My aching head.

Q Every day at work, I get a big headache. Nothing seems to help. I gulp Tylenol, drink caffeine, and take prescription meds. I need help!

A You're not alone. Forty million Americans suffer from recurrent headaches. Finding the cause is important. Tension, fatigue, allergies, sinus problems, and eyestrain can jump-start a headache. A change in routine (such as skipping a meal, oversleeping, undersleeping, drinking too much alcohol, and changes in bodily hormones), can trigger them as well. Some people have found that depression, caffeine, cheese, bright lights, and noise start the pounding.

Tension headaches, the most common, are distinguished by a steady ache and are caused by electro-chemical instability in key brain centers. Migraine headaches affect mostly women and are triggered by an expansion of blood vessels and release of chemicals, which cause inflammation and pain. Cluster headaches usually affect men, involve severe pain around one eye, may last one to two hours, and can recur over months.

Avoiding headaches involves a balanced lifestyle. Try to eat foods that are healthy for you, exercise regularly; keep your body hydrated, and see if you can identify any of the aforementioned triggers. Remember, exercise releases endorphins, which are natural chemicals that relieve pain. Participating in activities you enjoy and that are relaxing to you will also help.

Prescription meds may be needed at times, but overuse of medication can reduce the body's ability to manage pain naturally. When the medication wears off, the headache returns. Please check with your health care provider for more help.

James L. Marcum, M.D., F.A.C.C., is a behavioral cardiologist with the Chattanooga Heart Institute. His newest book Heartbeat is available at www.adventistbookcenter .com.