16 Ways to Keep the Pain at Bay

Headaches. We've all had them. From the morning-after-celebrating-too-much headache to the tough-day-at-the-office headache to the you might as well kill me now because I'm going to die anyway headache. Sometimes, an aspirin or other analgesic may ease the pain; at other times, nothing short of waiting it out seems to help.
If you suffer from frequent, severe headaches that put you out of commission several times a month, you need to seek medical attention. Likewise, if your headaches are associated with physical exertion, changes in vision, or weakness, numbness, or paralysis of the limbs, skip the urge to self-treat and see a doctor. If you're already seeing a physician and aren't getting relief, think about getting a referral to a headache specialist or headache clinic.
However, if you are prone to occasional headache pain, read on. The tips that follow can help you feel a lot better fast.
Don't overdo the pain pills.
Although an occasional dose of an over-the-counter analgesic may help alleviate your headache for a few hours, taking these drugs too often may actually worsen the pain, according to Sabiha Ali. M.D., a neurologist at the Houston Headache Clinic in Texas. These drugs are OK in limited quantities, she says, but if you need to take more than two doses a day, you should see a doctor.

Lie down.
Lying down and closing your eyes for half an hour or more may be one of the best treatments for a bad headache. For some types of headaches, such as migraines, sleep is the only thing that seems to interrupt the pain cycle. The most important thing is to recognize that the faster the patient with a severe headache stops what they're doing and goes to bed and rests, the faster the headache will go away, says James R. Couch, Jr., M.D., Ph.D.. professor and chairman of the Department of Neurology at the University Oklahoma Health Sciences Center in Oklah City. You need to recognize when the big headache is coming. That's the time to give go to bed.

Don't let the sun shine in.
Especially if your symptoms resemble those of a migraine (such as severe pain on one side of the head, nausea, blurred vision, and extreme sensitivity to light), resting in a darkened room may alleviate the pain. Bright light may also cause headaches, according to Seymour Diamond, M.D., founder of Diamond Headache Clinic in Chicago. Sometimes, looking at a computer screen may bring on a headache, he says. Tinted glasses may help.

Use a cold compress.
A washcloth dipped in ice-cold water and placed over the eyes or an ice pack placed on the site of the pain are other good ways of relieving a headache, says Fred D. Sheftell, M.D., director and founder of The New England Center for Headache in Stamnford, Connecticut. Other good solutions are the headache hat, which is an ice pack that surrounds the head, and the ice pillow, which is a frozen gel pack that is inserted into a special pillow, he says. (These special ice packs can be found in some pharmacies; if you don't see them at yours, ask your pharmacist about ordering them.) Using ice as soon as possible after the onset of the headache will relieve the pain within 20 minutes for most people, Sheftell adds.

Try heat.
If ice feels uncomfortable to you, or if it doesn't help your headache, try placing a warm washcloth over your eyes or on the site & the pain, Ali says. She recommends leaving the compress on for half an hour, rewarming it as necessary.

Think pleasant thoughts.
Many headaches are brought on or worsened by stress and tension, according to Couch. Learning to handle life's difficulties in a calm way may keep the volume down on a bad headache, he says. Turn off all thoughts of unpleasant, crisis-provoking things, he says. Think about pleasant things. Just for the moment, try to forget about the confrontation with the boss or the coworker. Try to relax while you work out a strategy to cope with the problem.Check for tension.
Along with the preceding tip, Sheftell recommends that patients periodically check their body for tension through-out the day. If you notice that you get these head-aches frequently, check the body for signs of tension, he says. Are your jaws set very tightly? Are you scrunching your forehead? You want to check to see if your fists are clenched. Also, when you stop at a red light, are your hands gripping the wheel very tightly? If the answer to any of the questions is yes stop, relax, and take a deep breath or two (don't go beyond a couple of deep breaths, though; otherwise, you may begin to hyperventilate).

Quit smoking.
Smoking may bring on or worsen a headache, Couch says, especially if you suffer from cluster headaches extremely painful headaches that last from 5 to 20 minutes and come in groups.

Don't drink.
Alcohol, aside from its notorious morning-after effect, may also bring on migraines and cluster headaches, according to Diamond. Alcoholic beverages contain tyramine, an amino acid that may stimulate headaches (see Dr. Diamond's Antiheadache Diet for other foods and beverages that contain tyramine).

Start a program of regular exercise.
Regular exercise helps to release the physical and emotional tension that may lead to headaches, according to Ali. She recommends walking or jogging. These and other aerobic activities, she says, help to boost the body's production of endorphins (natural pain-relieving substances).

Cut down on caffeine.
Caffeine can increase muscle tension and your anxiety level, Sheftell says. It also creates difficulties in sleeping, which can cause headaches. Another problem is that many people drink several cups of coffee a day during their work week but cut their consumption on weekends. This can lead to weekend caffeine-withdrawal headaches, according to Sheftell. My advice to those people is for them to slowly decaffeinate themselves, he says. Decrease your caffeine intake by one-half cup per week. I suggest that people who are prone to headaches cut down to the equivalent of one cup of caffeinated coffee per day, says Sheftell. One five-ounce cup of drip
coffee contains about 150 milligrams of caffeine. A five-ounce cup of tea brewed for three to five minutes may contain 20 to 50 milligrams of caffeine. And cola drinks contain about 35 to 45 milligrams of caffeine per 12 ounce serving. Sheftell also recommends checking the caffeine content of any over-the-counter drugs in your medicine cabinet.

Fight the nausea first.
Some headaches may be accompanied by nausea, which can make you feel even worse. What's more, the gastric juices produced by stomach upset may hinder the absorption of certain over-the-counter and prescription analgesics, which may make these drugs less effective at relieving the pain of your headache. So, by first taking care of the nausea, the pain of the headache may be easier to treat, says Sheftell. He says that many of his patients have found that drinking peach juice, apricot nectar, or flat cola has helped alleviate nausea. Over-the-counter antinauseants such as Emetrol and Dramamine may also be useful.

Rise and retire at the same time every day.
Going to bed and getting up at the same time every day also helps prevent headaches, according to Diamond. Changes in body chemistry that occur when you oversleep can precipitate migraines or other headaches, he says.

Keep a headache diary.
If you get frequent headaches, try to tease out the factors that seem to be responsible, says Sheftell. Pick up patterns. Figure out a way to record headaches and rate them on a zero-to-three scale of intensity: no headache, mild headache, moderate to severe headache, incapacitating headache. Start to look at what foods you are eating. Women should begin tracking their periods, as well as their use of hormone-replacement medications or oral contraceptives. You can show this calendar to your doctor.

Dr. Diamond's Antiheadache Diet

At Diamond Headache Clinic in Chicago, patients are advised to eat a diet low in tyramine, an amino acid that is known to promote headaches, nausea, and high blood pressure in certain individuals. People who take certain antidepressant drugs called monoamine oxidase (MAO) inhibitors are especially prone to accumulating high amounts of tyramine. The following diet keeps tyramine levels to a minimum.
Foods allowed: Decaffeinated coffee, fruit juices, club soda, non cola sodas. Caffeine sources to be limited to no more than two cups per day.

Foods to avoid: Caffeine (does not contain tyramine, but aggravates headache symptoms): coffee, tea, colas in excess of two cups per day Hot cocoa, all alcoholic beverages.

Foods allowed: Milk: homogenized, low-fat, or skim. Cheese: American, cottage, farmer, ricotta, cream cheese. Yogurt limit to one-half cup per day.

Foods to avoid: Cultured dairy, such as buttermilk, sour cream, chocolate milk. Cheese: blue, boursault, brick, Brie types, Camembert types, cheddar, Swiss, Gouda, Roquefort, Stilton, mozzarella, Parmesan, provolone, Romano, Emmentaler.

Meat, Fish, Poultry
Foods allowed: Fresh or frozen turkey, chicken, fish, beef lamb, veal, pork, eggs (limit three per week), tuna fish. Foods to a void: Aged, canned, cured, or processed meats; canned or aged ham; pickled herring; salted, dried fish; chicken liver; aged game; hot dogs; fermented sausages (no nitrates or nitrites allowed), including bologna, salami, pepperoni, summer sausage; any meat prepared with meat tenderizer, soy sauce, or yeast extracts (it's not the yeast itself that's a problem, but yeast contains an enzyme that alters an amino acid to become tyramine).
Breads and Cereals
Foods allowed: Commercial breads: white, whole wheat, rye, French, Italian, English muffins, melba toast, crackers, bagels. All hot and dry cereals: cream of wheat, oatmeal, corn flakes, puffed wheat, rice, bran, etc.

Foods to avoid: Hot, fresh, homemade yeast breads, breads and crackers containing cheese; fresh yeast coffee cake, doughnuts, sourdough breads; any breads or cereals containing chocolate or nuts.

Foods allowed: Potatoes, sweet potatoes, rice, macaroni, spaghetti, noodles.

Vegetables, Legumes, and Seeds
Foods allowed. Asparagus, string beans, beets, carrots, spinach, pumpkin, tomatoes, squash, corn, zucchini, broccoli, green lettuce. All except those listed in the next paragraph.

Foods to avoid: Pole, broad, lima, or halian beans, lentils, snow peas, fava, navy, or pinto beans; pea pods, sauerkraut, garbanzo beans, onions (except as a condiment), olives, pickles, peanuts, sunflower, sesame, or pumpkin seeds.

Foods allowed. Prunes, apples, cherries, apricots,
peaches, pears. Citrus fruits and juices.Limit to one-half cup per day of orange, grapefruit, tangerine, pineapple, lemon, or lime.
Foods to avoid. Avocados, bananas (one-half allowed per day), figs, raisins, papaya, passion fruit, red plums.

Foods allowed. Cream soups made from list of allowed foods, homemade broths.

Foods to avoid: Canned soups, bouillon cubes, soup bases with autolyzed yeast or monosodium glutamate (MSG)-read labels.

Foods allowed. Fruits listed above, sherbets, ice cream, cakes and cookies made without chocolate or yeast, gelatin.

Foods to avoid. Chocolate-flavored ice cream, pudding, cookies, or cakes, mincemeat pies.

Foods allowed. Sugar, jelly, jam, honey, hard candy Foods to avoid. Chocolate candies, chocolate syrup, carob.

Foods allowed. Salt (in moderation), lemon juices, butter or margarine, cooking oils, whipped cream, white vinegar and commercial salad dressing in small amounts.

Foods to avoid. Pizza, cheese sauce, soy sauce, monosodium glutamate (MSG) in excessive amounts, yeast, yeast extracts, Brewer's yeast, meat tenderizers, seasoning salt, macaroni and cheese, beef stroganoff cheese blintzes, lasagna, frozen dinners, and any pickled, preserved, or marinated foods.

Recipes for Relaxation

In addition to being given an antityramine diet (see Dr. Diamond's Antiheadache Diet), patients at Diamond Headache Clinic in Chicago are instructed in relaxation techniques. The following is a typical relaxation exercise. The exercise can be memorized, or the written instructions can be recorded on a cassette tape. The entire exercise, which relaxes the facial area, neck, shoulders, and upper back, takes about five minutes. Before you begin, make sure you won't be disturbedclose the door and take the phone off the hook.
1. Settle back quietly and comfortably into a favorite chair or sofa. Allow your muscles to become loose and heavy.

2. Wrinkle up your forehead, hold it, then smooth it out, picturing the entire forehead becoming smoother as the relaxation increases.
3. Frown, creasing your eyebrows tightly, feeling the tension. Let go of the tension, smoothing out your forehead once more.

4. Close your eyes more and more tightly. Feel the tension as you hold them shut. Relax your eyes until they are closed gently and comfortably.

5. Clench your jaws and teeth together. Feel the tension build, then let go and relax, letting the lips part slightly. Allow yourself to feel relief in the relaxation.

6. Press your tongue hard against the roof of your mouth. Again, feel the tension, then relax.

7. Purse your lips together more and more tightly, then relax. Notice the contrast between tension and relaxation. Feel the relaxation all over your face, forehead and scalp, eyes, jaws, lips, and tongue.
8. Press your head back against your chair, concent rating on the tension in the neck. Roll your head to the right and feel the tension shift. Repeat to the left. Straighten your head and bring it forward, pressing chin to chest. Finally, allow your head to return to a comfortable position.

9. Shrug your shoulders up to your ears, holding the tension, then drop. Repeat the shrug, then move the shoulders forward and backward, feeling the tension in your shoulders and upper back. Drop the shoulders and relax.

10. Allow the relaxation to spread deep in to the shoulders, into your back. Relax your neck and throat. Relax your jaws and face. Allow the relaxation to take over and grow deeper and deeper. When you are ready, slowly open your eyes.

Fred D. Sheftell, M D., recommends the following relaxation exercise to his headache patients:

Lie down and relax your muscles. Place your hand on your stomach and take a deep breath. As you inhale to the count office, feel your stomach rise. Allow yourself to slowly exhale to the count of five, letting your stomach fall. Imagine that you are breathing in relaxation and breathing out tension. As you breathe, visualize the muscles in your head and neck as if they were scrunched up, tense. Then, picture them becoming relaxed and smooth, parallel to one another. Continue the deep breathing for five minutes, then slowly open your eyes.

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