Podcast Summary: "Headaches: causes, cures and exercise?!"

Podcast: What's That Rash?
Host: ABC Australia
Date: March 31, 2026

Overview

This episode of "What's That Rash?" explores the omnipresent health concern of headaches—what causes them, how to manage them, and whether exercise can help. Hosts Tegan and Norman, both long-time headache sufferers, address listener questions about stress and cluster headaches, share colorful historical treatments, discuss modern evidence-based therapies, and highlight the importance of recognizing potentially serious warning signs.

Key Discussion Points and Insights

1. Understanding Headaches: Types and Red Flags

[01:07–05:24]

• Types of headaches:

  • Tension headaches (tightness or pressure)
  • Migraines (often throbbing, one-sided, can include visual aura)
  • Sinus headaches (pain behind eyes, cheekbones, congestion)
  • Cluster headaches (seasonal, severe, often one-sided)
  • Ice-pick headaches (brief, stabbing pain)
  • Thunderclap headaches (sudden, extremely severe)

• When to worry:

  • A new or dramatically different headache warrants a check-up.
  • Warning signs: if headache wakes you up, worsens in the morning, doesn't go away, or is associated with neurological symptoms (speech, facial droop, arm weakness).
  • “If it’s affecting your speech, your face, whether or not you can lift your arms ... then you ... need to call the ambulance.” — Norman [04:54]

2. Cluster Headaches: Adam’s Story and the Latest Science

[06:37–07:34; 17:06–20:09]

• What are cluster headaches?

  • Cyclic, often seasonal, very painful, sometimes linked to circadian rhythm and hypothalamus activation.
  • More common in men and over-30s; familial tendency.

• Adam’s N=1 experiment:

  • 30-year sufferer; headaches have intensified over decades.
  • Finds aspirin at first sensation or intense exercise (“100 to 200 body weight squats”) can prevent or halt headache.
  • “While I know that oxygen therapy is a recognised treatment for cluster headaches ... I may be an N equals one of getting extra oxygen into my system through exercise.” — Adam [18:16]

• Exercise as therapy:

  • Norman cites a systematic review: exercise can outperform conventional treatments for tension headaches and chronic migraine. [18:37]
  • Mechanisms may go beyond oxygen—include hormonal and neurological crosstalk.
  • “Muscles talk to the brain and the brain talks to muscles. … It could be through distraction ... exercise [is] a whole body process, which has extraordinary effects on the brain.” — Norman [19:06]

3. Migraines: Nature, Triggers, and Treatments

[07:34–09:38]

• Migraines are more disabling than simple headaches; often present with throbbing pain, light sensitivity, aura (e.g., flashing lights).
• Migraine with aura slightly increases stroke risk, so take new neurological symptoms seriously.
• Modern migraine-specific therapies are now more available in Australia; early intervention at the first sign is most effective.
• Common triggers: wine (particularly red), certain foods (e.g., chocolate, oranges).
• “Once the migraine is established, it’s quite hard to get rid of the pain and other symptoms ... starting treatment as early as possible [is key].” — Norman [08:17]

4. Historical and Folkloric Headache Remedies

[09:59–12:32]

• From ancient Mesopotamia to the Anglo Saxon “Leech Book,” headaches have inspired creative (and sometimes bizarre) remedies.
• Examples: applying red nettle with vinegar, rue juice up the nostril, stag’s horn, frankincense, catfish skull.
• Ancient treatments occasionally overlapped with modern ideas (e.g. massaging/stimulating areas at the back of the head).
• Delightful asides:
  • Athena was mythically born from Zeus’s headache—“If your headaches aren’t birthing the goddess of war and wisdom, maybe you’re doing them wrong.” — Tegan [13:26]
  • Old neurosurgical technique: drilling a hole in the skull to relieve pressure (not recommended at home).
    • “You’re safer to take your drill from your shed, dip it in cowshit and bur into the brain than not burr it at all.” — Norman recalling a medical school lecturer [14:09]

5. Modern Classification of Headaches

[15:23–15:44]

• Primary headaches: the problem itself (e.g., migraine, tension headache, cluster headache)
• Secondary headaches: due to underlying, often urgent, conditions (e.g., stroke, tumour, infection)
• All headaches should be contextualized—pay attention to significant changes or accompanying symptoms.

6. Lifestyle Factors and Practical Management

[16:10–21:26]

• Stress is a well-recognized trigger for headaches, impacting muscle tension and brain chemistry.

• Sleep, nutrition, and mental health profoundly affect headache frequency and intensity.

• Keeping a headache diary: helps identify personal triggers (may include foods, stress, sleep changes).

• Standard first-line pain relief: paracetamol and ibuprofen.

• Oxygen therapy is effective in cluster headaches; exercise also shows promise but isn’t a universal prescription.

• “If you are feeling psychologically distressed ... that does not help headaches.” — Norman [21:10]

• “Get in quickly: paracetamol, ibuprofen, see what works for you.” — Norman [21:23]

Notable Quotes and Memorable Moments

• “If you get a headache out of the blue and you haven’t had it before ... you need to go and get it checked out.” — Norman [03:21]
• “It’s not a tumour. But really, what you’re saying is ... it could be a tumour.” — Tegan [04:10]
• “We love an N equals one here at What's That Rash.” — Tegan [02:52]
• “Have you heard the story of the birth of the Greek goddess Athena?” — Tegan [12:44]
• “No leeches. The whole book is called the Leech Book.” — Tegan [11:03]

Important Timestamps

• [01:07] — Introduction to episode and listener questions
• [03:21] — When to worry about headaches/new symptoms
• [06:37] — Cluster headaches explained
• [07:34] — Origin of 'migraine' and historical context
• [09:38] — Early migraine treatment and triggers
• [09:59] — Historical treatments and “Leech Book”
• [13:26] — Athena and the mythology of headaches
• [14:09] — Hair-raising neurosurgical anecdotes
• [15:23] — Modern classification: primary vs secondary headaches
• [16:10] — How stress impacts headaches
• [17:06] — Adam’s experience with exercise for cluster headaches
• [18:37] — Evidence for exercise as therapy
• [20:29] — Toolbox: tracking triggers, sleep, nutrition, psychology
• [21:23] — Painkillers: when and how to use

Takeaway Messages

• Always get new, severe, or unusual headaches medically assessed—don't just “wait and see.”
• For long-term headache sufferers: track triggers, maintain healthy lifestyle habits, and treat early.
• Exercise may be a valid adjunct therapy for some, with mounting scientific support.
• Migraine management has improved; specialized treatments exist—discuss with your doctor if standard painkillers aren’t enough.
• The understanding and treatment of headaches continues to evolve, and everyone’s experience is unique.