Common headaches are very normal and most people will experience them at different points throughout their life, but other types of headache can become more problematic.

Neuraxpharm provides medication alternatives for headache and once your doctor has determined your specific needs, they can prescribe the product that best adapts to your needs and condition.

Learn about the different types of headache, their symptoms and how to deal with them.

What is a headache?

As the name suggests, headaches involve pain in the head. The severity and exact location of the pain will vary depending on the type of headache you’re experiencing. Some headaches may also affect the eyes, neck and face, and they can also be accompanied by symptoms such as nausea and sensitivity to light.

What are the main types of headaches?

Broadly speaking, headaches fall into two categories – primary and secondary headaches. In primary headaches, the headache is the actual condition – this is the most common form, accounting for over 95% of all headaches1. Secondary headaches mean that there is another disease or condition causing the headache, such as a brain tumour or an infection of the central nervous system, such as meningitis or encephalitis. The main types of primary headache are:

  • Tension headache – the common ‘everyday’ headache that most people experience, also known as tension-type headache (TTH). These are generally nothing to worry about and usually pass within a few hours.
  • Migraine – a migraine usually affects one side of the head, but the pain can also affect the front or both sides. This is an intense headache that can last for hours, or even days, and is often accompanied by nausea, vomiting and sensitivity to light.
Hormonal changes can also be a cause of headaches, especially in women. These can occur as a result of the natural drop in oestrogen around the time of menstruation or happen during pregnancy and the menopause when hormone levels are disrupted. The link between headaches and hormones in men is less clear, but some research2 suggests that oestrogen and testosterone levels could play a part in migraines experienced by men.

How many people have headaches?

Global statistics show that headaches are incredibly common. According to the World Health Organization (WHO), it’s estimated that half to three quarters of adults aged 18–65 have experienced a headache in the last year. Of those, 30% or more have had a migraine. Chronic headache (experienced on 15 or more days each month) affects 1.7-4% of the world’s adult population.

Symptoms

All headaches involve pain in some part of the head, but the specific symptoms you experience will depend on the type of headache you have.

What are the symptoms of headaches?

Some headaches cause a simple aching feeling in part of the head; others are more intense and are accompanied by other side effects. Here are the main symptoms to look out for:

Tension headache:
  • Involves a dull, aching pain in the head
  • Can be accompanied by tightness and pressure around the forehead and behind the eyes
  • May also include tightness in the neck
Migraine:
  • Often starts as a dull ache and develops into throbbing pain
  • Lasts for around four hours, but can go on for days
  • Often accompanied by nausea or vomiting
  • Many people develop sensitivity to light
  • Can be accompanied by an ‘aura’, or certain warning signs that indicate a migraine is coming, such as seeing flashing lights or wavy lines, or getting tunnel vision
Cluster headache: This is a rare type of primary headache that tends to affect people in their 30s and 40s. The main symptoms are:
  • Usually, a severe pain on one side of the head
  • Can feel like a burning, sharp or piercing sensation
  • Often comes on suddenly with no warning
  • May include pain around the eye, temple and face
Other possible symptoms include a watery eye, drooping or swelling in one eye and a blocked or runny nose in one nostril.

What are the stages of headaches?

Some headaches, such as cluster headaches, come on suddenly, while others like migraines can build up slowly. People who experience regular headaches often find it helpful to keep a headache diary and note down when each headache happens, how they felt beforehand and what symptoms they experienced. This can help to identify any common factors that could be affecting the headaches.

What are the early signs of headaches?

People who experience migraines are most likely to notice early signs. These include:

  • Being more sensitive than usual to light, sound, or smell
  • Feeling tired
  • Change in appetite or feeling very thirsty
  • Mood changes
  • Bloating, constipation or diarrhoea

Migraines may also be accompanied by an aura, which is a term used to describe symptoms that appear before a migraine, acting like a warning. These can include:

  • Seeing flashing lights, black dots or wavy lines 
  • Hallucinations (seeing things that aren’t there)
  • Developing tunnel vision or losing vision for a short time
  • A tingling or numb sensation on one side of your body
  • Ringing in the ears
  • Changes to your speech, smell, taste, or touch

Causes, risk factors and life expectancy

Primary headaches, such as tension headaches and cluster headaches, aren’t caused by another condition, but secondary headaches are a result of something else like an infection, allergy or sickness and can be more serious. Most primary headaches are harmless and come and go through people’s lives, but some – especially migraines – can have longer-lasting effects. Research by Harvard Medical School3 shows that people who experience frequent migraines are more likely to have other health issues, such as anxiety, depression, insomnia and irritable bowel syndrome. Other research suggests that migraines are associated with an increased risk of heart attack and stroke.

What causes headaches?

Tension headaches are primary headaches, so they are not caused by another condition, but there are certain factors that are thought to trigger them. These include stress and anxiety, dehydration, missing meals, bad posture, squinting and a lack of exercise.

Cluster headaches are also primary headaches. It is thought that people who smoke are more at risk of getting them, and they can also be triggered by drinking alcohol or by strong smells like petrol or paint.

Doctors are still unsure about the exact causes of migraine but they think it could be related to temporary changes in the chemicals, nerves and blood vessels in the brain. Some people find that their migraines are related to certain factors such as their menstrual cycle, diet, tiredness or stress.

Are headaches hereditary?

It’s thought that some types of headache could be hereditary. Around half of people who experience migraines have a close relative who also gets them, suggesting that there may be a genetic link. Similarly, genes can play a role in cluster headaches, with research showing that genetic factors are involved in around 10% of cases4.

Who gets headaches?

Migraines tend to affect more women than men. They can come on at any age, but they seem to be more problematic in middle age and ease off in the later stages of life.

Tension headaches are also more common in women and affect teenagers and adults the most. Cluster headaches are rarer and affect smokers more than non-smokers.

How long can you live with headaches?

Headaches are not life-threatening but they can affect your quality of life.

Most people’s experience of tension headaches is episodic, which means that they get them from time to time, but they can be chronic – when they are present for more than 15 days in a month.

Migraines can have a bigger impact on daily life, especially for people who suffer from regular, long-lasting migraines. The same goes for cluster headaches, which cause intense pain over a prolonged period of time. However, most people are able to find treatments to help reduce the symptoms.

Diagnosis

It’s not always necessary to get a diagnosis for headaches. Most people who experience tension headaches are able to deal with them without professional medical help; diagnosis can help people who get regular migraines.

If you think you have had a cluster headache it’s important to see your doctor straight away. They may recommend a brain scan to rule out other conditions that can have similar symptoms to cluster headaches.

How are headaches diagnosed?

It can take time to diagnose migraines as they are often unpredictable. Doctors will examine your vision, reflexes and coordination and ask you questions about your symptoms. If you have kept a migraine diary it can help them to spot any patterns and be a useful tool for the doctor to make a firm diagnosis.

It’s easy to keep a migraine diary – simply draw up a table so that you can note down any of the following information whenever you experience a migraine:

  • When the migraine happened
  • How long it lasted for
  • The type of pain you experienced, and whether there were any other symptoms, such as being sick
  • Whether you took any medication or treatments that day
  • What you ate and drank that day
  • Whether you took any vitamins or supplements
  • Other factors that may be relevant, such as the weather, menstrual cycle for women, stress factors and social or work activities

With cluster headaches, the doctors will ask you a range of questions about the symptoms you’re experiencing. If they carry out a brain scan, they will expect it to come back as normal. If you are diagnosed with cluster headaches, you may see a neurologist (brain and nerve specialist) to discuss your treatment options.

It can be difficult to tell primary and secondary headaches apart and doctors may need to take some tests if they’re unsure. These could include blood tests to check for other conditions, as well as MRI scans and CT scans to get a better picture of what’s going on inside the brain.

Tests to diagnose migraine

There are no specific tests to tell if you are getting migraines, but sometimes doctors will want to do tests to rule out other conditions with similar symptoms. These may include blood tests, MRI scans and an electroencephalogram (EEG).

Treatment and medication

The good news is that most types of headache can be successfully treated. A range of medication is available, and often making changes to your lifestyle can make a big difference, too.

How are headaches treated?

Depending on the type of headache you’re experiencing, you may need to try a combination of approaches, to see what works best for you.

Medication

Headache treatment falls into two main categories:

  • Prophylactic medication: this is also known as preventive treatment. It is most appropriate if you are having at least three migraines every month or at least eight headache days per month5, but it can take several months before it works properly.
  • Acute medication: this is medication that is taken at the time of the attack to stop or greatly reduce the pain. It includes over-the-counter painkillers and prescription medicines.
Over-the-counter painkillers are usually effective at treating tension headaches. Make sure you follow the instructions on the packet if you choose to take any medications.

If painkillers aren’t working or if you find yourself needing to use painkillers repeatedly, talk to your doctor. They may prescribe other medication, including some which are designed specifically for migraines.

Another possible medication for migraine is anti-sickness medicine, or anti-emetics. Some people find that these help their migraines, even when they don’t experience feeling or being sick (nausea or vomiting) as a side effect.

Remember that all medication may have side effects. It’s a good idea to talk to your doctor before you start any new medication.

Over-the-counter painkillers aren’t usually effective for cluster headaches, but your doctor may be able to offer different medication. Injections or nasal spray treatment options are also available, both of which can be administered by yourself at home. Talk to your doctor for further advice.

Diet

Altering your diet may be useful as part of a wider approach to lifestyle changes to help alleviate headaches. As a general rule, try to stick to a healthy, balanced diet and eat at regular times.

A number of dietary factors can trigger headaches, including fasting, eating high-sugar foods, extreme dieting and missing meals. For some people, delayed or irregular meals can also make a difference as they can cause blood-glucose levels to fall. Caffeine, alcohol and cheese can also play a part.

Again, keeping a headache diary (which includes details of everything you have consumed) will help you to identify any foods that may affect your headaches. 

Certain dietary supplements, including vitamins, minerals or herbal preparations can also be considered. For example, magnesium may contribute to normal functioning of the nervous system and to energy-yielding metabolism, while some botanicals may help to reduce tension states localised to one area or promote relaxation6.

Therapy and interventions

Studies have found that acupuncture can help to lessen the effects of migraine in some people. In one study7, when patients were given 12 treatments over the course of three months it resulted in 34% fewer headache days.

Green light therapy has also been found to be beneficial for migraines8. This involves spending time in a specific, narrow band of green light from a special lamp while filtering out all other light. It’s important to use this therapy properly, as other colour lights, including white, blue, amber and red, can exacerbate migraines.

Oxygen therapy is another treatment you may be offered for cluster headaches. It works by breathing in air containing higher levels of oxygen than normal through a mask or tube, and it can be set up in your home.

Tension headaches can be eased by reducing stress, so relaxation therapies such as massage can be a good treatment option if you’re experiencing these headaches regularly.

Transcutaneous vagus nerve stimulation (TVNS) is a treatment that is sometimes used to treat cluster headaches. It stimulates a nerve in the neck with low-voltage electrical currents in order to relieve pain and as a preventative method to help reduce the frequency of cluster headaches.

Exercise

As stress and poor posture are two of the main causes of tension headaches, exercise can be extremely beneficial in helping to treat and prevent them. Yoga is especially recommended as it works on posture and relaxation.

The link between exercise and migraines is more complex. Some people find that exercise can trigger migraines, while others say it is beneficial. As with tension headaches, the main benefit of regular exercise is that it helps to reduce stress, which is a very common trigger for migraines.

Prevention

There is no definitive way to prevent headaches but many of the treatments mentioned above can also be used as preventative methods to help stop them reoccurring.

Lifestyle factors such as taking regular exercise, following a healthy diet and taking measures to reduce stress, as well as reducing your alcohol consumption and giving up smoking, are all recommended as preventative measures for headaches.

Many people who suffer from migraines find that by gaining a better understanding of the factors that can trigger a migraine, they can take steps to prevent them from happening so frequently. One of the best ways to do this is through a migraine diary that can help to show whether a certain food, or something like stress or a lack of sleep, is triggering an attack.

Certain drugs have been shown to help prevent migraines in some people but they may not be suitable if you have other health problems and should only be prescribed by your doctor.

Scientific studies

Headache is one of the most common forms of pain and a well-used reason given for days missed from work and education, so it’s not surprising that research into the causes and treatment of headaches is rife. In the past five years there have been notable strides made in headache medication. These have included clinical trials of new medication to treat acute migraine and non-drug therapies including magnetic stimulation, and non-invasive vagus nerve stimulation (nVNS), also for the treatment of migraine9. Research has also shown the importance of understanding the premonitory phase of migraine, when symptoms such as yawning, tiredness, cognitive dysfunction and food cravings can occur. It’s thought that this may help explain to migraine triggers in some people and allow them to self-manage their condition more effectively.

Referenced sources

  1. Ahmed F. Headache disorders: differentiating and managing the common subtypes. Br J Pain. 2012;6(3):124-132. doi:10.1177/2049463712459691
  2. Van Oosterhout WPJ, Schoonman GG, van Zwet EW et al. Female sex hormones in men with migraine. Neurology. 2018;91(4):e374-e381. doi:10.1212/WNL.0000000000005855 
  3. Harvard Health Publishing – Harvard Medical School. The health risk of migraines in men. Accessed December 2020. https://www.health.harvard.edu/mens-health/feel-your-pain-the-health-risk-of-migraines-in-men
  4. Leroux E, Ducros A. Cluster headache. Orphanet J Rare Dis. 2008;3:20. doi:10.1186/1750-1172-3-20
  5. Kumar A, Kadian R. Migraine Prophylaxis. In: StatPearls. StatPearls Publishing. Updated October 27, 2020. Accessed December 2020. https://www.ncbi.nlm.nih.gov/books/NBK507873/
  6. Sun-Edelstein C, Mauskop A. Foods and supplements in the management of migraine headaches. Clin J Pain. 2009;25(5):446-452. doi:10.1097/AJP.0b013e31819a6f65
  7. Vickers AJ, Rees RW, Zollman CE et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. BMJ. 2004;328(7442):744. doi:10.1136/bmj.38029.421863.EB
  8. Noseda R, Bernstein CA, Nir RR et al. Migraine photophobia originating in cone-driven retinal pathways. Brain. 2016;139(7):1971-1986. doi:10.1093/brain/aww119
  9. Goadsby PJ. Primary headache disorders: Five new things. Neurol Clin Pract. 2019; 9(3): 233-240. doi:10.1212/CPJ.0000000000000654
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