What is your headache trying to tell you?
Whether you suffer with tension headaches or debilitating migraines, the throbbing, distracting pain of a headache can be almost unbearable. Every headache has a trigger point, so we’ve mapped out four different types of headaches to look out for and what you can do about them.
Suffering with a headache is not only painful, it’s utterly distracting. Endless throbbing, shooting pains from any part of your head can throw your concentration, and your general mindset, completely out of whack. There are so many different types of headaches, and their locations, causes and symptoms can vary from person to person.
Some of the more common types of headache — like tension headaches — can affect the whole head, while others — such as cluster or sinus headaches — typically affect a more specific, localised area.
Although most are short-lived and rarely a cause for concern, it’s helpful to know how to identify the type of headache you’re experiencing, so you know your best course of treatment, or if in fact you need to see a doctor.
From tension and cluster headaches to migraines and sinus pain, here are four different types of headache explained, so you know what to look out for and how to treat them.
Migraines
Anyone who suffers with migraines will characteristically experience an intense throbbing pain on one side of the head. This pain can last for days, and can significantly limit your ability to carry out your daily routine. People with migraine headaches are often sensitive to light and sound. Nausea and vomiting are also accompanying symptoms.
How do you know if it’s a migraine and not a headache?
Although a migraine is categorised as a headache disorder, headache pain is only one of the symptoms. They can be accompanied by a variety of other symptoms, a few hours, or even a few days prior to the migraine attack. The pain is also usually a lot worse than a headache — they can range to from moderate to severe, but for those who experience severe migraines, the pain can be debilitating. Attacks can last for a few hours or even a day or more.
There are various different types of migraine headaches, but the two main types are:
1. Migraine without aura (common migraine)
The majority of people who suffer with migraines have common migraines. These cause intense, throbbing headaches which are usually on one side of the head. The pain is moderate to severe, and gets worse with normal physical activity. They can also be accompanied with nausea and vomiting, and may feel worse around light and sound.
The headache can last between 4 to 72 hours if not treated. A common migraine doesn't begin with an aura — sensory disturbances that occur before or during a migraine attack.
Many common migraines come without warning symptoms, although some people experience “premonitory phase” or “prodrome” symptoms that occur hours or days before the headache strikes.
These can include:
- unexplainable mood changes
- food cravings
- stiffness of the neck
- frequent yawning
- constipation or diarreah
- sensitivity to light, sound, or smells
2. Migraine with aura (classic migraine)
Unlike common migraines, classic migraines are associated with sensory disturbances, which are known as “auras”. These disturbances can occur up to 30 minutes before the migraine, and can include flashes of light, wavy lines, blind spots, and other vision changes, or tingling or "pins and needles” in your hands or face.
Classic migraines usually accompany all the symptoms of a common migraine, just with the additional aura phase that strikes before the headache starts.
People who have migraine episodes with auras might not experience an aura every time, and they may also experience all of the elements of a migraine attack with an aura, just without the headache.
Common migraine symptoms (both common and classic) include:
- moderate to severe pain on one side of the head
- blurred vision, seeing flashing lights, zigzag lines, stars or blind spots (this is also known as an aura, usually a preceding symptom of the migraine) heightened sensitivity to light, sound and smell
- dizziness/light-headed
- nausea and vomiting
- stress and anxiety
- lack of sleep
- hormonal changes
- skipped meals
- dehydration
- some foods (such as cheese and chocolate) and medications
- bright lights and loud noise
- notice your headache getting progressively worse
- develop muscle weakness or paralysis
- have a high temperature
- develop double vision
- experience seizures
- notice a rash anywhere on your body
What are the best migraine treatments?
The best way to manage your migraine is to identify your triggers. If you know that something sets them off, then avoiding these triggers can help you to manage your migraine attacks. Keeping a symptom diary can be helpful for working out what things, if any, trigger your migraines.
Depending on the severity of your migraine, you may be able to manage the pain with over-the-counter painkillers. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin can help to relieve mild migraine pain.
If it’s taken at the onset of symptoms, aspirin can relieve even severe migraines. Bear in mind that aspirin should not be given to children younger than 16 years.
Paracetamol may also help relieve migraine pain in some people.
Nausea and vomiting are often common symptoms of migraines, so taking an anti-nausea medicine like Anagraine, Nausetil (Procholrpherazine) will help relieve sickness, and help to absorb migraine pain relief.
For severe migraines, your GP may prescribe a specific migraine medication if OTC pain relief is not effective at treating your symptoms. Triptan tablets are widely prescribed, but you could also get it as a nasal spray or shot. Most people feel better within 2 hours of taking it.
Triptans are not suitable for people with uncontrolled high blood pressure, coronary heart disease or blood vessel disease. It's important that your doctor knows what other medicines you take. Some drugs, even complementary ones, can interact with triptans and cause severe problems.
Tension Headaches
Tension headaches are the most common type of headache, often triggered by stress. Most people experience them occasionally and they present themselves as a dull, constant pain felt on both sides of the head, or tightness or pressure around your forehead or the back of your head and neck. Some people say it feels like a clamp squeezing their skull. They’re also called stress headaches.
There are two types of tension headaches:
Episodic tension headaches — happen fewer than 15 days per month, and can last from 30 minutes to a week.
Chronic tension headaches — happen more than 15 days a month. They could last hours and may be continuous. If your headaches occur 15 or more days a month for at least three months, they're considered chronic.
- Dull, aching pain on both sides of the head
- tenderness of the face, head, neck, and shoulders
- a feeling of pressure behind the eyes
- sensitivity to light and sound
Other potential tension headache triggers include:
- dehydration
- loud noise
- lack of exercise
- poor sleep
- bad posture
- skipped meals
- eye strain
- cannot control your headache with medication
- experience muscle weakness or paralysis
- feel confused or disorientated
- develop slurred speech
- feel nauseous or start to vomit
What are the best treatments for tension headaches?
Over-the-counter painkillers, such as paracetamol, aspirin, and non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac, ibuprofen and naproxen, are often the first treatments for tension headaches. It’s best to take them when your headache first comes on.
There are also combination medicines available that can help relieve tension headaches. These medicines contain paracetamol plus either ibuprofen or caffeine. These painkillers can be useful if your headache has not responded to other treatments. People with chronic tension headaches can also use some of these drugs, however, they shouldn’t be used frequently as they can lead to what’s called a medication overuse or rebound headache.
If you do suffer with chronic headache pain, visit your doctor for further diagnosis. They may prescribe antidepressant medicines to treat more severe symptoms.
As these headaches are mainly caused by stress, it can also be helpful to practice some stress management techniques such as cognitive behavioural therapy, regular exercise, and relaxation techniques such as yoga, meditation and breathing exercises.
You should also limit your alcohol, caffeine and sugar intake, and ensure you drink plenty of water to keep you hydrated. Dehydration can often lead to headaches.
Cluster Headaches
Cluster headaches are severe, recurring headaches that occur around or behind one eye or on one side of the face at a time. The term ‘cluster’ is used because the attacks occur in groups – typically they’ll happen for several weeks once or twice a year, often at the same time of the year.
People who get them find they have frequent headaches over the course of a few weeks or months, then they won’t have any for a long time. For few, headaches come on continuously.
They tend to recur at the same time every day or around the (they are most common at night), and are usually characterised by a severe stabbing or burning pain that’s usually localised around one eye, which can spread to the forehead, temple, cheek, and upper gum. Sometimes swelling, redness, flushing, and sweating can occur on the side that’s affected by the headache. Nasal congestion and eye tearing also often occur on the same side as the headache.
Each individual headache can last from 15 minutes to three hours. Most people experience one to four headaches a day, usually around the same time each day, during a cluster. After one headache resolves, another will soon follow.
Unlike migraine and tension headaches, cluster headaches generally aren’t associated with triggers, such as foods, hormonal changes or stress. They are usually sudden without any warning, and are three times more common in men than women.
There are 2 main types of cluster headache:
Episodic cluster headaches — these occur regularly for between one week and a year followed by a headache-free period (remission) of at least 14 days. These are the most common type of cluster headache.
Chronic cluster headaches — these occur regularly for longer than a year without remission or with remissions that last less than 14 days.
Common symptoms of cluster headaches can include:
- stabbing or burning pain centred around one eye
- watering eye
- swollen eyelid
- a blocked or a runny nose
- sensitivity to light and sound
- restlessness or agitation
- shrunken or constricted pupil
Doctors aren’t sure what causes cluster headaches, but they are more common for people who smoke. It may be possible to avoid them if you limit your exposure to cigarettes and strong-smelling chemicals in perfume and paint. You should also avoid drinking alcohol during an attack.
When to consult your doctor
Cluster headaches are not life-threatening but if you are experiencing one for the first time, you should seek immediate medical attention to rule out other causes, including meningitis or a stroke.
You should also seek immediate advice if you experience any of the other following symptoms:
- notice a change in their frequency or severity
- experience new symptoms
- develop weakness or paralysis
- have a fever
What's the best treatment for cluster headaches?
If you suffer with cluster headaches, your doctor will prescribe course of medication specific to you and your symptoms. There are medications for acute treatment that work quickly to treat the headache as soon as it starts. Some treatments include:
- oxygen therapy — breathing oxygen through a mask
- triptans — either oral or nasal sprays
- a local anaesthetic nasal spray
There are also certain things you can do to reduce your chances of a cluster headache attack, including:
- getting plenty of sleep
- exercising frequently
- not smoking
- avoiding alcohol
- avoid strenuous physical activity and high altitude
Allergy or Sinus Headaches
Sinus headaches are caused by sinusitis, a swelling of the sinuses. This is usually the result of an allergic reaction or infection — sinusitis often occurs after a viral upper respiratory infection or cold. The pain is severe, and consists of a dull, throbbing ache around the eyes, cheeks, and forehead. The pain can often worsen with movement — the pain generally gets worse when you bend forward — and at times can spread to the teeth and jaw.
These types of headaches are usually accompanied by a thick green or yellow nasal mucus, decreased sense of smell, and pain in one cheek or upper teeth. If there are no nasal symptoms, then the headache is more likely to be a migraine. They are often easy to confuse as they display similar symptoms.
People who suffer with chronic seasonal allergies or sinusitis are susceptible to these kinds of headaches.
Common symptoms of sinus headaches can include:
- blocked, stuffy nose
- pain, pressure in your cheeks, brow or forehead
- fever
- light or sound sensitivity
- fatigue
- an achy feeling in your upper teeth
When to consult your doctor
A sinus headache can also be a symptom of a sinus infection. In this case, your doctor will need to prescribe you a course of antibiotics to clear up in the infection.
Seek further medical advice if you experience any of the symptoms below:
- experience severe pain that gets worse
- symptoms don’t improve with painkillers
- headache does not improve after a week
- headaches occur frequently
What are the best treatments for sinus headaches?
If your headache is caused by congestion from allergies, you can take over-the-counter medications to help reduce your allergy symptoms. By reducing your allergy symptoms, this will then reduce your headaches. Over-the-counter allergy medications usually need to be taken every day, for as long as you are exposed to the allergen.
Most people can take following:
- antihistamines — these block the effects of the chemical histamine, which is responsible for the sneezing, itchy eyes, and runny nose often associated with allergies.
- decongestants — either oral or nasal, and may be your best option for treating nasal congestion that leads to headaches. They may relieve the stuffiness and pressure you may feel in your sinuses.
- steam inhalation perhaps including a few drops of eucalyptus oil
- comfortably hot compresses held against the face
- pain relief medication, such as paracetamol
- intranasal corticosteroids — these are also effective against allergic rhinitis, and can help reduce your nasal congestion and runny nose.
Seek advice from you doctor before taking any of these medications.
You can also take steps to prevent these headaches, by working out what your trigger is. When you know what you’re allergic to, you can make necessary changes to your home, schedule, activities, foods etc. Keep an allergy journal to figure out what it is that’s causing your reaction, and then can you make steps to avoid it.
If your allergies are and headaches are triggered outdoors, you can limit your exposure by staying indoors when triggers like pollen and mould are at their highest, and you can also keep windows closed, or avoid using window fans that can bring outdoor allergens into the house.
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