CHENNAI : Medha, Smita and Radha (not their real names), all in their 20s, have something in common: headache.

Smita and Radha know it is migraine. Bhuvana, a back office employee in a multinational bank, says her colleagues regularly complain of headache. Medha, a BPO employee for the past three months says, "I work the 7 p.m.-4 a.m. shift but when I work till 6 a.m., I come home with a headache. And I cannot sleep because it is daylight."

Irregular working hours can result in chronic headache, says Ninan T. Mathew, director, Houston Headache Clinic, Texas. Headache is a common disorder found in five per cent of the general population across the world, he says. Anxiety, depression, sleep disturbance, obesity, snoring, overuse of caffeine or pain medication can also cause headache.

Chronic patients are those who suffer from headache for more than 16 days in a month. But it can also be due to contraction of neck, face and scalp muscles, caused by stressful events.

But the pattern differs in men and women. Over 18 per cent of women suffer from migraine during their reproductive years. Cluster headaches, common in men, occur in a bunch over a period of weeks and disappear for several years.

In women, when oestrogen levels fall during the menstrual cycle it could cause headache. During pregnancy, oestrogen production rises and headache is rare. Though stress can trigger migraine, it is genetically inherited, say doctors.

Too much consumption of caffeine, packaged food such as chips containing mono sodium glutamate, can trigger migraine and could include symptoms such as nausea. Smita's migraine is inherited. Radha's doctor advised her to avoid eating chips. Both women were advised sleep to get over their migraine.

Headache can be controlled but not cured, says Dr. Mathew, who was in Chennai to teach doctors the use of Botox injections. "It is a disorder like diabetes or hypertension. In the past 20 years, we have come a long way in the treatment of migraine. We have better preventive medicines and the disability due to headache can be reduced by proper treatment. The only difference is that people in the U.S. take a lot of pain medication. Here [in India] they don't."

Aspirins are good for normal headache but not for chronic cases. They must be treated with non-addictive beta-blockers and sometimes small doses of anti-depressants.

Only when the lifestyle of patients is affected, are Botox injections prescribed. Botox relaxes the muscles and causes no biochemical changes. It is considered the first line treatment for migraine, says the specialist.

Yoga helps

Preventive therapies such as yoga, regular physical activity, enough sleep (during day if working night shifts), eating healthy breakfast and fixed lunch and dinner time, listening to music, reading a book and a hot bath can help. Medha sometimes reads a book to fall asleep.

(Names have been changed to protect identity).

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