Headaches

What is a headache?

A headache is pain experienced in any part of your head. It is a common condition, and most people will have at least one in their lifetime. Headaches can affect males and females of any age.

In most cases, a headache is unpleasant but not a cause for concern. Occasionally it can be a symptom of a serious illness.

There are many different types and causes of headache. You may need to see a doctor to work out what type of headache you have.

What symptoms are related to headaches?

There are more than 200 different types of headaches, and they can feel quite different to each other. Here are symptoms of some common types.

Tension-type headache

Tension-type headache is one of the most common forms of headache. The pain is usually on both sides of your head and feels dull or tight. It can last between 30 minutes and 7 days.

Migraine

Migraine is a common health problem where as well as headache, you may have one or more other symptoms, such as nausea, vomiting or feeling sensitive to light or noise. The pain is usually throbbing on one side of your head and can last hours or days.

Some people experience other symptoms before or during a migraine attack, for example visual aura or changes in their vision. Visual aura might include flashes of light, blind spots, or seeing ‘zig zag’ patterns. Others will have problems with their speech, or feel ‘pins and needles’ (a numb, tingling feeling) in their arms and legs.

Cluster headache

Cluster headaches are a more rare type of headache that can be very painful. They generally occur in groups or ‘clusters’ of attacks. The pain is usually behind one eye and feels stabbing or burning. You might have a runny nose and a red eye with watery discharge. It can last up to 3 hours and may happen a few times a day.

Sinus headache

Headaches due to sinus problems cause pressure in your forehead or cheek bones, on one side or both sides of your face. These areas might feel sore if you press on them or bend forward. Your teeth might also be sore, and you may have a blocked or runny nose or a cough.

Alcohol headache

Headache due to drinking alcohol causes throbbing pain that gets worse with exercise.

Dehydration headache

Headache due to dehydration causes pain all over your head.

Altitude headache

Altitude headache is an intense, throbbing pain that is either generalised all over your head or mainly in your forehead. It is also known as ‘mountain sickness’, but can happen when you change altitudes. Mountain climbing can cause pain all over your head that gets worse with exercise. Diving can cause a headache accompanied by dizziness, difficulty breathing or confusion. Flying in a plane can cause pain in one side of your forehead.

Sleep apnoea headache

Headache due to sleep apnoea is usually felt when you wake up in the morning, on most days of the week.

What causes headaches?

Headaches can be primary (when they happen on their own, and not as a result of another health problem) or secondary (resulting from another health problem).

Primary headaches

Sometimes primary headaches can be triggered by dietary factors, such as:

• alcohol, particularly red wine
• certain foods, such as cheese, citrus fruits, processed meats and foods containing monosodium glutamate (MSG)
• large amounts of caffeine
• skipping meals
• not drinking enough water

Other common triggers include:

• too much or too little sleep
• bad posture
• stress — or relaxing after stress
• too much screen use
• bright lights, strong smells or loud noises
• sexual intercourse
• hormonal changes — in females

Secondary headaches

Common causes of secondary headaches include:

• acute or chronic sinus infections
• eye strain
• dental problems
• middle ear infections
• side effects of some medicines
• dehydration

Potentially serious health problems that can cause secondary headaches include:

• aneurysms
• high blood pressure
• glaucoma
• brain tumours
• head injuries
• meningitis
• stroke

When should I see my doctor?

You should see your doctor if your headaches occur frequently, and they prevent you from doing the things you can normally do. You should also see your doctor if you take pain medicine for headaches more than 3 times a week.

If you have already been diagnosed with a certain type of headache, see your doctor again if your headaches become different or more severe.

In some cases, headaches can be a symptom of something more serious. See your doctor straight away if you experience:

• a severe headache that comes on suddenly
• a headache that gets progressively worse over the course of several weeks
• a morning headache with nausea that doesn’t go away
• a headache that starts after an injury to your head
• a headache that wakes you up when you’re asleep

You should also see your doctor straight away if you have a headache accompanied by:

• fever
• vomiting
• confusion or a change in personality
• neck stiffness
• blurred or double vision
• loss of balance
• a seizure

How is a headache diagnosed?

Your doctor can often diagnose your headache type by talking to you about your symptoms and examining you.

It’s helpful to keep a headache diary in the weeks leading up to your appointment. It can help you track when and how often you get headaches and what might trigger them.

Your diary should record:

• the number of days you have a headache
• how severe your headache is
• any other symptoms associated with your headache
• any potential triggers

It is important you let your doctor know how your headache affects your day-to-day life and the impact it has on your family, work and activities.

In most cases, there’s no need for any tests. However, if your doctor suspects there might be another health problem causing your headaches, they may ask you to have:

• an eye check with your optometrist
• blood tests
• a CT or MRI scan of your head
• a lumbar puncture

Your doctor may refer you to a neurologist — a specialist doctor who diagnoses and treats conditions of the brain, spinal cord and nerves.

How are headaches treated?

Although there is no complete cure for a headache, there are several helpful treatment options available.

If your headaches are mild and don’t occur often, it may help to try:

• lying down in a dark, quiet room
• sleeping
• placing a cold or warm cloth on the back of your neck or on your forehead
• taking a walk outside in fresh air
• having a drink of water
• stretching your neck muscles
• over-the-counter pain relief medicines like paracetamol, ibuprofen or aspirin — but don’t give aspirin to children under 16 years

If your headaches are more severe or occur often, a visit to your doctor is a good first step. Finding out the cause of your headache will help you work out the best way to treat it.

Treatment options may include:

• relieving stress
• avoiding triggers
• neck exercises and massage
• over-the-counter pain relief medicines
• other medicines that need to be prescribed by a doctor

You may need to try several different treatments before you find what works best for your headache.

Can headaches be prevented?

Lifestyle changes can help you avoid triggers and prevent headaches. You might want to try:

• eating healthy food regularly and avoiding any trigger foods you have identified
• drinking enough water
• working on good posture
• exercising regularly
• techniques for managing your stress
• getting the right amount of sleep every night
• limiting alcohol and caffeine

There are also several preventive medicines and other treatments available. If you get headaches frequently, ask your doctor about whether these may be appropriate for you.

Complications of headache

Some people who use pain medicines often to treat headaches may experience ‘medication overuse headache’. This feels similar to a tension-type headache or a migraine. Your doctor or pharmacist can guide you on how to use your pain medicines safely.