Headache

What causes headaches?

Most people who suffer from regular headaches have either migraine or tension headaches.
Headaches can occasionally be caused by diseases involving the teeth, sinuses or eyes. In rare cases, headaches can be caused by diseases affecting the brain - including infections, tumours and bleeding.
There is some evidence that taking more than the recommended amount of some painkillers may cause headaches. Food additives can sometimes cause headaches.

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What is migraine?

A typical migraine causes quite a severe, throbbing headache affecting only one side of your head. You may feel sick and find that bright light or moving around makes your headache worse. Before your headache starts you may see flashes of light or experience some other sensation for a few minutes, which acts as a warning that a migraine is coming on. A migraine may last from a few hours to two or three days. You should feel perfectly well between migraine attacks. Not all migraines happen in this way and they vary from person to person.
Migraines may run in your family. They may start in childhood or later in life and you may have migraine attacks for many years.

Common triggers for a migraine attack include:
• Hormonal changes in women, eg menstruation and the menopause.
• Caffeine and some foods, such as chocolate and some cheeses.
• Psychological factors, such as anxiety and extreme tiredness.
• Environmental changes, eg bright light or changes in the weather.

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What are tension headaches?

This is the commonest type of headache, but the link with stress is not clear. A tension headache is usually less severe than a migraine, and affects both sides of your head. It feels like a tight band or a weight pressing down on your head. Tension headaches may come and go over days or weeks.

When should I see my doctor?

If you are having headaches more than twice a week, it is worth seeing your doctor. Your doctor may recommend that you keep a record of your headaches to help with diagnosis and to find out if there are any triggers which may bring on your headaches or migraine.
You should see your doctor urgently if you have a headache together with slurred speech, numbness or dizziness, blackouts or persistent vomiting. You should also see your doctor if you start having frequent headaches over the age of 50 or if your headaches are getting worse and will not go away.

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Will I need any tests?

Often the cause of your headache will be clear to your doctor from your description and a simple examination in the surgery. You may need tests to rule out other illnesses that can cause headaches. These may include blood tests, X-rays and special scans. Your doctor may refer you to a hospital specialist if the diagnosis is not clear.

What treatments are available?

For tension headaches treatment with simple painkillers, such as paracetamol or ibuprofen which can be bought from the chemist, may be all that is needed.
For migraine you may need something to take at the start of an attack, before you begin to feel sick. For mild migraine your doctor may recommend a simple painkiller and some medicine to stop you being sick. For more severe attacks you may need one of the newer migraine-specific treatments.
Your doctor may prescribe other treatments which need to be taken daily to prevent migraine attacks, or make them less severe. Generally, these need to be taken for at least 6 to 12 months to control the attacks.
Some people say their headaches are helped by complementary therapies, eg acupuncture or yoga.

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Help yourself

• Keep a diary, recording each headache, what may have caused it and what helped to relieve it.
• Avoid things that you know will trigger a headache.
• Take regular exercise, eg a brisk walk or swim, for 20 minutes three times a week. This may help to prevent headaches.
• Try to manage stress better.
• Do not take more than the recommended amount of painkillers or tranquillizers.

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Further information

This factsheet supported by Zeneca

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