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Headache 101: On migraines, pain medicine and when to visit a doctor

stress-543658_1280I'm a stomachache gal; when something is troubling me, my tummy lets me know. So I've always felt a mixture of curiosity and puzzled empathy for those who suffer from frequent headaches or migraines — how odd and awful that must be.

As the founding director of Stanford's Headache and Facial Pain Clinic, and a migraine sufferer himself, Robert Cowan, MD, is well-positioned to offer headache guidance (and insight for outsiders like me).

He recently chatted with writer Sara Wykes for an Inside Stanford Medicine piece on migraines, pain medicine and more. Here's Cowan:

A migraine is much more than a headache. It occurs on average one to four times a month. Unlike a tension headache, it is often accompanied by nausea or vomiting. Its pain is intensified by physical activity and is so severe it interferes with daily activities. About 30 percent of migraineurs — people with migraine — have a warning that consists of neurologic signs, or auras, they experience before the migraine episode begins. The most commonly experienced aura is visual, during which patients see small, colored dots, flashing bright lights or multicolored zigzag lines that may form a shimmering crescent-like shape.

The best way to cope with migraines and other headaches is not to keep pounding pills, Cowan cautions:

The vast majority of headaches should not be treated with opioids or any other pain medications. It depends upon what kind of medicine you are taking, of course, but a good rule of thumb is not to take any pain medication more than two days in any week, and no more frequently than recommended on the label or as prescribed. If you need more medication to control pain, you should consult a physician. Overuse of acute medications can actually increase the frequency of your headaches.

Cowan says the best approach to minimizing headaches may be to pay attention and log symptoms such as irritability or a food craving that may appear right before a headache starts. "You may begin to see patterns that were not readily obvious," he advises.

Previously: Study examines trends in headache management among physicians, More attention, funding needed for headache care and Director of Stanford Headache Clinic answers your questions on migraines and headache disorders
Photo by geralt

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