Headaches and Migraines

How can I prevent tension headaches?

DEAR DOCTOR K: I get tension headaches fairly often. What's the best way to treat and prevent them?

DEAR READER: Tension headaches are the most common type of headache. The pain -- usually a dull tightness or pressure -- may envelop your entire head, or it may strike only your forehead or the back or top of your head. (I've put an illustration showing where tension headaches usually strike below.)

What will help my sinus headaches?

DEAR DOCTOR K: I'm a woman in my 30s who has suffered from sinus headaches for years. Allergy medications haven't helped. What else can I try?

DEAR READER: Seasonal allergies can cause sinus congestion, sneezing and a runny nose. But when you experience pain and pressure in your head, it may be time to consider other causes. That's because sinus problems do not usually cause headaches. At least, they don't cause what most people refer to when they use the term "headache." Most people with sinus congestion refer to "head congestion," not headache.

I get migraines regularly — should I have a brain scan?

DEAR DOCTOR K: I regularly get terrible migraine headaches. My doctor has prescribed medication, but I still think I should have a brain scan to make sure there's nothing more serious going on.

DEAR READER: Severe headaches cause both misery and fear. Obviously, the fear is that something serious, like a brain tumor, may be causing the headache. Still, the pain of even a severe headache rarely comes from something catastrophic like a tumor.

What pain relievers are safe to take for tension headaches if you have cirrhosis of the liver?

DEAR DOCTOR K: I have cirrhosis of the liver. I also get tension headaches. What pain reliever can I take for my tension headaches?

DEAR READER: One of the liver's many jobs is detoxification -- ridding the blood of toxins. Cirrhosis, a liver disease, interferes with the liver's ability to detoxify substances in the blood. Your liver sees medications as toxins. When your liver is compromised, medications that are normally considered "safe" may no longer be safe for you.

What can I do to prevent my painful cluster headaches?

DEAR DOCTOR K: I get excruciatingly painful cluster headaches. What can I do to treat, or better yet, prevent them?

DEAR READER: Cluster headaches are rare. Only about one adult in a thousand suffers from them. But they are among the most painful of all headaches. We doctors have theories about what causes cluster headaches, but the fact is that we don't really know. They do run in families: There is an inherited, genetic component.

What could be causing my chronic headaches?

DEAR DOCTOR K: I've had a headache every day for six months, despite taking painkillers every day. What could be causing the headaches? And what can I do to stop them?

DEAR READER: Most people who suffer from frequent headaches don't have them every day. If your headaches have literally been with you "every day for six months," and this is something new for you, consult your doctor. While your headaches still could be one of the two most common causes of headaches -- migraine headaches or tension headaches -- they also could point to something more serious.

What can I do about tension headaches?

DEAR DOCTOR K: I get tension headaches. Over-the-counter pain relievers help, but not completely. What else can I try?

DEAR READER: Tension headaches are the most common type of headache. They cause a dull tightness or pressure in a band-like pattern across the forehead or in the back of the head. Sometimes the entire head hurts.

Can acupuncture relieve chronic headache pain?

DEAR DOCTOR K: I suffer from chronic tension headaches. Do you think acupuncture might help?

DEAR READER: Acupuncture has long been used to treat headaches. But until recently, there hadn't been strong evidence to support its use for headache pain. Two large scientific reviews have changed that. One review found that acupuncture may help people with episodic or chronic tension headaches. The other review found that acupuncture may prevent migraine headaches as well as or better than medications.

What can I do for terrible sinus headaches?

DEAR DOCTOR K: I get terrible sinus headaches during allergy season. Antihistamines help, but not completely. What else can I try?

DEAR READER: I see many patients during allergy season complaining of sinus headache pain. It occurs most often in the center of the face, the bridge of the nose and the cheeks. And it's sometimes accompanied by nasal congestion and clear or opaque nasal discharge.