Headache: 'A huge public health problem'

Almost everyone experiences headaches

Headaches are a major public health problem and ruin the lives of millions of people across the world, according to doctors.

Studies to be presented at a major conference this week will explain why headaches should be taken seriously.

The Headache World 2000 conference in London will hear doctors attempt to work out how the condition is caused and what hope there is for patients.

As of yet, doctors know relatively little about why people get headaches. A cure has proved elusive.

Headaches are estimated to cost the UK in the region of £3bn per year, through missed working days and costs to the NHS.

The problem of headaches on the world stage is enormous

Dr Timothy Steiner

Nine out of 10 people will suffer from a headache at some point in their lives.

But for others, the condition is much more serious.

Some 15% of people suffer from migraines, a headache which can be debilitating and very painful.

One-in-15 people suffer from a continuous headache and wake every morning with a throbbing head.

Major problem

Dr Timothy Steiner, of Imperial College School of Medicine in London and chairman of the conference organising committee, says headaches are a major problem.

"The problem of headaches on the world stage is enormous. It is a major public health problem.

"Part of the problem with headaches is the perception that headache disorders are trivial.

"Most of the population have headaches from time to time and either ignore it or take tablets and get on with things. But many can be seriously disabled by it."

It can adversely affect the quality of a person's life.

"It is enormously costly to individual people because of the amount of time they have to take off work and their quality of life.

"It may seem a bit of a joke for somebody to take time off work because of a headache but much of it is legitimate."

In fact, persistent headaches and migraines, while being obviously quite painful, can have a devastating impact on a person's live.

"We see between 40 and 50 people who have a headache every day. They wake up in the morning and the headache is there," says Dr Steiner.

"They may take a painkiller and experience some partial relief but the headache is back again a few hours later.

"Some patients are so disabled by headaches they seek early retirement or retirement on medical grounds.

Recent years have seen drug treatment advances

"While it may not be true to say they cannot do anything or cannot function because of the headache, it can also affect them on social levels.

"They may not go out as much as before or if they do make plans they may cancel because of their headache."

Dietary factors

Doctors are largely at a loss to explain why headaches occur. In many instances, they do not even know where the pain is.

While some headaches can be caused by psychological factors, doctors maintain that these are very rare.

They believe that headaches can sometimes be triggered by dietary factors.

They believe that some types of alcohol, red wine and port in particular, can contribute to the onset of a headache. Cheese has also been linked.

But Dr Steiner maintains that dietary factors are not the single cause.

"I think diet as a cause is overemphasised. A lot of people put in an enormous effort to see what in their diet is causing the headache, often with little success.

"They can also be triggered by overindulgence. Too much sleep can trigger a headache and equally so can not enough sleep."

Other causes are thought to be hormone levels. Women tend to suffer most from headaches during menstruation but they tend to abate during pregnancy and after menopause.

In fact, women suffer more from headaches than men and three times as many woman are affected by migraine compared with men.

Since little is known about why headaches occur, doctors remain a long way off finding a cure.

"We do not understand the cause or biology of headaches," says Dr Steiner.

"There is a growing belief that migraine is genetic. But a genetic cause is less likely for other forms of headache."

There have been advances in recent years in drug treatments for migraine and there are hopes that genetics and gene therapy could provide an eventual cure for the condition.

"There is certainly a lot of hope that if migraine is demonstrated to be a genuine genetic disorder then that raises the possibility of gene therapy.

"But that would be a long way off," says Dr Steiner.