After giving birth to her third child, Shereen Hussain started suffering from such debilitating migraines that she was often out of commission for days at a time. The throbbing pain would hit her right behind the eyes or at the base of her skull. The only way to deal with it was to put on a blindfold, get in bed, and wait it out—not the easiest prospect to face every six weeks with three children and a job.

Hussain’s story is hardly unique. Dr. Christopher Oakley, assistant professor for neurology at Johns Hopkins Medicine and director of the Pediatric Headache Center, says chronic migraines—and headaches in general—are a vast problem. Chronic is defined as at least 15 days of symptoms a month for three or more consecutive months.

“Headaches, especially in adults, are quoted to be as prevalent as 80 to 90 percent,” he explains. For migraines, “in some studies it’s as many as one in three [adults]. In other studies, it’s somewhere in the mid-teens to mid 20 percent.”

There are several hundred types of headaches, Dr. Oakley says, and they can be classified into three categories. The primary class means there’s no underlying cause and the symptoms come on randomly. The second type identifies a cause, such as stroke, seizure, aneurysm, or other illness or medical issue. The third is a more “other” category, dealing with things like neurological conditions and facial pains.

The primary bucket is where migraines, tension headaches, cluster headaches, and most everyday headaches fall. Migraines are differentiated from your routine aches by throbbing that’s aggravated by basic activities, as well as nausea or sensitivity to light and sound. Tension are the most common—spread across the temple, not localized, with potentially sore muscles—and cluster refer to cycles of throbbing, with indicators such as a runny nose and redness in the eyes.

Of course, many patients who experience severe cases of head pains worry that it’s not common and could be symptoms of something more serious, such as a tumor. But Dr. Oakley says doctors would be able to identify any red flags and if there are no extreme circumstances or family history that show up on a routine work-up, the issue is likely something a specialist could help with.

Hussain tried several remedies after the first onslaught of agony, including Eastern homeopathic drugs that out-of-country relatives and friends brought when they visited her. Nothing made a huge difference. After several years, she decided to take medication, something she had been avoiding. “I finally broke down one day,” she remembers. “It was like a dream come true; [my headaches] went away immediately.”

She took the medicine for a year until a doctor warned her that the side effects could be frightening, including increasing the possibility of a stroke. Dr. Oakley agrees that chronic patients have to weigh the cost and benefit of using stronger drugs. For some, it’s the only solution. Hussain felt that her body was becoming immune to the pills anyway since she was having to take more and more to get relief. Still hoping to find another way, and with her sister-in-law, a fellow sufferer, seeing a naprapath, who concentrates on a holistic approach focusing on connective tissues, Hussain explored the idea of alternative therapies.

“I think that it really did work,” she reflects. “[The headaches] really, really decreased.”

Her naprapath, Dr. Kim Selir, employs a variety of techniques because, while headaches are prevalent, the causes vary from patient to patient. She concentrates on three aspects in her practice: eating, moving, and thinking. “[That] combination of things is where our balance lies,” she explains. “When that gets out of balance, the body can’t function appropriately.”

There could be several causes for any head pain, including lack of sleep, not enough nutrients, and tension. The answer could be as simple as inadequate water intake or lack of exercise. Dr. Selir also examines general lifestyle issues, such as interactions with family or if career and finances are causing stress.

“You really have to sit and listen to the individual.” Dr. Selir continues, “To me, it’s really sitting and listening and figuring out what the cause or multiple causes are. There’s a reason that the body is not able to function at its optimum. Unless you came out of the womb having headaches, then something happened somewhere along the line that is causing that to happen.”

Dr. Selir gave Hussain the tools to help her deal with the reasons that could be leading to her pain, and it led to some larger changes. “She really got to the bottom; it’s not just one thing,” she expands. “It can be stress, but where’s the stress coming from? It can be diet; it can be not moving enough during the day. It made me think about all the things; it was like a whole lifestyle change.”

Dr. Oakley himself suffered from migraines for six years as a teenager and uses the same techniques he prescribes to patients. “The first step is always going to be lifestyle,” he says. This includes eliminating stress, which he admits is much easier said than done. “A little bit of stress can be helpful for a lot of people,” he explains. “If the stress is causing problems, then you have to recognize it and seek help for it.”

He echoed Dr. Selir’s suggestions: diagnosing any sleep problems, staying hydrated while avoiding too much caffeine and alcohol, cardiovascular exercise (pushing yourself to be “hot, sweaty, and out of breath” for at least 20 to 30 minutes three to four times a week, but preferably every day), and eating well-balanced meals that include sufficient nutrients and vitamins. “This is where diet, obesity, inactivity go hand in hand,” he continues. “If you’re healthy, you tend to do better.”

However, both Dr. Oakley and Dr. Selir resist prescribing a specific eating regimen or avoidance of certain foods, though, experts are divided on the effects of specific foods. If there are triggers, such as fatty substances or chocolate, it’s a good idea to notice them, but they aren’t universal problems for all sufferers.

Dr. Selir says, while items such as cashews and cheese tend to be ones many can point to as a cause of headaches, she usually is a bigger proponent of adding items to a routine over removing them. She prescribes including more organic fruits and vegetables, along with proteins. “This is all going to lead to less inflammation in the body, and less inflammation is less chance of any kind of a symptom,” she continues.

When it comes to migraines, though, Dr. Oakley says there’s no real explanation for why some suffer them and others don’t. He and others do know that patients have brains that function differently, with higher levels of melatonin and serotonin. Nerves also process pain differently. Genetics can contribute, and hormones are a factor as well, which is why women usually suffer more than men do and often experience symptoms around their menstrual cycles.

Dr. Oakley says there is even evidence that socioeconomics play a role. Additionally, there are many external issues out of people’s control, such as a change in barometric pressure. Dr. Oakley gives his patients complementary alternative therapies—physical therapy, massage, relaxation, acupuncture, cognitive behavioral therapy—which he admits may not work for everyone and, therefore, may not be cost-effective, as they’re usually not covered in health plans. It’s also up to patients to test out different options and see what may or may not help.

Dr. Oakley looks at medication and daily prevention as the final prong of care. “It has to be disabling enough that it’s causing problems—[for] kids [it’s] missing school. For adults, it’s missing work or family affairs,” he expands. For people like Hussain, too, they have to understand that there’s no cure, just ways to temper occurrences.

Hussain followed many similar recommendations in her quest to live a pain-free life. She pinpointed some triggers, such as hunger, dehydration, and exhaustion. She visited Dr. Selir’s office three times a week for four months for manipulation of muscles and tissues. Because the procedures aren’t covered by insurance, she didn’t continue them, but months out she has still felt the positive effects. A bad ache hasn’t hit her since seeing Dr. Selir, although she plans to take medication if she faces another episode that keeps her from her life and work. While she’d prefer not to take the drugs, using them every once in a while is a much easier prospect for her than having to rely on them constantly.

That’s also a respite after 20 years of suffering. “When you’re a migraine sufferer, you’d mortgage your house for some relief,” she contends. After experimenting with different solutions, Hussain is happy to have found a balance that seems to be helping. “It was awful; it was really bad. It’s drastically improved,” she says.

Perhaps not as trendy today as in the last couple decades, no- and low-carb diets are still quite popular. The idea, which is supported by science, is that if the body isn’t consuming enough carbs to fulfill its energy purposes, then it will begin to burn fat instead. Although this does work in the short-term, especially for those looking to lose a substantial amount of weight in a short period of time, it is not a lifestyle that should be implemented for the long term. “The danger of breaking down fat only for long periods of time is a buildup of ketones. It is called ketosis,” explains Ahmad. “It causes headaches, nausea, bad breath, and is not an optimal metabolic state to be in. So yes, you can survive with no carbs, but you will probably be cranky all the time.”

In the long run, low-carb diets cannot be sustained. Your body needs complex carbs, and even sugars, in order to control and maintain several necessary bodily functions. Rather than focusing on carb quantity, instead pay attention to the carb quality. Weight loss will be gradual but healthy and more likely permanent, leading to more energy, better sleep cycles, and a stable mood.

Nadia Malik holds a degree in journalism and is a former reporter for a Chicago-area newspaper. She has written for websites and publications and has also worked for several non-profit organizations.