When you have a headache, it affects virtually every aspect of your life, from how you do your job to how you react to your family and friends.

Headaches are one of the most disabling and costly disorders in the United States. Because headaches tend to be most common and severe in middle adulthood, many sufferers are hit during what should be their most productive years. More women than men are plagued by headaches.

Can you learn to predict a headache? In some cases, maybe.

Headache triggers are those things that can set off a headache says Lynne Geweke, M.D., director of the Headache Clinic at UI Hospitals and Clinics. Triggers vary from person to person and headache to headache. If you pay attention to your headaches and what you were doing or eating before the pain started, you may identify your personal headache triggers. Some triggers you can control, like what you eat, while others, such as the weather, are beyond your control. And some headaches have no triggers.

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• Red wine
• Other alcohol
• MSG (monosodium glutamate)
• Caffeine
• Chocolate
• Cheese
• Pickled foods
• Nuts
• Bananas
• Citrus fruits
• Freshly baked bread (yeast)
• Coffee, tea, cola
• Aspartame

Behavioral triggers:

• Stress/tension
• Depression, anxiety, frustration
• Poor posture
• Skipping meals
• Straining/lifting
• Eating or drinking cold foods or beverages

Environmental triggers

• Odors
• Altitude
• Sea sickness
• Flickering lights
• Change in weather

Physical triggers:

• Dental problems
• Sinus problems
• Hormonal changes
• Eye strain
• Certain medications
• Exposure to smoke or chemical fumes

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Regular use of pain medications, including all over-the-counter medications and especially ones that contain caffeine, can actually make headaches worsen says Geweke.

"These medications should not be taken daily. It's a form of habituation called rebound and is common in chronic headache sufferers."

If occasional use of these medicines gets rid of the headaches, Geweke says, "Fine, use them. But if they don't relieve the headache, the medications should be discontinued and you should talk to your doctor.

"If they don't get rid of the headache, don't take them."

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The most common headache trigger is stress--about 75 percent of headaches are attributed to stress and tension. Eliminating stress from your life is not the answer

because stress is part of life. Stress comes with change, both good and bad. Stress comes with managing your family and your career.

Stress is part of your relationships, even the good ones. Geweke says even happy events, like weddings and holidays, can cause stress. "A life without stress would be no fun." Geweke says that while some people get headaches when they are under stress, many others get headaches when the stress lets up.

For information about UI Family Care's Mindfulness-based Stress Reduction program, please call Counseling and Health Promotion Services at 384-7900.

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While most headaches are just that, an ache, some headaches may signal the presence of a serious medical condition.

If any of the following experiences apply to you, don't be alarmed, but check with your family doctor or contact a UI Family Care site, 319-384-8442 or 800-777-8442, for an appointment.

• Does your headache get steadily worse over time?
• Has your headache changed in character?
• Do you have headaches more than three times a week?
• Do you take pain medication every day, or almost every day, to relieve the headache?
• Did your headaches begin after the age of 50?
• Is your headache accompanied by:
• Stiff neck or fever
• Shortness of breath
• Unexpected symptoms that affect your eyes, ears, nose, or throat
• Dizziness, slurred speech, weakness, numbness, or tingling
• Confusion or drowsiness
• Persistent or severe vomiting

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For more information:

• National Institute of Neurological Disorders and Stroke
  Headache Hope Through Research
• Drugs and Stress Management Together Best Manage Chronic Tension Headache: Clinical Trial Proves Benefit of Combined Therapies
• University of Iowa Health Care
  • Headaches: Cluster
  • Headaches: Sinus
  • Headaches: Migraine
  • Headaches: Tension

Listed above are several Web sites that offer additional information on this topic. University of Iowa Health Care does not sponsor or endorse these sites, or guarantee the accuracy of the information contained on these sites. These links are here for general information only, and should not be used for personal diagnosis or treatment. If you have any questions, please contact UI Health Access.

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