I’ve suffered from headaches since I was a young girl. Each year at my annual checkup I’d ask the doctor what I could do for them. “Not much,” he’d reply. “Try taking some aspirin.” As an adult, doctors still give me the same advice. A couple of years ago I was given a prescription migraine medication; it knocked out my headache, but it knocked me out, too—for the rest of the day.
What I really wanted were suggestions on how to stop my head-aches before they reached the point where medicine was necessary. I’d noticed that I was more prone to developing a headache on days when I was stressed, when I hadn’t eaten enough throughout the day, when I drank red wine, and, strange as it sounds, when it rained. Were these clues to preventing headache pain?
Dr. David Buchholz, a neurologist and associate professor at Johns Hopkins University and the author of Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain, urges just this kind of preventive approach to dealing with headaches. Recently, I spoke with Dr. Buchholz about the causes of headaches, and how yoga and other healthy living habits can help people avoid and alleviate headache distress. He was the first doctor whose advice about headaches made intuitive sense to me.
Headaches occur when we are subjected to triggers such as stress, hormone fluctuations, sleep disturbances, changes in weather, and certain medications.
I can usually tell when a headache is coming on: my shoulders and neck start to tense and tighten. So I always assumed that tight muscles cause headaches. Not so, says Dr. Buchholz. It’s the swelling and constriction of the blood vessels in the face and neck that cause headache pain.
Unlike many physicians who distinguish between stress, tension, and migraine headaches, Dr. Buchholz thinks of headaches as a continuum of pain, with migraines being the most extreme. According to him, what’s commonly considered a tension or stress headache is simply a less extreme version of the same malady.
Headaches, whatever their level of intensity, result when we are subjected to triggers such as stress, hormone fluctuations, sleep disturbances, changes in weather (especially barometric pressure), and certain medications, particularly birth control pills and hormone re-placement therapy. Our diet, sleep schedule, and, for women, our monthly menstrual cycle, all contribute to our headache “trigger load” on any given day. Some of us have a lower trigger load threshold than others, and those that do will have more frequent headaches. The good news is that reducing some of these triggers can bring headaches under control.
According to Dr. Buchholz, cutting out certain foods that trigger headaches can make a big difference. Unfortunately, dietary culprits include some favorites: chocolate, cheese (particularly aged cheeses like blue or aged cheddar), yogurt, bananas, citrus fruits and fruit juices, and peanut butter. MSG, often disguised as “added natural flavors” on packaging and used in some restaurants (not just Chinese), is another known headache inducer. Nitrates (used to preserve meats) and alcohol are also on the list, as are alcoholic drinks. Some forms of alcohol are worse than others: red wine and champagne are the most difficult to tolerate, vodka is the easiest for the headache-prone to handle, and white wine and beer fall somewhere in the middle. Dr. Buchholz recommends cutting out these items in order to get headaches under control, and then experimenting with re-introducing them into your diet one by one to discover which trigger headaches.
Another headache hazard is caffeine. At first, it provides quick headache relief by constricting swollen blood vessels. But after the initial effect wears off, the vessels swell up more than before, creating a cycle of “bounce back” headaches. Given that, Dr. Buchholz says it may be worth giving up caffeine altogether—and suffering through a few days or a week of withdrawal headaches—to see if this reduces the number and intensity of your headaches in the long run.
Similarly, according to Dr. Buchholz, while over-the-counter drugs containing caffeine, such as Excedrin, Sudafed, or Tylenol-Sinus, offer short-term relief, they also encourage a cycle of drug dependency. Prescription migraine drugs can have the same effect. Aspirin or plain Tylenol are safe to use, but, Dr. Buchholz warns, if you are taking any over-the-counter medicine on a regular basis, you should be working on prevention by reducing your overall trigger load.
Because stress is one of the main headache triggers, finding ways to reduce and manage stress is an essential part of prevention.
Because stress is one of the main headache triggers, finding ways to reduce and manage stress is an essential part of prevention. Dr. Buchholz advises headache sufferers to cultivate a regular and consistent yoga practice, supplemented by a brisk walk or swim or other cardiovascular activity several times a week. Not only will this regimen—combined with getting enough sleep at night—help with stress reduction, the endorphins released during exercise help prevent headaches. When the first signs of a headache strike, the doctor recommends taking a break from work or household obligations and making the time to practice soothing yoga postures.
The series described below is a good place to start. Linda Sparrowe and Patricia Walden, authors of The Woman’s Book of Yoga & Health, dedicate a chapter in their comprehensive resource and reference book to a discussion of headaches and offer a wide range of restorative poses you can practice during a headache episode.
Here are a few of the poses that have worked especially well for me. If possible, practice this series when a headache first starts to come on, or try using the poses as a preventive measure on particularly stressful days.
Kneel on the floor with a bolster placed horizontally before you. Keeping the toes together, let the knees spread apart wide, and stretch the trunk and arms forward. Take hold of opposite elbows and rest your forehead on the bolster. Close your eyes, relax completely, and remain in the pose for 3–5 minutes.
Place a folded blanket at the top of a bolster. Sit in front of the bolster, facing away from it, and bring your feet together, letting the knees move all the way apart to the floor. Add a folded blanket under each knee for additional support, if necessary. Belt a strap behind your sacrum, over and around your hips and shins, and underneath your feet. Tighten the strap until you feel a firm sense of support. Lie back on the bolster and rest your head on the blanket. Relax and rest here for 5–10 minutes.
Arrange two bolsters: one horizontal against the wall, and a second placed in a vertical direction a few inches apart from the first. Lie on your back, with your shoulders and head resting on the floor and your feet touching the wall. Rest the arms in a position that is comfortable—either spread out to the sides or with elbows bent and palms faced up. Remain in this position for 5–10 minutes.
Place your bolster, horizontally, a few inches from the wall. Sit on the floor and turn onto your right side, propping yourself up with your hands. Arrange your lower back on the bolster. Lift your legs up and inch up closer to the wall until the back of your legs rest on the wall. (Getting into this pose may feel awkward at first.) Adjust your position on the bolster so that the lower back feels lifted and supported. You may want to place a folded blanket under the neck and head. (This pose is an inversion, so leave it out of the sequence during menstruation.)
Set a folding chair, padded with a blanket, at your feet and place two folded blankets vertically in front of it. As you lie down on the blankets, bend the knees and arrange your lower legs on the seat of the chair. Close your eyes and rest here, relaxing your entire system, for 5–10 minutes.