Learn more about headache: overview
More than 10 million people in the UK get headaches regularly, making them one of the most common health complaints. But most aren't serious and are easily treated.
In many cases, you can treat your headaches at home with over-the-counter painkillers and lifestyle changes, such as getting more rest and drinking enough fluids.
However, it's a good idea to see your GP if your headaches aren't relieved by over-the-counter treatments, or if they're so painful or frequent that they affect your daily activities or are causing you to miss work.
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Tension headaches are the most common type of headache and are what we think of as normal, "everyday" headaches. They feel like a constant ache that affects both sides of the head, as though a tight band is stretched around it.
A tension headache normally won't be severe enough to prevent you doing everyday activities. They usually last for 30 minutes to several hours, but can last for several days.
The exact cause is unclear, but tension headaches have been linked to things such as stress, poor posture, skipping meals and dehydration.
Tension headaches can usually be treated with ordinary painkillers such as paracetamol and ibuprofen. Lifestyle changes, such as getting regular sleep, reducing stress and staying well hydrated, may also help.
Read more about tension headaches.
Migraines are less common than tension headaches. They're usually felt as a severe, throbbing pain at the front or side of the head. Some people also have other symptoms, such as nausea, vomiting and increased sensitivity to light or sound.
Migraines tend to be more severe than tension headaches and can stop you carrying out your normal daily activities. They usually last at least a couple of hours, and some people find they need to stay in bed for days at a time.
Most people can treat their migraines successfully with over-the-counter medication. But if they're severe, you may need stronger medication that's only available on prescription. This may be able to relieve and prevent your migraines.
Read more about migraines.
Cluster headaches are a rare type of headache that occur in clusters for a month or two at a time around the same time of year.
They're excruciatingly painful, causing intense pain around one eye, and often occur with other symptoms, such as a watering or red eye and a blocked or runny nose.
Pharmacy medications don't ease the symptoms of a cluster headache, but a doctor can prescribe specific treatments to ease the pain and help prevent further attacks.
Read more about cluster headaches.
Medication and painkiller headaches
Some headaches are a side effect of taking a particular medication. Frequent headaches can also be caused by taking too many painkillers. This is known as a painkiller or medication-overuse headache.
A medication-overuse headache will usually get better within a few weeks once you stop taking the painkillers that are causing it, although your pain may get worse for a few days before it starts to improve.
Read more about painkiller headaches.
Reducing your stress levels, having a regular sleeping pattern, and ensuring you don't miss meals may help reduce headaches associated with your menstrual cycle.
Read more about hormone headaches.
Other causes of headaches
Headaches can also have a number of other causes, including:
- drinking too much alcohol
- a head injury or concussion
- a cold or flu
- temporomandibular disorders – problems affecting the "chewing" muscles and the joints between the lower jaw and the base of the skull
- sinusitis – inflammation of the lining of the sinuses; read more about sinus headaches
- carbon monoxide poisoning
- sleep apnoea – a condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing
Click on the links above for more information about these conditions.
Could it be something serious?
A headache is more likely to be serious if:
- it occurs suddenly and is very severe – often described as a blinding pain unlike anything experienced before
- it doesn't go away and gets worse over time
- it occurs after a severe head injury
- it's triggered suddenly by coughing, laughing, sneezing, changes in posture, or physical exertion
- you have symptoms suggesting a problem with your brain or nervous system, including weakness, slurred speech, confusion, memory loss, and drowsiness
- you have additional symptoms, such as a high temperature (fever), a stiff neck, a rash, jaw pain while chewing, vision problems, a sore scalp, or severe pain and redness in one of your eyes
If you're concerned that your headache might be serious, you should seek immediate medical advice. Contact your GP or NHS 111 as soon as possible, or go to your nearest accident and emergency (A&E) department.
Learn more about headache: tension headaches
A tension-type headache is the most common type of headache and the one we think of as a normal, everyday headache.
It may feel like a constant ache that affects both sides of the head. You may also feel the neck muscles tighten and a feeling of pressure behind the eyes.
A tension headache normally won't be severe enough to prevent you doing everyday activities.
It usually lasts for 30 minutes to several hours, but can last for several days.
Who gets tension headaches?
Most people are likely to have experienced a tension headache at some point. They can develop at any age, but are more common in teenagers and adults. Women tend to suffer from them more commonly than men.
It's estimated that about half the adults in the UK experience tension-type headaches once or twice a month, and about 1 in 3 get them up to 15 times a month.
About 2 or 3 in every 100 adults experience tension-type headaches more than 15 times a month for at least three months in a row. This is known as having chronic tension-type headaches.
When to seek medical help
There's usually no need to see your GP if you only get occasional headaches. However, see your GP if you get headaches several times a week or your headaches are severe.
Your GP will ask questions about your headaches, family history, diet and lifestyle to help diagnose the type of headache you have.
You should seek immediate medical advice for headaches that:
- come on suddenly and are unlike anything you've had before
- are accompanied by a very stiff neck, fever, nausea, vomiting and confusion
- follow an accident, especially if it involved a blow to your head
- are accompanied by weakness, numbness, slurred speech or confusion
These symptoms suggest there could be a more serious problem, which may require further investigation and emergency treatment.
What causes tension headaches?
The exact cause of tension-type headaches isn't clear, but certain things have been known to trigger them, including:
- stress and anxiety
- poor posture
- missing meals
- lack of physical activity
- bright sunlight
- certain smells
How are tension headaches treated?
Tension-type headaches aren't life-threatening and are usually relieved by painkillers or lifestyle changes.
Relaxation techniques can often help with stress-related headaches. This may include:
Read more about relaxation tips to help with stress.
If you're taking these medications, you should always follow the instructions on the packet. Pregnant women shouldn't take ibuprofen during the third trimester, as it could risk harming the baby, and children under 16 shouldn't be given aspirin.
Medication shouldn't be taken for more than a few days at a time and medication containing codeine, such as co-codamol, should be avoided unless recommended by a GP.
Taking painkillers over a long period (usually 10 days or more) may lead to medication-overuse headaches developing. Your body can get used to the medication and a headache can develop if you stop taking them.
If your GP suspects your headache is caused by the persistent use of medication, they may ask you to stop taking it. However, you shouldn't stop taking your medication without first consulting your GP.
Read more about painkiller headaches.
Preventing tension headaches
If you experience frequent tension-type headaches, you may wish to keep a diary to try to identify what could be triggering them. It may then be possible to alter your diet or lifestyle to prevent them occurring as often.
Regular exercise and relaxation are also important measures to help reduce stress and tension that may be causing headaches. Maintaining good posture and ensuring you're well rested and hydrated can also help.
Guidelines from the National Institute for Health and Care Excellence (NICE) states that a course of up to 10 sessions of acupuncture over a 5-8 week period may be beneficial in preventing chronic tension-type headaches.
In some cases, an antidepressant medication called amitriptyline may be prescribed to help prevent chronic tension-type headaches, although there's limited evidence of its effectiveness. This medication doesn't treat a headache instantly, but must be taken daily for several months until the headaches lessen.
Learn more about headache: treatment
The aim of taking medication is to improve your quality of life. All painkillers have potential side effects, so you need to weigh up the advantages of taking them against the disadvantages.
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Paracetamol is used to treat headaches and most non-nerve pains.
Two 500mg tablets of paracetamol up to four times a day is a safe dose for adults. Side effects are not common and this dose can be taken regularly for long periods.
Overdosing on paracetamol can cause serious side effects, however, so don't be tempted to increase the dose if your pain is severe.
If the pain lasts for more than three days, see your GP.
More on paracetamol.
So-called non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac and naproxen, seem to work better when there is clear evidence of an inflammatory cause, such as arthritis or an injury.
They should not be used for long periods unless you have discussed it with your doctor.
If you take them for long periods, there's an increased risk of stomach upset, including bleeding, and kidney and heart problems.
Don't take more than the recommended dose, as this will increase the risk of serious side effects.
More on ibuprofen.
Aspirin is another type of NSAID.
It produces the same kind of side effects as other NSAIDs, but is not as effective as a painkiller, which means it's not usually prescribed for pain.
It is dangerous for children under 16.
Codeine doesn’t work very well on its own. It works better when combined with paracetamol in a single pill.
You can buy co-codamol (paracetamol and low-dose codeine) over the counter. Higher-dose codeine has to be prescribed.
Codeine and other medium-strength prescribed painkillers can cause dependency, which means that when you stop taking them you may feel unwell for a short period.
If you need more and more of these drugs, contact your GP or other healthcare professional for advice.
Effervescent painkillers are high in salt, containing up to 1g per tablet.
Too much salt can raise your blood pressure, which puts you at increased risk of health problems such as heart disease and stroke.
You may want to consider switching to a non-effervescent painkiller, especially if you've been advised to watch or reduce your salt intake.
Amitriptyline and gabapentin
Amitriptyline is a drug for depression and gabapentin is a drug for epilepsy.
Each of these medicines can also be used to treat pain caused by nerve sensitivity or nerve damage, such as shingles, diabetes nerve pain and sciatica.
You don’t have to have depression or epilepsy for these tablets to help your nerve pain.
Amitriptyline and gabapentin both have to be prescribed by a GP.
Side effects include drowsiness and dizziness.
Morphine and morphine-like drugs (such as oxycodone, fentanyl and buprenorphine) are the strongest painkillers there are.
Some come as a patch, but they all work in similar ways and should only be used for severe pain.
They will only be prescribed after consultation with your GP or a pain specialist. The dose and your response will be closely monitored. These drugs should only be used as part of a long-term plan to manage your pain.
Read about the NHS help on offer if you have persistent pain.
Further advice on painkillers
Talk to your pharmacist or GP, or call NHS 111 if you need more advice on painkillers.