THOUGH HEADACHES AREN'T really brain pain, they can still drive you out of your skull. We look at the most common causes — and how to prevent them.

Doctors call it ‘cephalalgia,’ but you know it as that hammering, drilling, pounding, clenching pain that throbs inside your skull, behind your eyes, your temples or wherever else the common headache likes to attack.

These painful episodes have a wide variety of causes, ranging from eye strain and tension to dehydration, caffeine withdrawal and more life-threatening conditions such as cerebral aneurysms and brain tumors. Fortunately, up to 99 percent of all headaches are of a benign cause. And oddly enough, headache pain does not actually come from the brain, which lacks pain-sensing nerve fibers. The pain signals are caused by interactions between the brain and the surrounding blood vessels and nerves.

Headache sufferers spend billions of pounds per year seeking relief, but prevention costs you nothing. By making minor lifestyle adjustments to avoid the common triggers for different types of headaches, you can prevent their recurrence — or at least reduce their frequency and severity.

TOO MUCH TENSION

Odds are, when your skull begins to throb, it’s what doctors call a ‘tension headache.’ This is the most common type, accounting for approximately 78 percent of all headaches. Tension headaches affect both men and women at any age, but women suffer more than men, especially between the ages of 30 and 39.

Tension-headache pain originates in the area where the muscles of the head and neck meet, manifesting as mild to moderate pressure or tightening pain all over the head. Unlike other types of headaches, tension headache pain does not worsen with physical activity and is usually not associated with nausea or sensitivity to light or noise.

Because there are several common triggers for tension headaches, you can make lifestyle changes that may be more helpful than any other preventative measure (see sidebar Common Culprits). Not surprisingly, stress is cited as the most common trigger, and stress management — though sneered at as something that is definitely easier said than done — is one of the best preventative techniques. Managing stress can be as easy and quick as deep breathing, and other relaxation techniques such as yoga or meditation also help. Organizing your daily activities in advance also relieves pressure. While you’re filling in your calendar, set aside time during your day to relax: Send the kids to a friend’s to play and then relax in the tub, read or just daydream.

And don’t forget to relax your muscles. Massage and heat therapy with hot-water bottles, heating pads or hot baths are two of the best methods. Some people have found that the other extreme, cold therapy, provides relief — applying ice packs and showering under cold water. Exercise also relaxes the muscles and increases the levels of the body’s natural stress relievers, thus reducing the frequency and severity of headaches. Try regular aerobic activities such as running, swimming, bicycling or walking.

Your posture plays a significant role in how your muscles work, with bad posture putting strain on your muscles. By improving your posture and changing positions often when sitting, you can decrease your chances of suffering a tension headache (see sidebar Picture Perfect Posture).

NOT TONIGHT, DEAR

Many of us still chuckle at the age-old comedy routine where an imploring husband is left facing his wife’s back after she rolls to the other side of the bed sighing, “Not tonight honey, I have a headache.” Funnier still when the woman deters her lover’s advances by claiming, “Not tonight, honey. I’m going to have a headache.” But those who do experience sex-related headaches, a painful problem capable of cooling even the hottest of passions, aren’t laughing, Sometimes called ‘coital headaches,’ sex headaches turn pleasure to pain.

There are two types of sex headaches. In the first, the excitement accompanying intercourse causes muscle contractions in the head and neck, resulting in head pain. The second type is a form of vascular headache, technically termed ‘orgasmic cephalalgia’ and sometimes called an ‘orgasmic headache.’ Usually a sharp, severe pain often described as ‘a thunderclap,’ the headache is frequently felt in the base of the skull but may also be located around or behind the eyes. The pain comes on suddenly at or near the moment of orgasm, with intense pain usually lasting 10–15 minutes and lesser pain lingering for another hour or two.

Despite continuing research, there is still no consensus on what exactly causes sex-related headaches. Some researchers say it is a type of exertion headache, in which vigorous physical activity caused by blood-vessel changes in the brain triggers the pain. During sex, heart rate speeds up and increases blood pressure, and the body releases catecholamines, chemicals that increase metabolic activity. It is postulated that these chemicals act on the blood vessels or affect certain sensitive areas of the brain to trigger head pain. Many people who suffer sex-related headaches are also are prone to other types of headaches such as migraines.

Who is more likely to use the line, “Not tonight, honey; I have a headache” — males or females? If you guessed females, you’re wrong. Men are far more likely to suffer sex-related headaches than women: Most experts say men account for about 80 percent of the cases, meaning they are four times as likely to suffer from sexual headaches than women. Researchers found two peaks in the ages at which men were at highest risk of getting the headaches: 20 to 24 and 35 to 44. Again, there’s little consensus on why men suffer disproportionately. One theory claims that for women, vaginal stimulation may help block pain as a way of preparing them for childbirth.

Yeah, sure, it’s only a headache, but if you got one every time you have sex, wouldn’t you be a little distressed? Sex-related headaches can really interfere with your life but fortunately, almost all cases can be successfully managed. Abstaining from sex for a couple of weeks has helped some sufferers, while others have found relief by varying their sexual positions and trying more passive approaches to cut down on sexual exertion. About half of the people in a recent German study said they could avoid some headache attacks by slowing down their sexual activity and increasing their excitement more gradually.

Some drugs have proven successful, such as propranolol and indomethacin, as well as the common over-the-counter headache remedy ibuprofen. But before self-medicating, be sure to consult your doctor and keep in mind that anything that improves general health such as losing weight, lowering blood pressure and eating a balanced diet is likely to help the headaches as well. Ending the nightmare of coital head pain isn’t just a dream; the majority of suffers say that they suffered several attacks but then the headaches went away on their own and never returned and they never had to use that line again.

IDENTIFYING YOUR TRIGGERS

Keeping a headache diary can help you identify your specific triggers, making painful pounding a problem of the past. After each headache, record specific information such as:

COMMON CULPRITS

By avoiding certain trigger foods and activities, you can decrease your chances of suffering from tension headaches.

PICTURE PERFECT POSTURE

Good posture has more than aesthetic perks. By improving your posture and changing positions often, you can prevent unnecessary muscle strain and pain.

Facts To Put You a Head Above the Rest

Ancient Greeks and Romans applied cabbage and onions to the head in an attempt to relieve headaches.

Long ago, headaches were perceived to be the work of evil spirits. Rituals were performed to drive them out and in some cases circular chunks of skull were removed to let the spirits escape. Amazingly, people seemed to have survived these operations, as neolithic skeletons have been found that showed new bone growth around these holes.

Ice cream headaches are no myth: You really can get them from eating this frozen dairy treat. Ice cream’s intense cold causes the blood vessels to spasm, which interrupts the blood flow and causes the vessels to swell.  et