Photo of aspirin tablets
Painkillers like aspirin and paracetamol may be giving you a headache [Image: Chaval Brasil - Wikimedia Commons]

Headaches: healthier ways to make the pain go away

20 October, 2011

Got a headache? Take a pill. It’s such an automatic response that most of us never think about it any more.

Around 20% of adults suffer from chronic headaches, with migraines comprising 8% of all headaches.  Encouraged by advertising that convinces us that pain is the enemy we down handfuls of analgesics (painkillers) each year.

Today up to 70% of the population in the West uses analgesics regularly, primarily for headaches, but also for other specific pains and to reduce fever.

Women consume more painkillers than men by a huge margin. So confident are we in their pain-deadening properties that analgesics are widely, but wrongly, used to treat other types of ‘pain’ for which they are not recommended – for instance bad moods, anxiety, sleep problems and stress.

Headaches are responsible for more visits to general practitioners than any other condition and more drugs are prescribed, or bought over the counter, for headache pain than any other condition.

Because chronic headaches tend to strike individuals during their ‘productive’ years, ages 20-50, they are also amongst the most common reasons for missed days at work.

So what’s causing your headache?

It’s infuriating but in truth almost anything can cause a headache. Depending on which research you read there can be anything from 3 to 300 different kinds of headaches. Why so many? Because headaches are a particularly complex health conditions.

In truth we do not really understand the mechanism of headache well. A headache can be muscular, spinal or circulatory in origin. It can also be caused by a number of different external triggers including stress, chemical sensitivity, changes in weather, changes in sleeping patterns and stress.

Certain foods, for instance artificial sweeteners like aspartame (NutriSweet) and sucralose (Splenda), or foods containing amines (such as pickles, caffeinated drinks, flavour enhancers such as MSG, chocolate and processed meats) can also trigger a headache.

Coffee consumption and daily smoking also raise the odds in favour of regular headaches. Women on diets (around 50% of the population) take greater amounts of OTC analgesics to combat the headaches that result from lack of proper nutrition.

Women are also three times more likely to suffer from severe headache like migraines than men, as are those who come from a family with a history of migraine.  Taking the birth control pill can raise a woman’s risk of chronic headaches. There is some evidence to suggest a link between a woman’s normal monthly hormonal fluctuations and headache, while in men hormone levels do not appear to play a role.

Other common triggers include:

Poor posture as well as any kind of physical trauma to the spine or elsewhere can turn into headache pain. Chiropractic or osteopathy will be more effective than a pain reliever.

Toxic air. Is daily exposure to old carpets, dust, mould, cigarette smoke, cleaning products causing a sensitivity or allergic headache? Allergy testing may help you get to the bottom of it.

Is it eye strain? Does the lighting in your office, or home need improving? Is it time to have your eyes checked

Muscle tension can be the cause and the result of headache pain. If you haven’t yet found a way to completely relax on a regular do it now. Yoga, exercise, hobbies, socialising anything that completely absorbs you and make you lose track of time will also completely relax you thus reducing the likelihood of headache.

Labelling headache causes and types is not an exact science but (very) broadly speaking chronic headaches are an expression of some kind of ‘stress’ for instance physical, environmental, metabolic/digestive or psychological/emotional. Often this stress is self-inflicted and the causes can become more obvious if you keep a headache ‘diary’ of the whats, whens and wheres of your headaches.

There is, however a hidden cause of headaches most of us never hear about.

Painkillers – a hidden cause of headaches

Headache has become such a common complaint that, without careful diagnosis, it is difficult to separate primary headaches – for instance those caused by the conditions listed above – from secondary, or rebound headache, caused by our over-consumption of headache medication.

This phenomenon once known as drug induced headache, was renamed by the medical profession as medication overuse headache, or MOH, early in the 2000s. About 20% of people with chronic headaches and most with daily headaches suffer from analgesic rebound headaches and this phenomenon is five times more common in women than men.

Overuse of painkillers, which often has an addictive, psychological component to it, is the key and without addressing this it can be hard to convince sufferers to simply stop taking the pills. But even without this element, other factors can turn analgesics into problems rather solutions. For instance, many headache medications are combinations of ingredients.

One of the most common added ingredients is caffeine – usually around 30-60 mg of caffeine per tablet (a cup of coffee contains 50-150 mg of caffeine, and a can of Coke about 45 mg). Caffeine enhances the painkilling actions of many classes of analgesics, but it can also cause a rebound headache after the effects of the combination wear off.

Symptom trade-offs

Rebound headache is only one of the trade-off symptoms we get for ‘fast relief’. A large study comparing the treatment of tension headaches with paracetamol, or paracetamol plus caffeine, or aspirin the researchers found significantly more side effects (stomach discomfort, nervousness and dizziness) with the paracetamol preparations that contained caffeine.

They concluded  that this was the result of an unintended interaction of the ingredients, since neither paracetamol nor caffeine would be expected to produce such side effects by themselves at the doses used.

Sometimes the adverse effects are more serious. Studies show that one to seven days of treatment with aspirin or ibuprofen produces lesions (scars) in the gut lining in 20-50% of otherwise healthy people.

Although paracetamol does not cause the kind of gastrointestinal problems you get with aspirin and ibuprofen, it can cause liver damage, and these effects can occur at therapeutic doses because metabolising paracetamol requires the enzyme glutathione, produced in the liver. Large regular doses of paracetamol deplete the liver of glutathione, leaving it vulnerable to cellular damage.

Because of this damage, an overdose of paracetamol can be fatal. This damage can be prevented or minimized if an antidote is given within 16 hours of taking the drug, but there’s a catch. The first symptoms of overdose – gastrointestinal pain, vomiting and loss of appetitesometimes don’t appear for 24 hours and abnormal liver function may not be apparent for 48 hours.

Other evidence suggests that almost any analgesic if overused can cause kidney damage. Amazingly the absolute risk of end-stage renal disease for an ‘abuser’ of OTC analgesics in the same range as the risk of lung cancer for a smoker: 1.6 in 1000 people per year for those who abuse analgesics versus 2.1 in 1000 people per year for those who smoke.

Many of us are in denial about the amount of painkillers we take. Studies looking for the presence of painkillers in the urine of people whose guts have been damaged by aspirin show, for example, that around 10-13% of regular users denied using aspirin at all.

Tackling the individual causes of headache can be effective but in truth the medical treatment of headaches is often very hit and miss.

The medical literature is full of survey data showing that people with difficult to treat pain are perceived in a negative light by health care professionals who find their symptoms hard to understand or treat.

But while encouragement to use OTC painkillers may get difficult to treat patients out of the waiting rooms, it doesn’t contribute to good health in any positive way. It can also lead to unsupervised overuse of these medications and cause more health problems than it actually solves.

Suggestions for quick relief

Apart from treating the obvious problems linked to the causes above there are also a number of easy techniques you can try to relieve headache pain fast. These include:

Go nuts. Try eating a handful of unpeeled almonds.  They contain the natural ‘aspirin’ salicin and this remedy is used in areas of North Africa and Asia where almond trees are common.

Brush your hair. Brushing your hair can help to improve the circulation in your scalp and reduce the occurrence of headache. Use a natural bristle brush or one with rounded tips and brush your hair in a downward motion. Alternatively give yourself a mini-massage by brushing in small circles beginning at your temples and working your way down your scalp. Make sure you cover all of your scalp in this way for the greatest benefit.

Make a ginger compress. Cool and warm compresses on the head can be very restful and revitalising. Cut and peel one whole root of fresh ginger. Boil it in 3 cups of water until it turns cloudy. Soak your washcloth in the warm mixture and then apply it to the back of your neck. This works to expand the contracted muscles and relive dull, steady pain and combined with a 20 minute rest this should help lift your headache.

Treat your feet. On a hot day try an icy foot bath to draw congestion away from your head. Fill a basin with icy water and soak your feet in it. After a few minutes your feet will actually start to feel warm and your headache may drain away.  Reflexology may be a good way to deal with chronic headaches.

Make yourself a tonic. Apple cider vinegar (be sure not to use any other kind) is pH neutral and has a long history of use in folk medicine.  You can make a simple tonic of a glass of water, 2 teaspoons of  apple cider vinegar can ease digestive stress. Have this each day with 2 teaspoons of honey to follow if you prefer.


  • Adapted from Headaches: the Commonsense Approach by Pat Thomas (NewLeaf). See here for details.