Your Health

Headache specialist weighs in on treatments

Courtesy of Dr. Ken Peters
Dr. Ken Peters of the Northern California Headache Clinic in Mountain View offers expert advice for migraine sufferers.

According to the World Health Organization, nearly 47 percent of Americans reported experiencing at least one headache in the past year, and more than 10 percent reported suffering a migraine. While headaches are an annoyance for some, they can be downright debilitating for others. Migraine headaches, among the leading causes of missing work, can place significant stress on family life.

For a better grasp of the subject, I asked headache expert Dr. Ken Peters of the Northern California Headache Clinic in Mountain View to share his insights on the causes and potential cures for migraine headaches.

Q: Who gets migraine headaches?

A: Migraine occurs in 12 percent of the population, with 18 percent of females and 6 percent of males being afflicted. The age of onset varies from early childhood to early 40s. The frequency of migraine attacks per month can vary from rarely to near daily. Approximately 4 percent of the population suffers with chronic migraine – when the migraines occur at least 15 days a month.

Q: What does a migraine look like?

A: The symptoms of migraine consist of head pain, which is usually throbbing nausea, vomiting, as well as uncomfortable sensitivity to light, sound and movement. Fifteen percent of sufferers have an aura that is usually visual that precedes the onset of head pain.

Q: When should someone seek medical attention for a headache?

A: Sometimes a severe headache can be the first symptom of a life-threatening event. Red flags that warrant emergency care are:

• The worst headache of your life.

• Headache associated with neurological symptoms such as arm or leg weakness, poor coordination, difficulties with speech or change in alertness.

• Headache associated with fever or stiff neck.

Q: What causes a migraine headache?

A: The common triggers for migraine include:

• Stress.

• Foods such as alcohol, aged cheeses, chocolate, MSG and nitrates. Caffeine can help stop a migraine, but if taken daily it can cause rebound headaches.

• Hormonal effects such as menstrual migraine and worsening of migraine with oral contraceptives.

• Environmental such as sunlight glare, air pollution, pungent odors or change in barometric pressure. It is helpful to keep a headache diary to discover one’s individual triggers.

Q: How do you treat migraine headaches?

A: There are many effective treatment options for sufferers. Lifestyle change such as regular aerobic exercise, keeping well hydrated, not skipping meals and not overscheduling yourself can be quite helpful in prevention. Non-medication approaches such as biofeedback, cognitive behavioral therapy, mindfulness meditation and acupuncture are effective and highly recommended. Certain supplements such as magnesium, riboflavin, CoQ10, butterbur and feverfew show benefit in controlled studies.

Q: Which over-the-counter medications are most effective?

A: Certain over-the-counter meds can be helpful for abortive treatment of migraine. Excedrin can be helpful if used sparingly. Daily use could lead to daily medication overuse headaches. Aspirin and nonsteroidal anti-inflammatory drugs such as ibuprofen and Naprosyn can also be helpful.

Q: What about prescription headache medicine?

A: There have been great strides made in medications available to treat migraine. The triptans were initially developed in the early 1990s. They are used to abort a migraine attack and have improved the lives of millions of sufferers. New methods of delivery have recently been developed that allow quick absorption into the bloodstream and improve treatment.

There are also several effective medications that help prevent migraines. These are generally taken daily and include topiramate, amitriptyline and propranolol. For those who suffer chronic migraine, Botox treatment has shown effectiveness and is approved by the Food and Drug Administration.

Migraine headaches: An alternative view

In Chinese medicine, two people may have the same headache but have completely different diagnoses. Following are some common patterns that explain headaches.

• Liver energy imbalance headache. The liver is easily affected by stress, anger, alcohol and lack of sleep. Liver-type headaches include sharp or dull pain at the top of the head or the temples. They worsen with strong emotions, especially stress, and around menstruation.

• Kidneys energy weakness headache. The kidney is affected by overwork, fear, over-sex and inherited weakness. Kidney-type headaches start at the back of the neck and travel to the forehead. They are better with rest and difficult to treat with medication.

• Spleen and stomach imbalance headache. The spleen and stomach are affected by eating too fast, too late or too much; worry; cold food; and sweets. Spleen and stomach-type headaches, associated with food allergies, include throbbing (may be resolved by eating) and pain in the entire head or behind the eyes. They become worse when a person is tired.

Regardless of the cause, acupuncture and herbal medicine work to restore the underlying imbalances and treat the symptoms of headache. A successful course of treatment can result in remission of headache symptoms or in greatly reducing their intensity and frequency.

Ted Ray is a licensed acupuncturist and herbalist in private practice in Mountain View. For more information, call 564-9002 or visit

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