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Headaches

What is a headache?

Headache is a symptom

Headache is one of the commonest symptoms experienced by human beings - indeed it is unusual not to have at least occasional headaches.

When we say it is a symptom, we mean that it is not a disease but a change which we notice in the body.

Types of Headache

Tension-type headaches

Tension type headaches are the most common type of primary headache. Many people have 1 or 2 headaches of this type every month. Sometimes they develop more frequently, typically during times of stress.

•Tension-type headaches usually last only a few hours.

•They are more frequent in women compared to men.

Cluster headaches

These begin quickly and are one-sided, short-lived, excruciatingly painful headaches.

•They can recur frequently for several weeks and then subside, but another bout may develop later. Sleep is often disrupted, with the headache causing you to wake up at the same time each night.

•Approximately 80% of people who have cluster headaches are men.

•It is fairly rare, affecting around 1 in 1000 people.

Headache or Migraine?

Migraines are different from tension-type and cluster headaches, and usually cause symptoms of sickness or nausea in addition to a severe, one-sided, throbbing headache.  However, some people experience both migraines and tension-type headaches.

Migraine Information

Tension Headache Symptoms

•Mild or moderate pain and felt as a pressure (tightness) on both sides of the head,

•Constant and pressing pain (can be described as a tight band around the head) and can build gradually throughout the day,

•The pain is not aggravated by routine physical activity,

•There may be a feeling of pressure behind the eyes and a tightening of the neck muscles,

•No symptoms of nausea or vomiting or an unusual sensitivity to light or sound,

•Usually last a few hours or so, and

•The headache normally comes on during the day.

Cluster Headache Symptoms

•The pain is extremely severe but the attack is relatively short, lasting no more than an hour or two

•The pain starts quickly, without warning, and is often described as excruciating,

•The pain always affects one side of the head, is centred around one eye, and generally affects the same side in subsequent attacks

•inflammation and watering from the eye

•The attacks of pain are clustered in groups (often 1 to 3 attacks per day, although there can be more) that usually last for a few weeks to a couple of months, and are usually followed by a pain-free gap.

The headaches often occur at the same time each day during a cluster, with many people saying that they are being woken within around 2 hours of going to sleep, at the same time each night.

Or they are woken early in the morning. However, they can also occur during the daytime.

Causes of Tension Headaches

The cause of tension-type headaches is not clear, however they are thought to be triggered by certain situations, such as:

Causes of Cluster Headaches

Cluster headaches seem to be triggered in some people by examples of triggers include:

Diagnosis

Keep an headache diary.  Each time you have a headache, make a note of how bad it is, where the pain is, any other symptoms, and what you were doing at the time.  You may see a pattern emerge, which can help you to work out any triggers involved, and the type of headache you are getting.  

In most cases there is no need to visit your GP if you get occasional headaches.

You should visit your GP if:

•your headaches are frequent or severe,

•you have a severe headache which comes on suddenly like nothing before

•you have a severe headache which comes on suddenly, with a very stiff neck, fever, nausea, vomiting, and confusion,

•your headache follows an accident

•you also experience weakness, numbness, slurred speech, and/or confusion

Treatment

Tension-type headaches

Tension-type headaches can usually be soothed by using relaxation techniques, or using over-the-counter painkillers taken at the time of the headache.

Taking a painkiller such as paracetamol usually works well (not be taken for more than a few days at a time).

•Relaxation techniques include:

Visit your GP immediately if a severe headache lasts for more than 24 hours, and does not respond to any self-care treatment, or is accompanied by other symptoms such as blurred vision or vomiting.

Cluster headaches

Cluster headaches do not respond to over-the-counter painkillers, such as paracetamol.

However your GP may be able to prescribe you something to help.

Prevention

•Keeping a diary may be useful to determine a pattern of triggers. Triggers may include: certain foods, hunger, eye- strain, poor posture, stress, anxiety, anger etc.

•Breathing and relaxation exercises in stressful situations

•Regular exercise often eases stress and tension and can reduce the frequency of headaches.

•Avoidance of all alcohol during headache periods may reduce headache frequency.

•An extreme increase in temperature can trigger a cluster headache, so avoid exercising in hot weather

For more information on headaches...

NHS

Brain and Spine Organisation

Family Doctor