Advice for Spring time headaches

Up to 20% of the population suffers from allergic manifestations which take the form of debilitating headaches, sneezing, wheezing and itching eyes. Sinus congestion and pressure is a secondary condition, which has also been known to trigger headaches.

The chairman of the South African Headache Society Dr Elliot Shevel explains, "Usually hay fever is associated with spring, when airborne pollens from grasses are at their peak. October and November are peak allergy months in Cape Town, and with the Western Cape now consistently recording pollen counts of over 30 - considered extremely high - allergic people should be sure to seek help."

Hay fever headaches cause a dull, deep, throbbing pain. Some of the symptoms of hay fever headaches are pressure like pain in one specific area of your face or head (for example, behind your eyes), face is tender to the touch, pain is worse with sudden movements of the head and bending forward and worse pain in the morning (because mucus has been collecting and draining all night). They are caused by an inflammation in your sinuses (air-filled cavities around your nose, eyes, and cheeks). Headaches often begin as soon as you get up in the morning, and may be better by the afternoon.

Dr Shevel suggests the following to prevent or limit hay fever headaches:

• When the body comes in contact with an allergen, histamine and a number of other inflammatory chemicals are released as part of the body's allergic reaction. Antihistamines work by blocking the effects of histamines, thereby reducing the symptoms of hay fever. Regular use of antihistamines throughout the pollen season is effective especially if treatment is commenced early in the season.
  
• Decongestants when used topically for short periods (less than 7 days) are effective in reducing nasal blockage and help penetration of topical steroid nasal sprays.
  
• Cortisone injections tend to be prescribed only in more severe cases where the hay fever symptoms are not controlled with other over-the-counter medications. They can't be repeated frequently due to the possible side effects.
  
• Take note of the pollen count forecast on television or in the newspaper. Try to stay indoors if it's a high count or on windy days after thunderstorms.
  
• Choose plants that are pollinated by birds or insects in your garden, rather than plants that release their seeds into the air.
  
• A simple saline (salt water) nasal douche is effective. Saline and sea water nasal sprays help flush pollen grains off the nasal mucosal and improve nasal patency.
  
• Splash your eyes often with cold water to flush out any pollen.

It is crucial that if your headaches persist, you should get to the root of the problem. The longer the headache persists, the more damage will be done to the underlying structures. A "multidisciplinary" assessment will need to be done. There are so many different structures in the head, face and neck, all of which can be involved in the migraine process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. Which structures are causing the pain and generating the pain signals is the million dollar question added Dr Shevel.