If you suffer from regular headaches, you may understand the frustration of trying to make others understand just how debilitating and draining they can be.
Most tend to be quite mild, but some can be so debilitating that they affect our relationships and mental health. Some people learn to expect them like clockwork and others will know how they will affect their wider day-to-life. For others, they are milder and rare.
It's important for people to be aware of what type of headache they have and how best to treat them. Here, we've tried to explain the different types of headaches you can get, what causes them and how they can be treated.
1. Tension-type headaches
These are the most common type of headaches in adults and young teens. It can be described as a mild to moderate pain, with pressure on both sides of the head, behind the eyes and, on occasion, neck muscle-tightening.
Who gets them and what are the symptoms? As a very common type of headache, the NHS predicts tension-type headaches affect half the adults in the UK once or twice or month. Some people can even experience tension-type headaches up to 15 times per month. This can also be considered a "chronic tension headache". Though a very common type of headache, it mostly affects women.
What causes them? The NHS suggests a variety of causes that could trigger a tension-type headache. Those causes are - but not limited to - stress, anxiety, squinting, poor posture, tiredness, dehydration, missing meals, lack of physical exercise, bright sunlight, noise and certain smells.
What are the treatments? Tension-type headaches are most commonly treated with painkillers or lifestyle changes, including yoga and exercise. People should contact a GP if the headache is accompanied by nausea, vomiting and confusion. It can also be worrying if the headache is bought on suddenly or following an accident.
2. Migraine
Migraines are a common health condition but can prove incredibly unpleasant. There was promising news for sufferers recently when it was revealed that thousands of people in England who get migraines could benefit from a drug that has been approved on the NHS.
The National Institute for Health and Care Excellence said it was recommending rimegepant for preventing migraines in the approximately 145,000 adults where at least three previous preventive treatments had failed.
The NHS says migraines affect around one in every five women and around one in every 15 men. They are described as a severe pain on one side of the head and can sometimes be accompanied by nausea, vomiting and sensitivity to light.
Who gets them and what are the symptoms? Migraines affect many people, mostly emerging during early adulthood. Some people experience migraines frequently, while others can go years between each migraine. There are a few sub-genres to migraine:
- Migraine with aura: specific warning signs before migraine
- Migraine without aura: occurs with no warning signs
- Migraine aura without headache: migraine symptoms are experienced, but no headache
What causes them? The direct cause of migraines is unknown, although there have been many discussions about the triggers. Some believe the condition to be hereditary. Despite the lack of knowledge of a direct cause, there are a few reoccurring themes where a migraine will occur.
Those are:
- Emotional triggers: stress, anxiety, depression, tension, shock and excitement
- Physical triggers: fatigue, posture, poor work shifts, low blood sugar
- Dietary triggers: irregular meals, dehydration, alcohol
- Environmental triggers: lights, smoking, loud noises, strong smells
- Medicine: sleeping tablets, combined-contraceptive pill and hormone replacement treatment
What are the treatments? Unfortunately, there are no cures for migraines. But there are treatments to help reduce the symptoms including painkillers, triptans and anti-emetics. The NHS has suggested that some people find it it helps to sleep or lay in a darkened room. People should contact a GP if a migraine occurs for more than five days. Symptoms of migraines can also be symptoms of more serious issues like a stroke or meningitis. Call 999 if you experience the following symptoms: paralysis, slurred speech, a sudden agonising headache with splintering pain, seizures, double vision, stiff neck, high temperature and a rash
3. Cluster headaches
Cluster headaches are rare and can be described as an excruciating pain on one side of the head, most commonly behind or near the eye.
Who gets them and what are the symptoms? Anyone can get a cluster headache, but they are mostly common in men and start when someone is in their 30s or 40s. Cluster headaches normally occur once a day for several weeks before they disappear and then a remission will follow before they occur again. They tend to occur around the same time of year, the NHS suggests around spring and autumn.
What causes them? There isn't a clear, exact cause for cluster headaches. It has been considered that smoking may trigger cluster headaches, as well as drinking alcohol and strong smells such as petrol, paint or perfume. Cluster headaches have also been debated to be hereditary and linked to activity in a part of the brain called hypothalamus.
What are the treatments? Cluster headaches require specialist treatments as normal painkillers are not effective. These treatments include sumatriptan injections (which patients can give themselves), sumatriptan or zolmitriptan nasal spray and oxygen therapy. There have been new treatments introduced for cluster headaches. The first is transcutaneous vagus nerve stimulation (TVNS) which is electrical shock treatment to stimulate a nerve in the neck.
The second is a stimulation device implant which is when an electrical device is implanted in the patient and when turned on sends electrical currents through the nervous system. The NHS claims that it is important that patients are aware of their triggers (such as smoking) and recommends avoiding these activities. OUCH UK, is an advice organisation to help people living with cluster headaches, as living with the symptoms can be very difficult.
4. Sinus headaches
Sinus headaches can be described as a deep and constant pain in the cheek bones, forehead or the bridge of the nose. Other symptoms are a runny nose, a feeling of fullness in the ears, fever and swelling in the face.
Who gets them? Anyone can get sinus headaches, at any age and at any time.
What causes them? Sinus headaches occur when your sinuses (air-filled spaces inside the forehead, cheekbones and bridge of the nose) become inflamed due to an infection or allergy. Mucus will build up and the channels will not be able to drain them properly. This build up of pressure can result in headaches.
What are the treatments? There are many different ways to treat sinus headaches. These have been sectioned out into home remedies, pharmacists and GPs:
Home remedies: get lots of rest, drink lots of fluids, painkillers, place a warm flannel over the face, inhale steam and cleaning nasal passages with salt water solution.
Pharmacists: decongestant nasal sprays, drops or tablets as well as salt water solution
GP: if your symptoms are severe and painkillers are not helping, patients should visit the GP. They will prescribe steroid nasal sprays/drops, antihistamines and antibiotics. They may refer patients to a nose and throat specialist if it's reoccurring and the medicine does not work.
5. Hormone headaches
Hormone headaches are very common and are often referred to as migraines, triggered by hormonal factors. Symptoms include loss of appetite, fatigue, acne, joint pain, decreased urination, lack of coordination, constipation and cravings for alcohol, salt or chocolate.
Who gets them? Hormone headaches are mostly common in women, with more than five million women experiencing hormone headaches every month.
What causes them? There are many different causes for hormonal headaches, but the main four are:
- Menstrual cycle
- Pregnancy
- Perimenopause/Menopause
- Oral contraceptives/hormone replacement therapy
Other factors that may trigger hormone headaches are skipping meals, getting too much or too little sleep, intense lights/sounds/smell, severe weather changes, alcoholic beverages, too much caffeine or caffeine withdrawal, stress, processed meats, hard sausages/smoked fish, monosodium glutamate (MSG), a flavour enhancer, aged cheeses, soy products and artificial sweeteners.
What are the treatments? There are lots of home remedies patients can try to help ease the pain of hormone headaches. These remedies include:
- Drinking plenty of water to stay hydrate
- Lying down in a dark, quiet room
- Placing an ice bag or cold cloth to your head
- Massaging the area where you feel pain
- Performing deep breathing or other relaxation exercises.
There are also different medicines patients can take such as painkillers or triptans. For women who experience more chronic hormonal pains, medicines such as beta blockers or anti- depressants can be prescribed. There is also hormonal therapy if these medicines are unsuccessful.
Patients should seek medical attention if they experience any dizziness, a stiff neck, rash, shortness of breath, loss of vision and any other drastic symptoms.
6. Caffeine headaches
Caffeine headaches can be described as a moderate pain that starts behind the eyes and moves up towards the forehead. They have also been known to trigger migraines.
Who gets them? Caffeine headaches are mostly caused by people detoxing themselves from caffeine or accidentally consuming too much. Thus, the people affected will be those who are daily consumers of caffeine or those who abuse caffeine.
What causes them? The top five causes for caffeine headaches are caffeine withdrawal, varied caffeine consumption, caffeine overdose, caffeine sensitivity and a caffeine allergy.
What are the treatments? There are many different ways to cure a caffeine headache. The main home remedies include taking painkillers, drinking lots of water, avoiding medications, foods and beverages with caffeine and getting lots of sleep. To prevent caffeine headaches, it is advised that people consume the same amount of caffeine every day (no more than 50mg) or consume little to no caffeine at all.
7. Exertion headaches (activity-related headaches)
Exertion headaches share the same symptoms as migraines and usually occur after vigorous exercise. It can be described as a pulsating or throbbing sensation. Normally, the pain will fade away after the exercise stops, but in some rare cases the headache can last up to two days.
Who gets them? Exertion headaches commonly affect younger people, from adolescents up the age of 50.
What causes them? During exercise, blood pressure increases in the blood vessels of the brain, creating a pressure which is the headache. These are referred to as primary exertion headaches. Doctors recommend getting checked out if patients experience these frequently to rule out any other underlying, more serious conditions. As well as physical activity such as sport or sex, there are many other factors which can contribute to exertion headaches. These are poor nutrition, drinking alcohol, heat, high humidity, change in the barometric pressure, exercise at high altitudes,caffeine and low blood sugar.
What are the treatments? Exertion headaches are harmless and if they fade away after the exercise has stopped there is nothing to worry about and no need to seek medical advice. However, doctors do recommend if an exertion headache has been experienced and is so frequently, that they should run some tests just to ensure there are no more serious underlying issues.
8. Rebound headaches
Rebound headaches occur when patients overuse their medicine to treat other headaches, such as migraines. It can be described as a dull and constant pain, often most present in the morning.
Who gets them? Anyone who is taking medication for another form of headache is at risk of a rebound headache if the medicine is not taken properly. When the pain of a headache is dire, many patients will rely on painkillers and this heavy dosage will result in further pain.
What causes them? Rebound headaches are caused by "regular, long-term use of medication to treat headaches, such as migraine”. They are also caused by taking painkillers for longer than a couple of days of week. This will only occur if patients already have a headache disorder. The type of painkillers that can cause these headaches are simple painkillers, combination painkillers, migraine medicines and opiates. The NHS states: “Rebound headaches usually stop when you stop taking the pain medication. It's tough in the short term, but your doctor can help you beat rebound headaches for long-term relief”.
What are the treatments? The main way to cure rebound headaches is to resume normal consumption of pain relief medicine, or halt consumption altogether. There is a lot of different ways that rebound headaches can be prevented. Some factors include:
- Taking your headache medication as prescribed
- If you need headache medication more than twice a week, contact your doctor
Avoid medications that contain butalbital or opioids
Use OTC painkillers less than 15 days a month
Limit use of triptans or combination analgesics to no more than nine days a month
Also, looking after your health in general can contribute to avoiding rebound headaches by getting enough sleep, drinking plenty of water and reducing stress. Patients should consult their GP if they take painkillers for headaches more than twice a week or their headaches are getting worse.
9. Post traumatic headaches
Post traumatic headaches occur after an injury to the head or neck. The most common symptoms are head pain, neck pain, dizziness, double vision, exertion headaches, tired eyes and memory loss.
Who gets them? Anyone who has received an injury to the head or neck is subject to a post traumatic headache. There are between 1.4 to 1.8 million head/neck injuries per year, many are linked to alcohol. Statistically, men are more likely to experience this injuries. The ages of which these injuries are mostly likely to occur are between 15 to 29 and 65 to 70.
What causes them? There are many injuries that can cause a post traumatic headache. These include violence, motor vehicle accidents, falls, bicycle accidents and sports injures.
What are the treatments? There are no specifically designed medicines for post traumatic headaches, but mostly migraine medicines will be prescribed after an officially diagnosis. If a patient has been involved in a head or neck injury where they've been concussed, it's important to see a GP.
10. Cough headaches
Cough headaches are pains in the head caused by straining through coughing, sneezing and blowing your nose. Normally, cough headaches are harmless and common and do not require any treatment. Secondary cough headaches however, may require surgery.
Symptoms include a sharp, splitting pain on both sides of the head after straining. It may be followed by a dull, aching pain for hours.
Who gets them? Primary headaches usually occur in older people over the age of 40. Men are also more prone to getting cough headaches.
What causes them? Secondary causes are as follows:
- A defect in the shape of the skull.
- A defect in the cerebellum, the part of the brain that controls balance. This can occur when a portion of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord is supposed to be.Some of these types of defects are called Chiari malformations.
- A weakness in one of the blood vessels in the brain (cerebral aneurysm)
- A brain tumor
- A spontaneous cerebrospinal fluid leak
What are the treatments? Primary headache cures have a variety of drugs that can be prescribed such as Indomethacin, Propranolol and Acetazolamide (Diamox). A lumbar puncture can also be used by a doctor to drain any fluids around the brain and spinal cord. Secondary cough headaches often require surgery. Patients should see their GP if they are experiencing any of the symptoms of a secondary cough headache.
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