been extremely supportive, did not sign up to be with someone who's crabby and irritable all the time) and my work performance. As a software developer, it's almost impossible to concentrate on the code, etc with the headache. I hate the person this is making me become, and I need to figure out how to get back to who I was prior to this.

I'm not asking for medical advice - I've been to the doctor, who's been prescribing different pain medications that rarely work and often make it worse (rebound headaches). I've also been to the neurologist, who has started me on Nortriptyline, but that can take up to 2 months to be effective (if it even works). I'm supposed to be scheduled for a CAT scan, but this being BC with our slower-than-molasses health care system, god only knows when that will actually happen.

Instead, I'm asking for advice and wisdom from those who have been there. How did you deal with the chronic pain? Are there any lifestyle changes that have worked for you to minimize the headaches? (My docs haven't really suggested anything, and googling brings up a bunch of quack-ish results). Any tips on how to push through the pain and just get things done? Any other advice?

posted by cgg to Health & Fitness (24 answers total)

Are these cluster headaches?
posted by geoff. at 11:39 AM on January 17, 2007

Response by poster: Nope - not cluster headaches, as far as I can tell. If I were to self-diagnose using the internet, I'd call them chronic tension headaches, but the doctors haven't used that term specifically.
posted by cgg at 11:44 AM on January 17, 2007

I would try hot or cold compresses/showers/cloths/ whatever works. I used to get pretty debilitating migraines, and found that the best remedy was a hot shower. It certainly wasn't a cure, but it did help mitigate the pain. Perhaps a neck/shoulder massage might also be helpful? Good luck - I know your situation is extremely unpleasant right now.
posted by taliaferro at 11:53 AM on January 17, 2007

I suffer from headaches almost daily. They suck. I suffer mainly from sinus headaches and Benedryl has become my friend.

Take a yoga class to become more in tune with your body so that you can read "clues" as to when a headache is imminent. Take those clues and do something about it - stop what you're doing, relax, take a walk, stretch, eat a healthy snack to keep the headache at bay.
posted by Sassyfras at 11:53 AM on January 17, 2007

I've had migraines since I went through puberty. I've tried almost everything, quackish and not. Some of it may apply, but as migraines seem to be a little different in everyone, some of may not apply at all to you if you're just having lots of headaches.

Relaxation techniques -- learning to accept the pain rather than scrunching against it, trying to lower my stress levels (I get stressed because, Oh crap, another f-ing headache) so that I don't strike out at other people, etc. I went to hypnotherapy, and as a cure-all, it certainly wasn't it. But the accidental bit I learned, the self hypnosis self, has been really useful.

A routine. Nothing really cures my headaches. I can take a prescription so I can function enough to get home, but when it's there, it's there. So I have a routine of a snack, a beverage and a second to breathe, etc. It helps me deal with my headache because I believe it helps me deal with my headache.

I eat better, more focused on lean protein. I drink more -- water, juice, etc. I just keep hydrated. I get more sleep. 1) I can't feel it when I'm asleep. 2) No sleep + headache = bitchy gucky

I avoid exercise. I'm sure everyone else will disagree with me, but strenuous exercise (including sex) takes the pain away for a second and then slams back twice as hard on my head. Some people I know like yoga for headaches. (Not my thing)

Warm, not hot, herbal tea. Showers or baths. Gel ice packs or heat packs, depending on what my head's craving. Listening to a TV show or movie I've seen before so I don't have to watch it, but will take up my mental focus so I can close my eyes and pay attention to it, rather than focus on "damn my head hurts."

Sunglasses. Lightly tinted.

No headphones. Work from a quiet corner of the office or home if I can.

Take a look at your birth control. Ok, you're probably already doing this with your doctors, but hormones kick my headaches into high gear, whether that's depo, pills or just my monthly cycle.

Smoking pot hasn't helped me (it made it worse for me), but I've heard other headache sufferers rave about it. However, I live in a neighborhood with multiple pot clubs, so sampling bias is a certainty.
posted by Gucky at 11:56 AM on January 17, 2007

I know you're not asking for diagnoses, but I had headaches almost all day, every day for years, and it turned out to be TMJ. As for how I dealt with it: it's funny how you become accustomed to chronic pain. I mostly just lived my life. Ibuprofen sometimes helped temporarily, but when the headaches were just too bad to deal with and I couldn't do anything to alleviate the pain, I would lie down in a dark room and close my eyes. Occasionally, I would have to take a sick day at work or miss out on doing something social, but mainly I slogged along. I don't think I realized how abnormal it was until I told a dentist that I had headaches every day, and he looked at me with amazement and said, "That is not right."

I guess any lifestyle changes I would recommend depend on exactly what's wrong with you. But, again, consider the possibility of asking your doctor about TMJ while you're getting everything checked out.

On preview: Hmm, Sassyfras, TMJ caused me all sorts of sinus problems, too...
posted by amro at 11:57 AM on January 17, 2007

I've been living with chronic headpain for a few years now -- migraines that steadily got worse, more consistent, etc -- and I've tried prophylactic medications, pain meds, yadda yadda. More often than not, pain meds didn't work (maybe they dulled the edge, but rarely did they ever make my headache Go Away). The first daily med I was on worked for about 2 years before crapping out on me, and when they came back they were worse than before. So, for what it's worth, here's my advice.

Not that it's easy, but do your best to avoid rebound headaches. Only take your "as needed" pain meds when you're having the worst pain (often hard to judge when your pain is fairly constant... after a few hours/days, it's all your worst pain). Try to avoid taking them on weekends or whenever you don't really need to be "on". This will help cut down on your rebound headaches.

Drink lots of water. Dehydration can contribute to headaches (amongst other things), and many of us are chronically dehydrated without knowing it. Try to be conscientious about reminding yourself to stop a few times a day and drink a glass of water.

Get enough sleep. (Or as much as you can if your pain keeps you awake.) My doctor recently prescribed to me a low dose of amitriptylene for migraine, insomnia, and anxiety (I'm sure all of these things were feeding each other). As soon as my sleep improved I saw a dramatic improvement in my migraines.

I also found that seeing a licensed massage therapist and telling her as much as I could about my headaches provided some relief.

Definitely do get a CAT scan or an MRI. You don't mention anything about the onset of these headaches, and you're not specific about what kind of pain you're having, so I don't have any specific insight about different tacks to take in dealing with different kinds of headaches. But these things might help you see improvement in just about any headache. Over the years, I've learned that no drug is going to be the final answer for my chronic daily headache, so I try to rely on them as little as possible & find effective longterm coping strategies.

Good luck.
posted by dryad at 11:58 AM on January 17, 2007

In terms of non-medicinal ways to try to prevent headaches, I would consider taking a look at the food you eat. There are definitely certain triggers for me, but they can be different for everyone. My worst ones are MSG (which is in all sorts of processed foods) and aspartame. Sometimes, too much caffeine is bad for me - but a little caffeine helps. It's weird! Peanuts, aged cheeses, chocolate, ripe bananas, red wine. . . I can have trouble with all of these, too. Being aware of my triggers helps me feel a little more in control of my headaches, though I still can't avoid them entirely.

Here's a website that lists some other food triggers.

In terms of dealing with the pain, I like to lie down in a dark room with a bag of ice underneath the back of my head. I have tried a few prescription headache meds, none of which worked for me for various reasons. Now, I take a Fioricet when I have a truly awful headache, and it often works well. The drawbacks are it causes rebound headaches when used too often and it bothers my stomach.

I also second what dryad says about avoiding rebound headaches by putting off taking medicine as much as you can stand, and staying well-hydrated. Good luck. You're not alone!
posted by katie at 12:16 PM on January 17, 2007

I used to suffer from headaches daily, and I made the mistake of becoming dependent on Excedrin, which caused bad rebound headaches. I finally found a doctor who was successful in treating me by prescribing Effexor; though it is mainly used to treat anxiety, it can also help migraine sufferers. It helped me a great deal, and had the added benefit of improving my mood overall. The second part of the treatment involved modifying my diet by putting me on the LEAP program, which involves testing for food sensitivities.

Other than that, a hot bath, Excedrin or decongestants, drinking and eating enough, and rest are what I rely on if I do get headaches. For me, pot helps temporarily, but sometimes makes the headaches worse afterwards. My headaches were the worst when I had strong emotions; things as common as bad traffic or a few harsh words were enough to trigger a terrible headache. I used breathing and relaxation techniques, and occasionally pot, to help with this.

I really feel for you. I remember feeling like I could handle the headaches in the moment, but the thought of having headaches forever was too much to bear. Good luck.
posted by zoey08 at 12:16 PM on January 17, 2007

Definitely get the CAT.

You're in BC - have you considered marijuana? Have you tried it (for the purpose of mitigating the chronic pain)?
posted by unixrat at 12:32 PM on January 17, 2007

A few years ago I made several changes to my life, and I believe those changes are what eliminated my chronic daily headaches.

I eliminated caffeine and aspertame completely. For a week, this made everything worse. I wanted to chop my own head and neck off at the shoulder blades.

I stopped taking hormonal birth control. I did this for other reasons, but BCPs are commonly blamed for headaches - they could have contributed to my problem.

I got braces. I had a horribly aligned bite and I had constant ear/jaw pain. I was never diagnosed with TMJ and I never had any "popping" noises/sensations in my jaw - things just didn't line up right. To properly chew my food, I kind of had to gnash my teeth at a diagonal. The braces totally eliminated my jaw pain and I have to assume that helped my headaches, too.

Now that everything's cool, I do occasionally have caffeine, but nothing like I used to (6 diet cokes a day). I still don't drink anything with aspertame because I just get addicted to the taste and end up drinking way too much each day.

Now I only get headaches before I'm about to get a bad head cold. When that happens, I use those refridgerated eye masks, a microwaved rice pillow for my neck, and I take anti-inflammatories on a STRICT schedule. They only work for me if I have a continuous dose flowing through my system.
posted by peep at 12:35 PM on January 17, 2007

I say find the cause of the headaches and remove it. It seems your headaches started 3 months ago. What changed at that time that might have caused them? You don't mention what you think the cause of these is. Since you work at a screen, obviously lighting or reflections can be the cause. Seconding the stay hydrated, and/or cut down on salt. The cause could be a lot of things. In my case, I just had to get away from irritants, something like an allergy, but not something an allergist can pick up. Chronic pain often relates to muscular tension, something that we have to learn to attune to and release. Various things help with that, that people have mentioned, meditation, yoga, Alexander Technique, etc. All those helped me become body-aware and deal with headaches and other pains that come when you sit at a keyboard too much.
posted by Listener at 12:45 PM on January 17, 2007

Do you wear corrective lenses? If so, maybe the rx is slightly off, or the coatings interact with your monitor light. Try using a glare-reducing filter over your display and lower your screen resolution -- it might make it easier to work.

I get headaches a lot, in cycles, so I sympathize. In fact I had one earlier.

Other things I think influence my head: low blood sugar from missing a meal; dehydration; tri-phasic birth control pills; and grinding or clenching my teeth in my sleep and clenching my teeth when I'm awake (which I consider a problem that requires a holistic stress-reducing solution).
posted by loiseau at 1:14 PM on January 17, 2007

Oh -- and posture. My posture is terrible at work because of the setup of my desk and chair. My body is often tensed up for no reason, particularly around the shoulders and upper back.
posted by loiseau at 1:15 PM on January 17, 2007

One thing I didn't see anyone else mention - see your opthamologist and optometrist. It could well be eye-strain related.
posted by canine epigram at 1:18 PM on January 17, 2007

I have had constant headaches for years. I recently read the book Heal Your Headache by David Bucholz, and I liked his approach. I've had amazing results with the elimination diet the book describes--I was headache-free recently for almost 2 weeks, which was unprecedented. Over the years I've had every possible test, attended a week-long pain clinic for people with chronic pain, done therapy, relaxation, physical therapy more than once, had dental problems corrected... And The Headache Persists. But getting systematic about removing food triggers seems to be helping.

Bucholz' argument in a nutshell is that there are many many triggers and they are cumulative. He argues that foods are a good trigger to attack because they are such strong triggers for most people that removing food triggers will often reduce the impact of other triggers to below the pain threshold. Food triggers are also more controllable than many others, which is another reason to attack them. I found the book useful.
posted by not that girl at 1:26 PM on January 17, 2007

Here are the things that work for me, prevention-wise:
1. Hydration.
2. A foam pillow that supports my neck.
3. Eating better - more protein, eating breakfast.
4. Noticing when a headache is coming on and taking advil (4 of them) preventatively. I never take it once the headache has intensified, because it doesn't work well and causes rebounds.

I have never had them frequently enough to get a prescription but about once every two weeks

Recommendations that I have not followed but that worked for friends:
1. Getting a mouthguard to wear at night (a friend was unconsciously grinding her teeth).
2. Taking vitamin B12.
posted by mai at 1:49 PM on January 17, 2007

I have acquaintances who have had good luck with acupuncture for chronic headaches.
posted by altcountryman at 3:21 PM on January 17, 2007

As a former sufferer of daily headaches (and 1-2 migraines monthly), most of the suggestions above are something the NP could have helped out with.

In no particular order:

1) Drink less caffeine and more water. I saw several different doctors, and almost all of them talked about caffeine in the first 10 minutes.

2) Try eliminating the usual suspects from your diet on a month to month basis. 4 weeks will be long enough to tell if say red wine or nuts are the culprit. Googling food triggers for headaches should be a good start.

3) You have a desk job, and if a doctor determines that your headaches are a result of your work environment, you may have a work comp claim. Before rushing to piss off your employer, try doing a quick inventory of your working environment. How's your posture? Are you resting your arms on anything when typing? Does your monitor level need adjusting? Some companies have people who do these assessments for you, but YMMV with work comp stuff where you are. Your doctor's office should have handouts on things to do to prevent workplace-type issues.

4) Get your vision checked. A dated prescription for your corrective lenses could easily be causing headaches. If you don't have corrective lenses, it could be that vision is substantially better/worse in one eye.

5) Sleep. Everyone could use more of it - you might need more than you're giving yourself.

While I spent about 3 years working with doctors and behaviorists on this problem - keeping food/drink diaries, sleep pattern diaries, etc - I was able to be medicated to the point where I could live with it. If this is becoming a daily thing, ask your doctor to prescribe both abortive headache medicine and a daily/maintenance prescription. My experience was that the daily stuff will help you sleep and remove tension in your upper 3rd, and when you feel an especially bad headache coming on (you should be able to tell) take the abortive medicine. These usually require going home and vegging out for a few hours.

Best of luck. If you're interested in getting to the bottom of it, time and prescription meds are in your future.

Note: most don't know that if you are having more than 6 headaches as year, many doctors consider this to be a problem. My dad, for example, talked about getting a headache once a month, for as long as he could remember. I told a doctor I was seeing about this, and he said that there were likely issues in his lifestyle that he should look into. Scary, when I would have given a limb to have headaches that infrequently.
posted by littlelebowskiurbanachiever at 3:32 PM on January 17, 2007

Can I vote for a more hysterical approach?

I would think you want an MRI or a CAT scan sooner, rather than later. I don't know about Canadian health care at all, but with American health insurers there is generally someone you can harass until they get you a faster authorization for something that is really troubling you. Chronic headaches must be rotten to live with, but more than that there are some really undesirable conditions you want to rule out. If it isn't apparent, IANAD, but I had a relevant experience: one of my closest friends suddenly up and died New Year's Eve 2000, from a brain aneurysm that had manifested only as chronic headaches.
posted by Methylviolet at 3:36 PM on January 17, 2007

How much caffeine do you drink?

Everyone's headaches are different, but, in my case, caffeine was my 'trigger to end all triggers'. After I completely quit caffeine three years ago, my horrible weekly headaches went away. The withdraw wasn't fun. My head hurt and my thoughts were really fuzzy for two weeks, and kinda foggy for the next two or three weeks. But after that it was fine.

The couple times I slipped up--like the time when I drank decaf that wasn't cleanly decaffeinated--the same kind of headache that I used to have returned twenty-four hours later.

Of course, YMMV.
posted by umbú at 4:15 PM on January 17, 2007

nthing the suggestions to get your eyes tested and check your computer monitor. And suggesting something completely bizarre - are you exposed to any of those hideous plug-in air fresheners? Or other synthetic perfumes? I don't know why, but fake-floral gives me a headache.
posted by Lebannen at 4:24 PM on January 17, 2007

Oh - do you eat Splenda? Gives lots of people headaches.
posted by loiseau at 8:01 PM on January 17, 2007

For me, Theragesic applied 3x daily all the way around my neck and the back of my shoulders helps a great deal... if I keep the schedule.

I try to walk one mile 3-5x a week. This reduces the tension in my upper body by letting these muscles, usually idle at a desk, get some motion.

*Lots* of water. Up to a gallon a day. Nothing fancy here. From the tap is fine. Eating a pickle or drinking some sport drink helps this process.

I feel for you. I live with constant headache and get migraines too.
posted by kc0dxh at 9:02 AM on January 18, 2007