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What is the best way to manage recurrent headaches?

Q: I am 40 years old. For the past more than 20 years, I have been getting migrane headaches. The frequency of headache is on an average once a week. I will get the pain on the temples in the forehead. The pain will be on one of the temples only. If I get pain on the right temple now, next time the pain will be on the left side. In this connection, I have taken the following treatments: 1. Sinus surgery - But it does not have any effect at all and it has not reduced the migrane. 2. Treatment with a famous neurologist in Chennai - This also has not reduced the sufferings in any way. 3. Treatment with a famous acupressure consultant in Chennai - This also has not reduced the sufferings in any way. I started doing yoga also. Even though my general health had improved due to yoga, my headache problem has not been solved. In this connecton, I would also like to give the following information: Some of the triggers of my migrane are: going in hot sun, travelling for long time, straining of eys, smelling of dust, taking any cool drinks. But even without any of these also, I am getting regular headaches. Due to the above, I completely stopped drinking any drinks which are cool. I take only only hot coffee / hot tea. Even when I go in hot sun, I could not drink any cool drink, as it will immediately cause headache. I completely stopped drinking any liquids taken from refrigerator. Whenever, I get headache, I used to take one painkiller, most of the time the tablet, Megadol. Within half an hour of taking the tablet Megadol, I will get relief from the headache. In the above circumstances, I would request you to advise me whether I should have any treatment at all to get rid of the headache? Is the treatment only in allopathy or any other treatment is also available? Could you also advise me how I should change my lifestyle / behaviour so that the suffering is reduced? Also advise me whether taking painkiller in general and in particular, Megadol, once in a week will affect the health in any way?

A:I appreciate your anguish for having had to suffer a recurrent headache for about 20 years. Analysing your query, I can make three comments about your headache. First, it does not seem to behave like a typical migraine; it seems more like an environmental headache caused by a variety of external influences, as outlined in your letter. You did not mention but I presume you have no anxiety or depression; if you do then you must get some medical attention, since anxiety or depression can cause or aggravate headaches. Second, your headache is unlikely to be a manifestation of some serious underlying disorder, or else it would have shown up by now. Third, your headache is relieved by a simple analgesic such as megadol (I presume it contains paracetemol) and, therefore, you have a degree of control over it. In view of these considerations, I would suggest that you should accept your headache as part of your lifestyle and not seek any further interventions unless the character of your headache changes or you get a new type of a headache. Try to avoid taking any drugs for it unless it interferes with your work and then you can take a paracetemol. Remember, paracetemol can be addictive if taken every day for a long period, an occasional tablet should not cause any problems. If, on the other hand, you get too preoccupied with your headache it is likely to get worse and disrupt your life. If you accept it as an unavoidable occurrence you will be able to bear it with increasingly less discomfort and disruption.

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