Most people will have experienced headache at some time in their lives, but some are more prone than others. There are many different kinds of headache, with just as many different causes!
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. As there are so many different causes, this article will focus on the most common. You will find another page on migraine and cluster headache.
Headaches do not come from the brain or skull bones themselves as they cannot feel pain, but come from the sensitive structures surrounding them, which may be inside or outside the skull.
Any long lasting 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.
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. Headaches may occur premenstrually, or worsen at the time of the menopause.
Secondary headaches have an identifiable cause, such as 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. Low blood sugar can cause headaches in some people, and even fluorescent lights flickering unnoticeably at of 60 times per second may be a cause.
Injuries to the head and neck, such as concussion and whiplash, or arthritis in the neck and jaw may cause headache, as may infection in the teeth or sinuses. 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.
Chemicals in certain foods, such as smoked food which contains nitrates, or sulphurs in dried fruit, and monosodium glutamate (MSG),can trigger headache in sensitive individuals. Similarly, medication side effects or withdrawal also 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 the 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.
So 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 leading 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 anti-inflammatory (NSAID) medicines such as aspirin, ibuprofen, diclofenac etc.
If you have 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 are 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 else can I do for myself?
- Relaxation techniques such as yoga and simple muscle relaxation can relieve tension and other muscular headaches.
- 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 a fluorescent light for close work.
- A sinus headache can be helped by steam inhalations and washouts.
For further treatment of sinusitis, you are referred to the page dealing with colds, flu etc.
- Take a good multivitamin and mineral supplement containing Vitamins B complex, A, D and copper, zinc, calcium and magnesium.
- Magnesium alone can be helpful for muscle spasm as in tension headache.
- Ginger and chamomile teas are soothing.
- Tissue salts kali phos or ‘headache combin’, or consultation with a homoeopath may help.
WHEN TO WORRY
- A sudden severe headache for the first time.
- Headache with a convulsion, or loss of power or sensation in an arm or leg.
- Pain in an eye or ear.
- Headache with confusion or loss of consciousness.
- After a blow on the head.
- Severe headache with fever.
- Any headaches that interfere with normal life.
- Recurring headache in children.