Monday Medical: Heading off headaches |

Monday Medical: Heading off headaches

Susan Cunningham
For Steamboat Pilot & Today

From constant throbbing to extreme pressure, headaches can take many different forms.

But one thing stays the same: many people experience them.

“Headaches are one of the most common reasons for someone to visit a primary care office or ER,” said Dr. Rebecca Levin, a family medicine physician in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. “But, they should be addressed, especially if they present with any red flags.”

Below, Levin outlines types of headaches and how they’re treated.

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Types of headaches

Migraines are debilitating headaches that involve throbbing pain that is usually one-sided and gets worse over several hours. Nausea and sensitivity to light and sound are also common.

People may experience an “aura” which can manifest as bright spots, flashing and zigzagging lines or ringing in the ears before the migraine starts.

With tension headaches, pain is felt on both sides of the head and causes intense pressure across the forehead. “Some people complain about it being like a vicelike grip around your head,” Levin said.

If you’re using a lot of Tylenol or ibuprofen to control your headaches, you might end up with a medication overuse headache that doesn’t subside. “Using too much over-the-counter medication can actually backfire and make your headaches worse,” Levin said.

Finally, emergency headaches are accompanied by the following symptoms and should be evaluated by a medical professional immediately.

  • Fever, new neck pain or confusion along with a headache could be due to an infection or meningitis.
  • A headache with neurological changes, such as vision changes, slurred speech, weakness or numbness and trouble walking could be a sign of a stroke.
  • An extremely painful, “worst of your life” headache that comes on quickly could signal a hemorrhage.
  • Both minor and traumatic injuries that result in a headache should be reviewed, as these symptoms could be signs of a concussion.


Headaches can be triggered by stress, skipping meals, having too little or too much caffeine, poor sleep, neck tension or tightness, alcohol, some drinks and foods (such as red wine or certain types of cheese), hormonal changes and even pressure changes due to weather.

“A lot of factors can play into headaches,” Levin said. “I always like to tick through that list with a patient and see if that helps us figure out what could be contributing to headaches in their daily life.”

There’s also a genetic component: patients with a family history of headaches may be more likely to experience them.


Resting in a dark room or taking acetaminophen or ibuprofen can help, though you should check that any over-the-counter medication is safe for you.

If simple steps aren’t enough, a prescription medication may be helpful.

“Everybody is different,” Levin said. “The bottom line is your doctor can help find the best treatment.”

Levin also recommends limiting alcohol consumption, eating and sleeping at regular times, exercising several times a week, practicing stress reduction techniques such as meditation, taking breaks from computer screens, making sure your vision screens are up to date and staying hydrated.

“I like to have my patients make a headache diary,” Levin said. “They record when they have a headache, what made it worse or better and what happened right before. That can help us realize, ‘Oh, you’re always getting a headache after you drink red wine. That could be a trigger for you.’”

Don’t hesitate to see your primary care provider.

“Any time someone has new headaches, they should be evaluated,” Levin said. “And if you have headaches that are happening on a regular basis and interfering with your daily life, you should come in. There could be some things you don’t know about that we can help you with.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at

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