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What are headaches?

A headache is pain experienced in any part of your head. It is a common condition, and in most cases, not a symptom of serious illness. There are many different types of headache and they can be caused by a range of different things. Headaches can occasionally be associated with serious illness or injury, and your doctor may decide you need further testing or urgent treatment.

What causes headaches?

Headaches are classified either as primary (occurring on their own and not as a result of another health problem) or secondary (resulting from another health problem).

Sometimes primary headaches can be triggered by lifestyle factors such as:

• alcohol, particularly red wine
• certain foods, such as processed meats containing nitrates
• changes in sleep patterns or lack of sleep
• bad posture
• skipping meals
• stress

Conditions that can cause secondary headaches include problems with your:

• sinuses, such as acute or chronic sinus infections
• eyes, such as glaucoma or eye strain
• teeth, including a range of dental problems
• nerves, such as shingles
• blood vessels, such as aneurysms or high blood pressure
• ear, such as middle ear infections
• medicines and their side effects

Dehydration and head injuries are also common causes of secondary headaches.

What are the different types of headache?

The International Headache Society recognises more than 200 different types of headache. The most common types of primary headache include tension-type headache (TTH), migraines and cluster headaches.

Tension-type headaches

Tension-type headache is one of the most common forms of headache. With tension-type headache, your pain is usually on both sides of the head and can last between 30 minutes and 7 days.

Migraine

Migraine is a common disorder with a range of different types, symptoms and severity. However, it is characterised by a moderate to severe headache and nausea.

Cluster headaches

Cluster headaches are a rarer type of headache but can be extremely painful. They are called cluster headaches because the attacks generally occur in groups, or ‘clusters’ usually at night or in the early hours of the morning.

How can I tell if I have a headache or a migraine?

A headache is usually felt as a tight pressure on both sides of the head and is usually not severe. A migraine includes other symptoms as well as headache. Migraine pain is usually throbbing in nature and is often worse on one side of the head than the other. If you are experiencing nausea and vomiting, sensitivity to light and/or sound or seeing bright shimmering lights, you are most likely having a migraine. Treatments for migraine and other headaches are different and so it is important that you see your doctor to get an accurate diagnosis of your headache type.

When should I see my doctor?

Headaches are common and most people will experience at least one in their lifetime. They are usually mild, but you should see your doctor if your headaches occur frequently and they prevent you from doing the things you can normally do. You should also go to see your doctor if you frequently take pain medicine for headaches.

In some cases, headaches can be a symptom of something more serious. If you experience any of the following symptoms, see your doctor as soon as possible:

• ‘thunderclap’ headache — a severe headache that comes on suddenly
• a headache that gets progressively worse over the course of several weeks
• a morning headache with nausea that doesn’t go away
• a headache with fever, change in personality, neck stiffness, double vision, ringing in the ears, loss of balance or loss of sensation
• a new headache for patients with cancer, immunodeficiency, or anyone with a family history of glaucoma
• aura (vision) symptoms that last longer than an hour, include muscle weakness, are different than usual or occur for the first time when you take an oral contraceptive pill

In many of these cases, your family doctor may decide to refer you to a specialist.

How can the doctor tell what type of headache I have?

You can help your doctor to diagnose your headache type by keeping a headache diary in the weeks leading up to your appointment. Your diary should record the number of days you have a headache, how severe your headache is and any other symptoms associated with your headache, such as nausea. A headache diary can also help your doctor look for patterns and triggers, which can help with your treatment.

It is important that you let your doctor know how your headache affects your day-to-day life and the impact it has on your partner, children, employer, work colleagues and friends.

How can my headache be managed?

Many people who experience regular headaches will recognise some of the signs that a headache is about to come on. This might be the right time to take any medicines you have been prescribed by your doctor, or purchased over the counter. It may also help to try:

• lying down in a dark, quiet room
• sleeping
• placing a cold or warm cloth on the back of your neck or on your forehead
• taking a walk in fresh air

Your doctor or pharmacist can help you work out if you need medicine for your headache and the best time to take it.

What is the best treatment for a headache?

Although there is no complete cure for a headache, there are several helpful treatment options available. It is important to have the cause of your headache diagnosed before taking any medicine, so a visit to your doctor is a good first step.

You may need to try several different treatments before you find what works for your particular headache.

If you have headaches less frequently than once every 2 weeks, simple over-the-counter medicines like paracetamol or ibuprofen may be enough. People who have more frequent headaches or migraines often need other kinds of medicines that need to be prescribed by their doctor. This may include medicines taken regularly to prevent headaches or medicines such as ‘triptans’ for migraines. If you have cluster headaches, your doctor may refer you to a specialist.

Some people who use pain medicines to treat headaches more than 3 times a week, may experience ‘medication overuse headache’. This can feel similar to a tension-type headache. Your doctor or pharmacist can guide you on how to use your pain medicines safely.

Can I prevent a headache?

Avoiding triggers will help prevent headaches, and using the right medications as prescribed by your doctor or recommended by your pharmacist is also important. You can’t avoid all triggers, so finding the right balance of lifestyle changes and medications is key to long-term headache management.

Some of the more common triggers for headaches include:

• stress
• alcohol
• caffeine
• too much or too little sleep
• bright lights
• poor work conditions
• hormonal changes (in women)

Lifestyle changes can also help to prevent headaches, including:

• eating healthy food regularly
• drinking enough water
• good posture
• exercising regularly
• managing your stress

Ask your doctor if taking vitamins or supplements such as magnesium, riboflavin or CoQ10 will help prevent your type of headache, or if you are worried that overuse of pain medicine is triggering your headache.

If you get headaches frequently, your doctor may prescribe preventive medicines for you.

Resources and support

• Explore the Headache Australia website to learn more about headaches.
• Visit the ANZ Headache Society website for some examples of headache diaries and tips on lifestyle management for headaches.
• Join the Headache Register to access the latest research and treatments for headache.
• Connect with the Migraine Warrior Support Group to find a local support group for you.