Headaches are one of the most common health complaints with over 10 million people in the UK alone experiencing them regularly. Most of the time these are easily treatable at home with lifestyle adjustments and over-the-counter painkillers. You should see your GP, however, if your headaches occur regularly and/or are so painful they stop you going about your day to day activities.

Types of headaches

There are several different types of headache with differing causes and levels of severity. The NHS and NICE guidelines outline several types, their main causes and their recommended treatments.

Tension headaches are the most common type and are what most people would consider to be ‘normal’ headaches. Typically lasting around 3 minutes, a tension headache will often feel like a constant ache that affects both sides of the head as if a tight band is stretched around it. They normally aren’t severe enough to stop you going about your day to day life and are usually easily treated with painkillers such as ibuprofen and paracetamol and by ensuring you are well hydrated and getting regular sleep. The exact causes of tension headaches are unknown, but it suspected that they may be linked to factors such as stress, poor posture, skipping meals and dehydration.

Migraines are less common than tension headaches and often more severe. Felt as an intense throbbing pain at the front or side of the head, the pain can sometimes be severe enough to induce other symptoms such as nausea, vomiting and increased sensitivity to sound and light. They can often be debilitating enough that you are unable to carry out your daily activities and some people may find the need to stay in bed until they have passed. The causes of migraines are mostly unknown, but it is suspected that they are the result of temporary changes in the nerves, chemicals and blood vessels in the brain.

While over the counter painkillers can often work as treatment, if you experience frequent (on more than 5 days a month) or severe migraine symptoms the NHS advises consulting your GP. It is possible for frequent migraines to be a symptom of a more serious condition.

Cluster headaches are a rare type of headache that occur in clusters for about a month or two at roughly the same time of the year. These types of headaches usually cause intense pain around one eye that appears suddenly and without warning and often coincide with a watering or red eye and a blocked runny nose. Once again it is not exactly clear what causes cluster headaches, but they have been consistently linked to a part of the brain called the hypothalamus and it is thought that smokers are at higher risk.

If you experience a cluster headache you should seek advice from the GP as soon as possible. They may refer you to a brain scan to rule out other conditions and if you are diagnosed with cluster headaches it is likely you will be referred to a neurologist for further advice. Cluster headaches are not life threatening, but the pain from them can be severe enough to affect your quality of life. Over the counter painkillers are too slow acting to treat cluster headaches so it is likely you will be prescribed with one of three main specialist treatments.

One available treatment is sumatriptan injections, which you can administer yourself up to twice a day. If you prefer to not have injections you may instead be given a sumatriptan or zolmitriptan nasal spray, or referred to oxygen therapy. Your GP may also prescribe a preventative medication called verapamil which is taken as a tablet several times a day.

Hormone headaches can be experienced by women and many notice a link with their periods, the combined contraceptive pill, the menopause and pregnancy. Reducing stress levels and introducing a regular sleeping patter can help reduce these types of headaches.

Very rarely a headache can be the sign of a more serious condition. The NHS advises seeking medical advice if your headache occurs very suddenly and is experienced as a blinding pain, if it gets worse over time, occurs after a head injury or is accompanied by other worrying symptoms.

If all else fails?

What happens when you have tried all the medication and have not got any better? You should consider alternative and natural therapies. Physiotherapy and osteopathy are the first professions you should consider booking an appointment with. A physiotherapist will look for any neck problems, posture issues, or tight muscles that may be causing the problems. Osteopaths also treat cervico-genic headaches and migraines (i.e. neck causing headaches and migraines). Acupuncture around the head and neck can also be of benefit and many patients report cures from all three approaches.