1) The document provides 14 home remedies for headaches, including lying down in a dark room, applying a cold or warm compress, reducing stress and tension, exercising regularly, cutting down on caffeine, maintaining a regular sleep schedule, and keeping a headache diary. 2) It recommends seeking medical help for headaches associated with physical exertion, vision changes, or weakness as well as those that are frequent and severe. 3) Overusing pain medications can worsen headaches, so it's best to limit use to no more than two doses per day and see a doctor if needed more often. Rest, stress management, and identifying triggers are emphasized as first steps to headache relief.

1. FAMILY HOME REMEDIES
By
Nadeem Y. Mufti
HEADACHES - 14 Ways to Keep the Pain at Bay
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 of
Oklahoma Health Sciences Center in Oklahoma City. "You need to recognize when the
big headache is coming. That's the time to give up and 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 Stamford, 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 of the pain, Ali says. She recommends leaving the compress
on for half an hour, rewarming it as necessary.Think pleasant thoughts. Many headaches

2. 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 throughout the day. "If you notice that
you get these headaches 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 Extra! Extra! - "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

3. 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."