A headache is the
most common complaint known to mankind. But there are several types and
many different triggers. How can you tell what sort of headache you've
got, and what can you do to relieve it?
Headaches are among the most common reasons for patients to consult
their doctor. In fact, only one person in 50 can claim never to have had
a headache in their life. For most of us, a headache is gone in a few
hours, but some people suffer pain frequently - even daily.
There are a number of different types of headache, and most of the
recurrent ones are either migraine, tension headaches - half of all
adults get these at some time - or cluster headaches. Statistics show
that women suffer more than men from all types of headache, and get
three times more migraines.
WHAT CAUSES HEADACHES?
Although doctors know headaches arise from a chain reaction involving
nerve pathways and the blood supply to and from the brain, the precise
mechanism is unknown.
The pain does not come from the brain, but is thought to be caused by
the constriction of blood vessels surrounding the brain or by tension in
the scalp and muscles.
Neurologists suspect that the constriction of blood vessels is caused
by an imbalance in brain chemistry - a result of neurotransmitter
activity. Neurotransmitters are chemical substances, similar to
hormones, which act on the brain and aid communication throughout the
Medical research into headaches has focused on one called serotonin,
which has a narrowing effect on blood vessels.
Usually, it is not difficult to work out what caused a headache, for
example a poor night's sleep, a row at home, or stress at work.
In many cases, your headache may be caused by one or more of several
factors. The following list may enable you to determine what has
triggered your headache.
• Hunger: Low blood sugar can cause discomfort in the head which
grows into a headache if no food is eaten. People who don't have
breakfast may notice they develop a morning headache that disappears
with their first snack. Crash dieters often have headaches because of
low blood sugar.
• Red wine, beer, brandy and whisky: These alcoholic beverages
contain certain additives called congeners. Research indicates that
congeners can trigger headaches in sensitive individuals, even if they
haven't drunk very much.
• Hangover: Too much alcohol (often combined with smoking) results in
dehydration and poor quality sleep. It's the dehydration, not just the
quantity of alcohol you've had, that causes the hangover headache the
• Caffeine: Drinking less coffee, tea and cola than usual, or
occasionally drinking more, for instance over the weekend or on holiday,
can cause a thumping headache.
• Sexual activity: Orgasm can be an unusual and distressing trigger
for an intense headache. Pain at the back of the neck may also develop
from arching the spine.
• Environmental stress: Flickering fluorescent strip lighting or
glare can interfere with natural brain activity and tire the eyes. Also,
hot, stuffy, fume-filled or overcrowded rooms or excessive noise can
trigger a raging headache.
• Physical triggers: Simple actions such as wearing a too-tight hat
or hair band, as well as physical conditions such as eye muscle
disorders, eye strain, and toothache can all prompt a painful head.
• The weather: People who are sensitive to climate may find they
develop a headache just before a storm or in close, humid weather. Cold
weather, particularly with a biting wind, can cause head muscles to
contract and cause pain.
• Cinema and television: Any activity that involves a fixed focus for
long periods of time can cause head pain. For instance, many people come
out of the cinema with a headache. You may find sitting further back
from the screen helps.
• Smoking: Heavy smoking and breathing other people's smoke can
trigger a headache. And, if you're giving up smoking, you'll probably
find you get headaches for the first couple of days.
• Painkillers: It may seem odd that tablets taken to relieve a
headache can cause another the next morning. But painkillers are thought
to neutralize the body's naturally-occurring opiates (endorphins) which
act as our own painkillers. People who take 30 or more aspirin,
paracetamol or ibuprofen a month often suffer what are called analgesic
headaches. A week off all drugs usually brings dramatic relief.
WHEN TO WORRY
A really bad headache may make you wonder if you've got a brain tumour.
However, the headache that is caused by a malignant growth is
progressive, with a distinctly slow build-up. It's more severe in the
morning, often preventing you from eating. Less than three per cent of
brain tumours cause headaches at the time they're diagnosed.
Other very unusual causes of headache include brain haemorrhage and
meningitis. A headache can also be a symptom of temporal arteritis, in
which the arteries in the scalp over the temples become inflamed;
shingles; Paget's disease, which affects the skulls of elderly people;
or neuralgia (facial pain following the path of a nerve); but these are
MAKING A DIAGNOSIS
If you suffer from recurrent headaches, see your doctor. You might find
it helpful to keep a note of your headaches, as he'll want to know all
about them, for instance when and how often they occur, how long they
last, and any other symptoms, for instance nausea or blurred vision.
You'll probably be asked to describe the pain and what treatment you've
If a diagnosis cannot be made, you may be referred to a neurologist,
who may want you to have a brain scan. Although brain scans will not
usually show up any sign of a headache, they can indicate an underlying
FINDING WHAT WORKS
Most headaches respond to over-the-counter painkillers like aspirin,
paracetamol and ibuprofen. You may find the soluble versions work more
quickly to relieve pain, and are less harsh on the stomach.
In addition to a painkiller, tension headaches may require a muscle
relaxant as well. These are only available on prescription from your
People who regularly suffer headaches can often find relief from
alternative therapy. Acupuncture, aromatherapy, and manipulative
techniques such as osteopathy and chiropractic have all been shown to
help the pain of headache.