Head Start

How to stop headaches from becoming chronic

Headaches are a very common problem and many are mild, acute cases that can be treated at home.  But recurring headaches should be discussed with a primary care physician. The causes can often be complex, and the days of “Take two aspirin and call me in the morning” are long gone.

“Not many patients talk about headaches, or they will put it low on their list of concerns,” says Nolan Brackenrich, DO, a family medicine physician at St. Joseph's/Candler Primary Care located in Pooler. “A headache to me is an important concern, something we need time to talk about.”

Dr. Brackenrich’s first goal with a patient is to rule out any serious underlying conditions that could be the cause of the headache. From there, he will discuss the patient’s medical history and symptoms to hone in on other potential causes. Tension headaches, which often arise from stress, hunger or eye strain can sometimes be difficult to differentiate from other types of headaches such as migraines.

“My goal is to discover what’s causing episodic headaches in order to prevent them from turning into a chronic state,” Dr. Brackenrich says.

After the initial visit, he will often ask his patients to start a headache journal.

“Any little sensitivity can set off a headache, so it’s important to note all of the different factors that might contribute to it,” he says. “There are so many, including diet, nutrition, caffeine intake, water intake, alcohol, exercise and even the weather.”

Journaling helps patients become more aware of their triggers and also helps Dr. Brackenrich to see what he can’t see in an office visit—the patient’s daily life and habits.

“On the next visit, looking over your journal, we may discover that the last time you had a migraine, you drank two cups of coffee instead of one,” Dr. Brackenrich says. “Now we have caffeine as a potential culprit and a modifiable change that you can apply.”

Triggers can often be lowered or eliminated once they are identified, allowing some patients to manage or prevent their headaches without using medication.

“There is a perception that if you mention a headache to your primary care physician, he or she will just tell you to take some ibuprofen,” Dr. Brackenrich says. “But my job is to listen closely and have that conversation with you. Dealing with headaches now can help prevent long-term problems in the future.”