27 September 2011

When exams become a headache

Headaches have become a regular occurrence for students around this time of year and many of the feel vulnerable when dealing with this problem.


Headaches have become an ordinary occurrence for students around exam times and many of them feel helpless when dealing with this problem. Students are so overwhelmed by the pressure of assignments and exams that they completely forget about the effects this is having on their health.

Dr Shevel the Chairman of the South African division of the International Headache Society has the following advice for students:

Headaches brought on by stress

It is important that you keep your stress levels to a minimum. Plan ahead and double check the time and place of your exams and leave plenty of time to get there. Guarantee that you have sufficient time to study and also get enough rest the night before your exam. 

Finding out what triggers your headaches by keeping a diary. Each time you suffer from a headache, make a note about the warning signs, triggers and severity. If you can discover some of your personal triggers, you may be able to avoid future headaches. This diary is important as it will give your medical professional an accurate history of your headaches. It will assist with diagnosing conditions such as Medication-Overuse-Headache (MOH) and help you make a decision to go for no-drug methods of treatment. A Migraine diary is available free of charge at www.headacheclinic.co.za under Free Assistance.

Dietary related headaches

Dietary migraine is a common affliction. These are usually triggered by foods that assist with energy such as chocolate. Chocolate raises the blood sugar levels quickly and then allows it to drop quickly again. Low GI (Glycaemic Index) foods give a more even blood sugar level. Use the nutritional facts label to help choose healthy foods when shopping. Compare nutrient levels for similar foods. Common culprits include MSG, red wine, cheese, soy sauce and processed meats. Remember skipping meals is a surefire trigger for migraines as well. Eat in moderation and enjoy your meals. A dietary trigger diary is available on www.headacheclinic.co.za under Free Assistance.

Beware of Medication-Overuse- Headache (MOH). Medication is only appropriate for someone who suffers a few times a month. According to the International Headache Society, if you are taking medication more than twice a week you are at risk of developing MOH. This means that the drugs you are taking will cause the migraine to become more severe and more frequent over time. This leads to a downward spiral into constant medication overuse and constant pain. The more medication you take, the more pain you are in, the more medication you need and the cycle continues.

It is important that you keep your stress levels to a minimum. Plan ahead to guarantee that you have enough time to study and that you get sufficient rest each night. One should also take regular breaks.

Drink as much water as you can.

Dehydration is a common trigger, adequate intake of fluid throughout the day to prevent headaches. The human brain is more than 75% water, and it is very sensitive to the amount of water available to it. When the brain detects that the water supply is too low, it begins to produce histamines. This is essentially a process of water rationing and conservation, in order to safeguard the brain in case the water shortage continues for a long period of time. The histamines directly cause pain and fatigue, in other words a headache and the low energy that usually accompanies it. It is best to drink plain water, as many carbonated soft drinks contain substances that can also trigger headaches. Substances that headache sufferers should avoid include common ingredients in soft drinks such as caffeine.

Headaches relating to your posture

Be aware of your posture when studying as this can result in a tension headache. Use a good chair that supports your back and that gives the ideal posture. Get a free copy of the Ideal Computer Posture here. Learn the right stretching exercises to stretch the muscles of your head, face, neck and jaw. Stretching should be gentle and soothing, not agonizingly painful. Stretch your neck and jaw muscles carefully and you will get results.

Tension type headaches   

Take regular breaks approximately every 45 minutes to ensure that you don’t get overworked. Learn the right stretching techniques to stretch the muscles of your head, face, neck and jaw.

Stretching should be gentle and soothing, not agonisingly painful. If done correctly, this will give results. The Headache Clinic offers free stretching techniques, contact them on 0861 678 911 for them to send it to you. 

A recent study published in the Journal of Clinical Sleep Medicine, tested 32 women with tension-type headache. The investigators studied self-report data on headache triggers, pain interference with sleep, and self-management strategies for pain. 81% reported that going to sleep was the most frequently used self-management strategy, and this group also rated going to sleep as the most effective strategy. So don’t lose out on sleep. Fatigue is a major trigger of headaches as well, aim to sleep seven or eight hours a night.

“It is crucial that if your headaches persist, you should get to the root of the problem. The longer the headache persists, the more damage will be done to the underlying structures. A “multidisciplinary” assessment will need to be done. There are so many different structures in the head, face and neck, all of which can be involved in the migraine process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. Which structures are causing the pain and generating the pain signals is the million dollar question,” adds Dr Shevel.

When to consult a medical professional

If your headache persists after you have your exams, it is imperative that you undergo a multidisciplinary investigation to diagnose the specific factors behind the recurring headache.

For those patients who want
to have healthier alternatives to medication, there are a number of various breakthrough treatment options.

These include bloodless surgery, minimally evasive arterial surgery and posture modifying technologies.
In most cases it is possible to get to the bottom of the problem and resolve the pain permanently.

(Information supplied by The Headache Clinic)

-updated September 2011





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Headache expert

Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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