What are the different types of headaches and how are they treated?

Most people will experience headaches at some point. It refers to pain in your cranium (the part of your skull that covers your brain) and can occur at the back, front or sides of your head. 

Headache pain can be dull, throbbing or feel like a strain or tension in your head. In some cases, a headache is preceded by nausea or sensitivity to light. 

Headaches can also be associated with neck pain or excess tears and redness in the eyes.

Different types of headaches and their treatment

There are hundreds of different types of headache but there are four that are most common: migraines, tension headaches, cluster headaches and cervicogenic headaches. 

Cervicogenic headache

Cervicogenic headaches are caused by a neck problem eg trauma, such as a fracture or whiplash, or a medical condition, such as rheumatoid arthritis, cancer or an infection. 

Pain or a feeling of pressure usually starts at the top of the neck and moves upward into the head. You may also have limited movement of your neck and develop one-sided neck, shoulder or arm pain. 

Treatment usually involves medication, such as over-the-counter painkillers (eg paracetamol and ibuprofen), antiseizure drugs, antidepressants and muscle relaxants. Physiotherapy is usually also recommended to help strengthen the muscles in and around your neck and shoulders. In some cases, interventional procedures (eg injections) are also recommended.

Cluster headache

This type of headache is rare and refers to frequent, incredibly painful headaches that occur in clusters ie recurring for several weeks. They cause intense pain, often referred to as sharp or piercing, on one side of the head, often around one eye and/or the temple.

Other symptoms include a red, watery eye, a smaller pupil in one eye, a swollen, droopy eyelid, a blocked or runny nose and a sweaty face.

Over-the-counter pain medications (eg paracetamol and ibuprofen) do not usually improve the symptoms of cluster headaches. You will, therefore, need to see your doctor for prescription medication, such as triptans and oxygen administration.

Tension headache

This is the most common type of headache, which causes a constant ache on one or all sides of your head. It is linked to stress, dehydration, lack of sleep, skipping meals and poor posture. 

When you have a tension headache, it can feel as though you have a tight band wrapped around your head. Symptoms usually last anywhere from 30 minutes to several hours but can last for several days. 

Over-the-counter painkillers (eg paracetamol and ibuprofen) usually help ease symptoms. However, these medications shouldn't be overused as this can actually result in more frequent headaches called medication overuse headaches. 

Staying hydrated, taking part in relaxation activities and getting a good night’s sleep all help treat tension headaches.  

Migraine

Migraines affect around 10 million people aged 15–69 in the UK. A migraine attack can last from several hours to several days. 

Although the cause isn't clear, abnormal brain activity is likely involved, which affects signals, chemicals and blood vessels in the brain. This causes moderate to severe throbbing pain, usually on one side of the head. Other symptoms include nausea, vomiting and sensitivity to light or sound.

The two main types of migraine are migraine with aura and migraine without aura. In migraines without aura, there are no warning signs that you're about to have a migraine. In migraines with aura, which is less common, you may have sensory signs before your migraine eg see flashing lights or feel tingling in your hands or face. 

Over-the-counter painkillers (eg paracetamol and ibuprofen) and sleeping or lying down in a dark room can help treat migraines. However, in more severe cases, you may need prescription medication from your doctor eg triptans.

How to prevent headaches

There are several lifestyle changes you can make to reduce how often you get a headache. 

This includes getting a good night’s sleep, staying well-hydrated, reducing your stress levels, following a healthy, balanced diet, reducing how much alcohol you drink and avoiding any foods that you know trigger your headaches.

You should also avoid excessively using painkillers. 

Getting a diagnosis

It is helpful to keep a headache diary to show your doctor the pattern of your headaches and how long they last.

Note down anything that you suspect may be triggering or worsening your headaches. This may include dietary triggers, poor sleep or in women, hormonal changes during or in the run up to a period. 

You should also note down any other symptoms that occur with your headaches eg nausea, vomiting, light sensitivity etc. 

Your doctor will ask you detailed questions about your headaches and medical history to reach a diagnosis. 

Depending on your other symptoms, they may need to refer you to a doctor who specialises in treating the brain and nervous system (neurologist). 

When to see a doctor

If your headaches are reducing your quality of life and ability to carry out your usual daily activities, you should see your doctor. 

You should also seek urgent medical attention if your headache is sudden, sharp and new to you, or is associated with: 

• A history of trauma
• Blurred vision
• High blood pressure 
• Neurological symptoms ie altered levels of consciousness, disturbed speech or muscle weakness
• Persistent vomiting