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Heading for trouble

Headaches can be a regular and disabling part of your day. Victoria Neumark looks at how to avoid the pain.

How many teachers reach into their bags toward the middle of the afternoon and pop out a couple of capsules? For some, ibuprofen, paracetamol or aspirin are regularly on the grocery list. Are headaches an inevitable part of life, or can they be cured?

"It's my head," mutters Mrs Worry-wart as she fills a glass of water in an attempt to kill the throbbing behind her eyes before story time. It builds up every Thursday, regular as clockwork.

Mrs Worry-wart probably has a tension headache at the back of the skull, spreading in a band of pain around the temples. Although non- prescription painkillers will help in the short term, the headaches are unlikely to go until she alters the underlying cause of depression or anxiety. In her case, Thursday represents PE and hyperactive Harry playing up in the morning; team-teaching with a difficult colleague in the afternoon; staff meeting and a week's ironing after school.

Unfortunately, episodic tension headaches may, over time, become chronic. Regular use of medication can lead to "rebound" headaches, where the pain returns worse than before as the analgesia wears off. Repeat medication then leads to more headaches, until every day turns into Thursday.

Many over-the-counter remedies contain caffeine, and should not be taken with caffene-containing drinks. Caffeine makes analgesics more effective, but also promotes headaches. If you are using medication more than once a week, you may also become addicted to it.

Over-the-counter drugs can have adverse side-effects. Try to avoid medication and find other ways to release tension. Reschedule the ironing and offset the staff meeting with a social event. Try to find the triggers and avoid them.

Alcohol, caffeine, cigarettes and chocolate are triggers for migraine, typically a disabling headache accompanied by nausea, vomiting and sensitivity to light. Consult a doctor if you think you have migraine or any other form of severe headache.

Hormonal headaches may affect women during menstruation, pregnancy or the menopause. Cluster headaches tend to affect smokers and people with sinusitis; these are excruciatingly painful and occur in groups - several in a week and then none for months.

A tiny number of headaches are caused by brain tumours. Symptoms include sudden sharp pain made worse by coughing or physical activity, loss of balance, confusion, seizures and difficulty in speaking - not the same as being unable to finish reading a story because looking at Harry makes you feel unable to say another word.

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