Most people will be familiar with the throbbing discomfort of a headache. From a bout of the flu to a sore head after a night on the town, it’s perfectly normal to experience pain in your head every once in a while.
There are many different types of headache, which can impact one or more areas of the head and range from mild to severe pain. Different types of headache have their own set of symptoms and happen for unique reasons. Identifying your headache type could help you select the appropriate treatment and ease the discomfort faster.
Headaches can be painful and annoying, but experiencing one is not typically a sign of anything more serious and (unless you suffer from persistent pain) can usually be relieved by over-the-counter medicine or simple lifestyle changes.
Headaches have no singular cause, but they generally fall into two general categories:
- Tension headaches
Tension headaches are the most common type of head pain. They can occur in people of either sex and at any age, but are most common in adults and adolescents. Also known as primary headaches, this type of headache typically occurs in isolated incidents and is not caused by an underlying health condition, but can become chronic.
Pain is often felt in the generalised area of the head and neck and is sometimes accompanied by muscle tightness in the back of neck. Possible causes of muscle contraction associated with tension type headaches include stress, fatigue, poor posture, eye strain, sensory overstimulation including loud noises and bright sunshine, tobacco, excessive alcohol consumption and hormonal changes.
Tension headache treatments
If you suffer from isolated tension headaches, you should be able to manage symptoms with over-the-counter pain relief and anti-inflammatories (such as paracetamol or ibuprofen). Relaxation techniques and ensuring you get enough sleep can also help.
If you experience chronic headaches, nausea and vomiting, convulsions, loss of feeling in your arms and legs, or any severe and unusual symptoms, you should contact your GP immediately.
What causes migraines?
The underlying problem that leads to migraines is still not clear, but experts believe migraines are the result of a series of complex changes in the nerves, blood vessels and chemical signalling within the brain.
Migraines affect three times more women than men and are often chronic. In extreme cases, they can seriously disrupt a person's life. Various factors are thought to trigger migraines, including family history, lack of sleep, certain foods and the menstrual cycle, to name a few.
Migraines typically bring about a throbbing pain on one side of the head with an associated feeling of sickness and sensitivity to light and sound. However, there are various types of migraine.
What are classic migraine symptoms?
Migraine symptoms tend to follow four stages:
➡️ Prodrome: this occurs hours and sometimes even days before the onset of head pain. Prodromal symptoms include feeling unwell, low mood, exhaustion, changes in appetite, cravings, yawning and temperature changes in the extremities (such as hot ears or a cold nose).
➡️ Aura: one in three people experience an aura before a migraine – a warning symptom just before the headache starts, lasting 10 to 15 minutes. The aura can include visual symptoms such as flashing lights.
➡️ Headache: the headache phase can be the most debilitating aspect of a migraine attack, with the pain ranging from mild to severe. Symptoms can also affect other body parts.
➡️ Postdrome: similar to a hangover, many migraine sufferers feel exhausted, low in mood and lack concentration following a migraine.
What migraine treatments are available?
There are various treatments available for relieving acute migraine attacks, starting with simple over-the-counter (OTC) painkillers such as paracetamol or ibuprofen. These are most effective if taken as early as possible into the attack, preferably in a soluble form.
Some OTC medicines designed specifically for migraine also contain an anti-sickness medicine such as cyclizine.
If OTC painkillers are ineffective your doctor may prescribe alternative treatments containing different anti-sickness medicines, stronger painkillers, or one of a group of antimigraine medicines called triptans, eg sumatriptan (Imigran) or zolmitriptan (Zomig) which are not painkillers but work on blood vessel changes which occur in migraine.
Sumatriptan can now be bought OTC under the guidance of a pharmacist, but triptans don't work for everyone so speak to your GP for advice.
NICE (National Institute for Health and Care Excellence) has recently approved a new treatment for migraine called transmagnetic stimulation (TMS). This involves holding a small electrical device to your head which delivers magnetic pulses. Although it’s not really clear how this works, it does seem to reduce the severity of symptoms. For now, it is only available in specialist centres.
⚠️ If you suffer from frequent and severe migraines, speak to your GP about referral to a specialist migraine clinic.