16 July 2003

Losing your mind over headaches?

It is mid-morning. You had a good night’s sleep, a healthy breakfast and your usual morning coffee with two painkillers. Is a splitting headache part of your daily routine?


It is mid-morning. You had a good night’s sleep, a healthy breakfast and your usual morning coffee with two painkillers. Is a splitting headache part of your daily routine?

Headaches affect between 80 – 90 percent of people every year. Mostly they are not a serious health risk, and can be treated by simply taking a painkiller. Stress is often the cause of headaches, but they could be a warning sign of more serious disorders. Headaches are in fact the most common cause of pain which prompts patients to consult their GPs.


Before puberty, boys get headaches more often than girls, but adult women are four times more likely to suffer from this condition than men. This is largely linked to menstrual fluctuations.

Five leading causes of headaches

  • Headaches caused by tension. Scalp and neck muscle contractions cause these headaches. One in every five people in South Africa is affected by this.
  • Vascular headaches or migraines affect between 5 and 10 percent of the population.
  • Headaches due to infection of surrounding structures, such as sinus infection, tonsillitis, toothache or meningitis.
  • Headaches due to inflammation of surrounding tissues: cervical spine arthritis, constant coughing, straining of the eyes and other conditions.
  • Concussion, brain tumours and lumbar punctures can also lead to headaches.

Other possible causes include side effects of certain medications, eating or drinking iced foods and fluids, withdrawal from alcohol or caffeine, breathing in chemical fumes or smoke or chemical solvents, eating large amounts of monosodium glutamate, exposure to insecticides, lead and carbon tetrachloride, use of amphetamines, high altitudes (above 4500 m), high blood sugar, low blood sugar, low calcium levels in the blood and kidney failure.

In most cases headaches are harmless, but if the following symptoms are present, there may be serious underlying problems:

  • Fever, stiff neck or nausea
  • Sudden onset of headaches or a dramatic change in headache patterns
  • Headaches following physical exertion
  • Abnormal speech, eye movements or reflexes
  • High blood pressure

Preventing headaches

“Headaches have many causes and depending on the cause, different things work for different people’, says Cape Town doctor Bridget Farham. “People should guard against falling into a habit of taking headache medication daily as this can actually be the cause of the headaches. When taking painkillers, it is better to take either paracetamol or aspirin rather than combinations, as these give the kidneys quite a hard time, especially if taken regularly.”

“Headache and migraine sufferers should avoid known triggers, which can include coffee, chocolate, yellow cheese and alcohol, amongst others.”

“Lack of sleep, lack of fresh air or withdrawal from alcohol or caffeine can also induce headaches.”

“Most headaches are stress-induced. Finding stress relief is not always easy, but exercise, yoga, neck and shoulder massages or even therapy can help reduce harmful stress levels in headache sufferers. People should use whatever works for them”, says Farham. “If headaches continue, it is essential to see your GP, to find out whether there might be a more serious underlying cause.”

(Susan Erasmus, Health24)


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Ask the Expert

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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