Headaches: what you need to know

Most of us get occasional headaches, but for some people they’re extremely disabling. Follow our guide to the different types and causes, plus how to manage them

Written by Madeleine Bailey on February 21, 2019 Reviewed by Dr Rob Hicks on March 2, 2019

Most of us get headaches occasionally. In fact, they’re one of the world’s most common nervous system disorders: around half of adults have had a headache in the last year, according to the World Health Organisation. For some, headaches are only mild, but for others, they can dramatically interfere with your quality of life.¹ Find out why they happen.

What is a headache?

A headache is a pain that occurs in any part of your head. It may be dull, sharp, throbbing or vice-like, start suddenly or gradually, and last from minutes to days.² Most headaches will go on their own, and don’t indicate a serious health problem.³ Headache pain is caused by irritation of, or problems with, head or neck muscles, nerves, or blood vessels. Changes in your brain chemistry can also trigger headaches.⁴

Who gets headaches?

Only a lucky 5% go through life headache-free, according to a 2012 Hull Royal Infirmary study. Headaches can affect people of all ages, although more women experience them than men.⁵

The most common types of headache

If you’ve got a headache, it’s most likely one of the following:

Tension-type headache

Affecting around seven in 10 people,⁶ these feel like a tight band around your head, usually with mild to moderate pain, but the pain can be intense for some people. Tension headaches are usually triggered by emotional stress or muscle tension, for example from poor posture.⁷

Migraine

This severe throbbing pain, most often felt on one side of your head, is often accompanied by other symptoms, including nausea, vomiting and sensitivity to light or sound. Migraines affect around one in five women and roughly one in 15 men, and – while the exact cause is still unknown – it’s thought to involve temporary changes in brain chemicals, blood vessels, and nerves.⁸

Medication-overuse headache

If you take painkillers for at least 10 days a month, for more than three months, you could be experiencing medication-overuse, or rebound, headaches. One in 50 people get withdrawal headaches as the pain relief wears off, creating a vicious cycle as you feel you need more to numb the pain all over again.⁹

Cluster headache

These excruciating, short-lived headaches affect one in 1,000 people, especially men.¹⁰ They occur in cycles – hence the name – from anything to few days to over a whole year. They are one-sided, usually in or around an eye, which may be red. Other symptoms include a blocked or runny nose, droopy eyelid, restlessness and a sweaty face.¹¹ It’s not known what causes cluster headaches but it’s thought to involve the hypothalamus gland in the brain, which plays a role in many body functions.¹²

Common headache triggers

Reckon you know when a headache is coming? Here are some common causes:^13,14

• colds or flu
• stress
• eyestrain
• dehydration
• alcohol
• seasonal allergies, like hay fever
• poor posture
• physical exertion, including coughing and sex
• skipping meals
• hormonal changes

How to prevent headaches

If you’re prone to headaches, keep a headache diary – write down your food, drinks, medication, activities and sleep – to help spot any avoidable triggers. To avoid eyestrain, see an optician for a sight test and take regular screen breaks. Drink enough fluid to avoid dehydration, and stick to regular eating and sleeping routines.¹⁵ Also take steps to relax: a 2015 Korean study reported that yoga reduced the number and intensity of headaches. Researchers think it calms specific hormonal pathways and the nervous system, but said more research is needed.¹⁶

What are the treatments?

Common treatments include:

• over-the-counter painkillers – just be cautious of developing medication-overuse headaches
• a cold or heat pack¹⁷
• rubbing diluted peppermint oil on your temples – a 2016 report from the Kiel Migraine, Headache and Pain Centre in Germany described peppermint oil being more effective than placebo at soothing pain for tension headaches¹⁸
• prescription medication

When to seek medical advice

Talk to your GP if you get recurrent headaches, or painkillers don’t help.¹⁹ Sometimes severe headaches are a sign of serious underlying health problems, such as meningitis or stroke. Call 999 or go to A&E if a headache comes on suddenly, is the most painful you’ve ever experienced, or you’re also experiencing any of the following symptoms:²⁰

• difficulty with speech or comprehension
• vision disturbance
• confusion
• fever
• neck stiffness
• difficulty walking
• weakness or numbness on one side of the body

Advice is for information only and should not replace medical care. Please check with your GP before trying any remedies. Sources 1. World Health Organization. Headache disorders 2. Mayo Clinic. Headache 3. NHS. Headaches 4. James McIntosh. Medical News Today. What is causing this headache? 5. Ahmed F. Headache disorders: differentiating and managing the common subtypes 6. As Source 1 7. Deborah Weatherspoon. Healthline. Tension headaches 8. NHS. Migraine 9. Kristofferson ES, Lundqvist C. Medication-overuse headache: epidemiology, diagnosis and treatment 10. The Migraine Trust. Cluster headache 11. Mayo Clinic. Cluster headaches 12. NHS. Cluster headaches 13. National Headache Foundation. The complete headache chart 14. As Source 4 15. Diana Rodriguez. Everyday Health. Headache prevention 16. Kim S-D. Effects of yoga exercises for headaches: a systematic reviews of randomized controlled trials 17. National Headache Foundation. Hot and cold packs/showers 18. Gobel H, et al. Peppermint oil in the acute treatment of tension-type headache 19. As Source 4 20. As Source 2