​​Headaches can be caused by parts of the brain (usually the coverings) or by the elements protecting it (commonly the skin and muscle). The exact cause of many headaches is uncertain. Headaches are very common.

They can be a symptom, a more global problem such as colds and flu or can be an isolated phenomena drug symptom. Headaches in their entirety are one of the most common reasons why people visit their GP. Fortunately serious causes for these headaches are extremely rare, even more so if you have suffered with headaches for many years. 

Treatments

Tension headaches

These are probably the most common form of recurring headaches. It is thought that they are caused by tightening of the muscles which cover the scalp. Patients often describe it feels like a band tightening around their head, often at the front and just above the ears. Pain can sometimes stretch down to the neck and shoulders. Patients may experience tension headaches, they vary frequently (every day) or they may occur in small groups around particularly stressful situations.


​Migraine headaches

These are another common form of headache and because of their associated symptoms often prompt review with the doctor. They are usually single sided but any individual can experience a headache on one or other side during different attacks. They commonly are associated with symptoms of nausea and a dislike of the light. Patients often describe their need to lie down in a darkened room and go to sleep to allow the migraine to pass off. Less commonly may be frank vomiting and the eye symptoms may be more specific, such as flashing lights or zigzag lines. If there is a section of your vision missing it is an important sign that should be discussed with your doctor. Or rarely still, may be symptoms beyond the head such as pins & needles in arms or legs, numbness, weakness or altered speech. All of these symptoms should prompt review with your GP.

Migraines may be very frequent (every few days) or very rare (an individual experiencing only one or two). Approximately 10% of the population will experience a migraine at some time in their life. They seem to have a family tendency and so patients may know relatives who have similar symptoms.


Cluster headaches​

This is a rare form of migraine like headache. What differentiates these headaches is that they always occur in small groups. The headache may last several hours and are extremely intense. The cluster may last for several days and then there may be a period of several weeks before headaches recur again. In addition they have associated symptoms such as crying, runny nose, redness of the eye, blocking of the nose or sweating (any of these symptoms can occur and in any combination). At the time of the headache the patient is usually incapacitated.


Sinus headaches

This type of headache may be either recurring or a one off. Commonly patients experience pain in the temple region just above their eyes or in their face. They are caused when the, usually hollow, sinuses (which are airs spaces in the face bones) are blocked up. This leads to a build up of pressure and sometimes mucous. This can be related to infection such as a cold and may also be allergic, such as with hay fever.


Non-recurring headaches

Headaches are a common feature of any body illness, for example, coughs, colds, flu or other types of infections. The other symptoms do not have to be within the head region to still lead to headache as an additional symptom, such as urine infections. Often the cause in these cases is the temperature that goes along with the primary diagnosis.

Uncommonly serious infections and acute illnesses may also present with a headache, eg meningitis. If you are looking up this information because you have experienced the recent onset of a headache and you think it may be part of a serious illness such as meningitis you should look at this part of our website first.

Headaches on their own without any other physical symptoms are rarely caused by serious disease, even when that potential disease is in the head itself eg a brain tumour.

Trauma and accidents are an obvious cause of headache. As a general rule, if you have an accident and lose consciousness you should be assessed by a doctor. If you have either been assessed or did not require at the time and then developed confusion, change in your conscious level while vomiting or loss of other functions (such as limb functions) then you should seek medical attention.


Recurrent tension headaches

​​Though they could be treated with medication, should really be addressed by looking at their cause in attempting to deal with it. If this is not possible it may be worth discussing preventative medication such as Amitriptyline with your doctor (these medications are a tricyclic antidepressant drug that is used in a much lower dose that is used for depression).

Headaches can be caused by medication. If you develop headaches after starting a new medication from your doctor you should return and discuss the medication with them. In general it would not be a good idea to stop that medication, though if you are concerned you could discuss the safety of this first of all with NHS Direct.

Occasionally headaches can actually be as a direct result of overuse of headache medication/pain killers. It is an uncommon situation and should be discussed with your doctor.

Any form of stress can lead to tension headaches. Therefore relaxation and the prevention of stress are the key keys to reducing tension headaches. Relaxation can take any form that is appropriate for you. May be the use of specific techniques such as relaxation tapes or techniques such as tapes or meditation.

It may be more simple than that, to start the sport that you used to enjoy or make time to read a novel. These things appear simple though are accepted as being very difficult in our otherwise very busy lives. You have a choice between your symptoms and your lifestyle.

Alternative therapies can work very well for some patients, individuals must assess these and on their response and their own personal circumstances (for example massage, aromatherapy and reflexology).

As described above, there can be some triggers or provoking factors to headaches. The following list is by no means exhaustive and it is a good place to start:

  • Alcohol - This can be from both the additives in it and also dehydration the following day.
  • Caffeine - Reduce your coffee/tea intake and any other drinks (or painkillers) that may include caffeine.
  • Missing meals - If your body is short of glucose/sugars it will develop a headache as the brain uses this as an energy source.
  • Teeth grinding - This is a symptom of tension, which often leads to headaches that are felt in the morning.
  • Emotions - If you are distressed and have low mood this will often be felt as an accompanying headache.
  • Neck and shoulder pain - Common to all areas of the body if you have neighbouring pain nearby muscle groups will also tighten up and lead to discomfort in that area.
  • Food intolerance - Particularly relevant to migraines. Occasionally food can trigger headaches. You should be careful when assessing any potential food intolerance and only exclude one item at a time. Try reintroducing it after a period of no symptoms to just challenge whether it was indeed the trigger for the headache. Examples include cheese, caffeine, alcohol, chocolate.
  • Hormones - Some women find that either their own natural hormones through the month cause them headache or hormones they are prescribed. You should discuss both possibilities with your doctor.
  • Medication - As described above, any medication you feel may be leading to headaches should be discussed with your doctor. 

Types of headaches

Common types of recurring headaches

Simple headaches where the cause is either known or unknown but do not fit in to any of the concerning categories above should be treated with painkillers bought at the chemist.

The most common of these would be Paracetamol, Ibuprofen or low dose Codeine. Paracetamol gives very few side effects, is usually very cheap and is suitable for nearly all patients. This should be your first line medication. Do not think because it is cheap it is not effective.

Second line would be Ibuprofen. You should discuss this medication with the pharmacist if you suffer with asthma, kidney disease, stomach ulcers in the past or any form of inflammatory bowel disease.

Codeine can lead to a few more side effects and therefore may be reserved if you have already tried some of the others or have been specifically suggested this medication by your doctor or nurse.

There are more specific preparations for headaches such as migraine and sinus pain. Some of these help with the additional symptoms that may accompany these type of headaches.

When suffering with headaches on a frequent basis there may be medication that you can take to prevent them and these should be discussed with your doctor.

Headache

University of Lincoln Health Service ​​

Prevention Techniques