You and Your Headache

What is it?

A headache is any pain in the head and may be on one side, in the middle, at the back or over the whole head. In certain kinds of headaches there may be other symptoms, such as vomiting, dizziness or changes in vision, and these symptoms may give a clue as to the cause. There are numerous causes, and this article will focus on the most common causes of headache. You are referred to another page on migraine and cluster headache.

What it is not:

Headache does not come from the brain or skull bones themselves as they cannot feel pain, but it comes from the sensitive structures surrounding them, and may come from within the skull or outside it. Persistent headache should not be ignored; it may be a simple tension headache, but excessive use of pain killers can have long term effects, so no headache should be written off as unimportant if it lasts or recurs frequently.

Who gets it?

Most people will have experienced headache at some time in their lives, but some are more prone than others.

What are the causes:

Primary headaches are those without an underlying cause, such as tension headache, most commonly felt on top of the head, or migraine and cluster headache which are usually one sided.

Secondary headaches have an identifiable cause.

Systemic causes include dehydration, heat stroke, kidney failure, and any fever; it is a common symptom of flu, and Tick Bite Fever is notorious for causing severe headache.

Injuries to the head and neck, such as concussion and whiplash, or arthritis in the neck and jaw may cause headache.

Neuralgia, meaning nerve pain, may occur in the scalp or face and is usually felt as a shooting pain on one side of the head.

Infection in the teeth or sinuses, often causes one sided or forehead pain.

Fluorescent lights flicker unnoticeably at of 60 times per second and cause headache in sensitive people.

Low blood sugar causes headaches in some people.

Certain foods, such as smoked food containing nitrates, or sulphurs in dried fruit, and monosodium glutamate[MSG] trigger headache in sensitive individuals. Food allergy may also sometimes play a role.

Headaches may occur prementrually, or at the time of the menopause.

Medication side effects or withdrawal often result in pain over the whole head; this may also be due to poisoning, the best known cause of which is of course the hang over!

Serious causes of headache inside the skull include brain infection [meninigitis, encephalitis or a brain abscess], tumours, raised pressure in the brain, or bleeding from trauma or a burst vessel [subarachnoid haemorrhage].

Outside the skull a serious headache may be caused by glaucoma [raised pressure in the eye], severe hypertension [blood pressure] or temporal arteritis, an inflammation of the artery in the temple, which if untreated can lead to blindness.

What is the usual treatment?

Most tension type headaches will settle with simple over the counter remedies such as paracetamol or aspirin, and there are several compound preparations available over the counter with a muscle relaxant included in the formula. Treatment of the underlying cause is important for future prevention, and physiotherapy or neck massage may be helpful in correcting bad habits that lead to tension in the neck muscles, often from poor posture or sitting too long in one position e.g. in front of a computer. Carrying heavy bags may also cause headache in those who have neck problems, and it is important to ensure that any heavy weights are carried evenly in both arms.

Inflammatory headaches such as those caused by sinusitis, arthritis of the neck or jaw and some tension headaches are helped by nonsteroidal antiiflammatory [NSAID] medicines such as aspirin, ibuprofen, diclofenac etc.

In recurrent or persistent headaches a thorough examination is needed to establish the cause, and whether the headache is primary or secondary in origin. In secondary headache, identification and treatment of the cause is of prime importance, and this may involve x-rays, blood tests etc depending on the history of the problem.

A diary of when the headache occurs may be very helpful in reaching a diagnosis. Record the day and time the pain started, duration of the pain, what treatment you took and its effect, any associated symptoms such as nausea, dislike of light, dizziness etc, and for women, the time in your menstrual cycle. It is also worth recording all foods eaten in the previous 24 hours, as certain types of headache can be caused by food.

What other treatments are available?

Relaxation techniques such as yoga and simple muscle relaxation can relieve tension and other muscular headache.

Acupuncture is highly effective for many headaches.

Massage helps tense muscles relax.

Chiropractic, and osteopathy are useful if there is a problem arising from the neck.

Use a table lamp rather than fluorescent light for close work.

Sinus headache can be helped by steam inhalations and wash outs. For further treatment of sinusitis your are referred to the page dealing with sinus and hay fever.*

A good multivitamin and mineral supplement containing Vitamins B complex, A , and iron, copper, zinc, calcium and magnesium may help.

Ginger and chamomile teas can be soothing .

Tissue salts kali phos or ‘headache combin’, or  consultation with a homeopath may help.


A sudden severe headache occuring for the first time.

Headache with a convulsion, or loss of power or sensation in an arm or leg .

Pain in the eye or ear.

Headache with confusion or loss of consciousness.

After a blow on the head .

Severe headache with fever.

Headaches that interfere with normal life.

Recurring headache in children.

* watch this space!

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