There is a variety of ways to reduce the rush of blood to the brain that causes most sore heads. By Nicky Pellegrino.
As many as half the adult population has had at least one
headache in the past year.
Headaches are the most common disorder of the nervous system and Durham University neuroscientist Amanda Ellison thinks we are not very good at dealing with them.
"They are very misunderstood," says Ellison, author of a new book, Splitting: The Inside Story on Headaches. "There is a lot people don't know about headaches."
When throbbing in our temples starts, most of us reach for a painkiller. That may switch off the pain signals, but it doesn't treat the underlying cause, making it highly likely the sore head will return.
With summer's arrival, we need to watch out for dehydration headaches. It may be a hot day, you get a bit sweaty playing sport, don't drink enough water and instead consume alcohol followed by salty food. "Our kidneys need water to excrete these things and they are going to pull it from wherever they can," says Ellison. "There aren't many large repositories of water in the body, but the brain is one of them. As the water is sapped from it, the brain shrinks and that pulls on the meninges – the membranes that cover it – setting off pain signals.
"Your brain thinks it's under threat and you get a big inrush of blood, so your blood vessels dilate. Your system recognises that this isn't right and it sends out more pain signals for you to stop what you're doing."
There are various kinds of headaches, but all are caused by vasodilation. The key is identifying not only the type from which you are suffering, but also its trigger.
There are likely to be a lot of tension-headache sufferers at present, partly as a result of emotional stress triggered by the pandemic. Another contributor for the many people working from home since Covid-19 struck is poor posture from inadequate office set-ups. "People are working on their sofas and at dining tables, sitting hunched on Zoom calls and not getting up enough. It's a headache waiting to happen," says Ellison, pointing out that our shoulder and neck muscles have to work hard to keep the body in that position. "As those muscles get tighter, they produce the vasodilator nitric oxide. And extra blood is brought to the area to deliver nutrients and oxygen, because the last thing the muscles want is to be working anaerobically. That sets up more widespread vasodilation, which creates pain."
Equipping ourselves with an appropriate desk and chair, making a point of moving regularly and trying not to sweat the small stuff can all help to keep headaches at bay. It may also be helpful to treat ourselves to little jolts of feel-good hormones such as serotonin and dopamine.
"Serotonin is the unsung hero of pain relief. It blocks pain signals coming up from the body into the brain," says Ellison.
That is all the excuse you need to give in to a craving for a couple of squares of dark chocolate. It is a myth that this is a headache trigger; in fact, the opposite is true, says Ellison. "Chocolate is packed with tryptophan and that boosts serotonin."
Sex also spikes serotonin, as does hugging. Meanwhile, coffee acts as a vasoconstrictor and will deal to widened blood vessels that could be causing pain signals. So sometimes it does pay to give in to our urges.
"It is your hypothalamus yanking your chain," says Ellison. "You're actually self-medicating. The body is great at doing things we aren't aware of to keep us on the straight and narrow. Yawning is another one, particularly when people are in the phase before they get a migraine. That is about trying to regulate dopamine levels in the brain."
Any new sort of headache is worth getting checked out, says Ellison. She also recommends keeping a diary – a record of your day with what you ate and drank, how much exercise you got, emotional pressures and how you felt – and looking for patterns and potential triggers.
"I don't think people realise how individual headaches are," she says. "We also all experience pain differently. It's a complex interrelation between our biology and our developmental experience." l
Splitting: The Inside Story on Headaches, by Amanda Ellison (Bloomsbury, $32.99)