Almost everyone has had a headache at some point, but more and more in my practice I see people for whom a headache has become a regular, debilitating, and costly part of life.
Most often these headaches fall into one of two camps: migraines and tension headaches.
Migraines are usually located in one part of the head, they are pulsating or throbbing, and they are often accompanied by sensitivity to light and sound, nausea, or vomiting. They can also come with a warning sign called an aura, such as a temporary visual disturbance.
Tension headaches are usually located on both sides of the head and don’t frequently come with the other symptoms associated with migraines.
If you have frequent headaches of any kind, chances are you’ve thrown the book at them, from over the counter anti-inflammatory medications like NSAIDS (ibuprofen, aspirin) to prescription meds like sumatriptans, which are drugs that constrict inflamed blood vessels in the brain. Maybe you’ve even tried acupuncture and massage, both of which help a lot of people deal with their symptoms.
But what no one seems to be asking is the most important question of all. What is causing the headaches in the first place? What are the triggers? And how can you stop them for good?
Here are the top five underlying causes of headaches that I see, and solutions for rooting them out for good.
1. Food sensitivities
For some people, cleaning out their diet and eliminating inflammatory foods can clear up frequent headaches almost overnight. The most common food culprits are sugar, caffeine, artificial sweeteners, processed foods that contain dyes and artificial preservatives, dairy, and gluten.
Some people also have low-grade food allergies that cause headaches. The big ones again are dairy and gluten, but eggs, corn, and the nightshade family of vegetables (peppers, eggplant, tomatoes and white potatoes) can also be at fault.
If you get frequent headaches, cut out these foods for at least 21 days and see if your symptoms improve. If you’re not sure how to do this, follow my simple elimination diet. You can even eliminate one thing at a time, if doing them all at once feels like too much.
Emotional and psychological stress are a major driver of headaches. I once had a patient who woke up with a horrible migraine almost every day for a month. She tried every medication and chiropractic treatment available, but the headaches kept coming back.
Finally I spoke to her about her stress level. She revealed that the thought of going to her job every day left her with a knot in her stomach, that she was preoccupied with the trauma of her breakup with her longterm boyfriend, and that the stress of being suddenly, involuntarily single had been a huge blow to her self-esteem.
For me it was a wake up call. We got past the story of her cells, and got into the story of her self. Her biography, not her biology, was at the root of her heachaches. I taught her some basic meditation techniques, got her to enroll in a clairvoyant meditation class where she learned to release her stress and manifest her dreams, and encouraged her to work with a therapist with whom she could talk openly about her issues. The combination, plus more frequent exercise, which helped clear the fog of her underlying depression, cleared her headaches. Eventually she switched jobs and the knots in her stomach disappeared, too.
Migraines are a physical phenomenon, but they can often have an emotional cause. Addressing the emotional root is essential to making the pain go away for good.
3. Musculoskeletal tension
Too many people sit at a desk all day peering at a tiny computer screen, talking on the phone, or doing some repetitive motion, and as a result suffer from headaches. Does this sound like you?
First, get up and go for a five minute walk outside or around your office every hour. This will not only stimulate your metabolism, it will give your muscles a chance to relax and reset.
Second, get to a yoga class. Walking, running, biking, and weight lifting involve linear repetitive motions that increase muscle tension. Yoga lengthens, stretches, and contorts the body in non-linear ways, helping to release tension where it’s stored. It also improves your proprioception, or awareness of your body in space. I can’t tell you how many people didn’t know how tight, wrecked, or strained they felt in their own skin until they started doing yoga and found out what it’s like to not feel that way.
Third, invest in my favorite tool for tight muscles, the Ma roller. It looks like a rolling pin from the future. It’s actually a bodywork tool that lets you practice self massage in hard to reach places like the muscles along the neck and spine.
Getting to the bottom of your headaches might mean you have to change the way you move. If your boss gives you a hard time, come see me and I will literally write you a prescription for yoga and a Ma roller.
4. Hormone Imbalances
Your adrenals, thyroid, and ovaries or testicles secrete hormones that are responsible for the minute-to-minute regulation of every system and process in your body. If any of these are off, you may experience headaches.
Most frequently I see imbalances in cortisol, the king of adrenal hormones, which regulates blood pressure, blood sugar, and the fight or flight stress response, at the root of headaches caused by hormone imbalance.
To address this it’s important to get tested, and I recommend testing with a functional medicine doctor who will look at all of your hormones and assess how they are interacting with each other. (Full disclosure: I am a functional medicine doctor.)
5. Your Genetics
Every day we learn more about how your unique genetic profile influences your life experience.
In my practice we use data from 23andMe — a simple saliva test — and other genetic tests to look into how you metabolize B vitamins, Vitamin D, sulfites, dopamine and other critical neurotransmitters, to tailor our recommendations. We are only at the tip of the iceberg when it comes to understanding and using this kind of genetic information, but we are learning more every day and seeing great results in people whose genetics inform our treatments.
Your frequent headaches could be caused by the way you over- or under-metabolize a drug or a nutrient. If we can pinpoint this, we can often solve the problem.