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| aura, aching muscles, cold hands, a general sense of tension or any number of other indications. |
| A trigger for headache pain may be almost anything in one's lifestyle or environment. Triggers don't cause the pain; rather, they activate an already existing chemical mechanism in the brain. For example, does drinking red wine lead to a headache within a few hours? If so, we could call red wine a trigger. |
| Most people's headaches are triggered not by one factor but by the interaction of several. In general, the more triggers present at any given time, the more likely a headache is to follow. In one study, migraine patients reported an average of five triggers. This has important ramifications as it demands that triggers be observed systematically over time and that all be considered. |
| Factors that increase one's vulnerability to headache, but do not immediately lead to one, are called contributing or contextual factors. Such factors create a context in which a headache is more likely to be set off by triggers. Some people can develop migraine not only during a period of stress but also afterwards, when their vascular systems are still reacting. Migraines that wake people in the middle of the night are also believed to result from a delayed reaction to stress. |
| General "toxicity," that is, any tendency to constipation, liver problems or general congestion will be a marked trigger in some individuals. Structural, cranial and spinal misaligmnents may also be involved, as may poor posture, even when not associated with overt skeletal problems. |
| Common headache triggers include: |
| Stress. |
| Particularly for chronic tension headaches or migraine, stress can be a powerful trigger. Stress can come from major life events such as a divorce or moving, but everyday hassles like commuting or a demanding boss can have an even bigger effect. |
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