Nearly all of us have suffered from a headache at some point. However, the headache you experience may not be the same as someone else’s. Headaches are usually classified as either primary or secondary headaches. Secondary headaches are usually the result of an underlying illness. Most headaches experienced are usually primary headaches. The three most common types of primary headaches are tension, migraine and cluster headaches. Each type of headache has its own pattern of pain and cause, so once you know what type of headache you have, the better you’ll be able to deal with it.
Headaches aren't just for grown-ups either. Children get them too, including tension headaches – the only difference is they can’t always tell you, especially young ones. Although they’re not always serious, it’s important to keep an eye on headaches in children and consult a doctor if they get worse.
Tension headaches are the most common type of headache that many of us will have experienced at some point throughout our lives.
A tension headache feels like an aching type of pain. The onset of pain can be slow and creep up on you. It can feel as if there is pressure on your head like it's being squeezed. The ache can be constant and can affect both sides of your head like a tight band has been stretched around it. Neck muscles can feel very tight too. The pain might radiate around the whole of your head or just the sides or back of your head; your neck could also ache.
These headaches only last a short while, but may occasionally continue for several hours. However, tension headaches are not usually severe and mostly you can get on with what you're doing.
Causes and triggers of tension headaches
When you get a tension headache it can feel like the pain is coming from your head. The source of the pain however, could be due tomuscle strain. The muscles in your face, neck and around your head can all be involved. When muscles are strained, substances called prostaglandins can be released at the site of the injury. Prostaglandins stimulate pain receptors, which in turn can cause you to feel the pain in and around that area.
Several triggers can be linked to the cause of strained muscles:
- Stress and anxiety may cause you to feel tense and tight muscles
- Poor posture may cause the muscles in your neck, face, and head to be tensed when working at your desk
- Squinting whilst staring intensely at your computer screen can also be associated with straining muscles in your face, head, and neck
- You can sometimes feel tense when tired and muscles can be strained as a result
- Loud noises, dehydration, and some smells could cause tension and lead to muscle strain
Treating a tension headache
Treatment can be aimed at preventing the production of prostaglandins when muscles are strained. Nurofen, for example, is a well-known treatment for tension headaches. It contains ibuprofen, which inhibits the formation of prostaglandins in muscles.
Other treatments for tension headaches include paracetamol and aspirin.
Migraine headaches usually referred to simply as "migraines", are also reasonably common headaches. About one in five women and one in fifteen men are thought to be affected by migraines.
Migraine headaches are felt typically as a throbbing pain on one side of the head, although it can be felt on both sides. However, for some, it doesn't just involve a feeling of pain in and around the head. Migraines frequently have a wider range of symptoms. These can include being sensitive to light and/or to sound. Migraine sufferers or "migraineurs" can also feel nauseous and may vomit during a migraine attack.
Sinuses are the cavities behind your nose, eyes, and cheeks. Sinus headaches can occur as a result of inflamed sinuses and the build-up of mucus. This causes pressure in the cavities which can then lead to pain. For those who suffer, these headaches may be more severe in the mornings. This is because mucus drainage is poor at night, so more can build up over this time.
Cluster headaches are quite rare. Only about 1-2 in every 1000 people suffer from this type of headache. They can be even more painful and debilitating than migraines. More men than women suffer and it has been found to be more common in those who smoke heavily.
Cluster headaches are experienced in groups or "clusters". The clusters can involve something like one to eight headaches each day over several weeks or months. A headache will often begin during the night, perhaps an hour or two after the sufferer has fallen asleep. Following a period of these headaches, a sufferer may then go for a while with none at all.
How cluster headaches feel
The intense pain is usually focused on the area around and behind one eye. For many sufferers, this involves the same side each time. But for others it can vary, sometimes left, sometimes right. But always just on one side.
Cluster headache pain comes on very quickly. It usually hits its peak within 5 to 10 minutes and stays at this level for 30 and 60 minutes. They can have a longer duration, but don't usually last for more than three to four hours.3,5 When the pain stops, it can be quite abrupt and a great relief to sufferers.
People with cluster headaches can feel very agitated and restless during the attack. They sometimes don't know what to do with themselves, because the pain is so severe. They may feel the need to pace up and down or walk around in an effort to bear the pain better. Sufferers may also take drastic measures in order to try to cope with the pain, resorting to methods that are rather more painful than soothing.
As though the intense pain itself were not enough, a cluster headache often comes with other symptoms too. These include a blocked or runny nose, usually just one nostril, a red watery eye, or a drooped and swollen eyelid on the same side as the pain. And perhaps unsurprisingly, a flushed and sweaty face too.
Causes and triggers of cluster headaches
The exact cause of cluster headaches is the subject of much research. But it has been linked to the part of the brain called the hypothalamus, which plays an important role in linking the body’s nervous system to other bodily functions. There is also some suggestion of a genetic link since 1 in 20 people who suffer cluster headaches have a family member who are also sufferers.
Alcohol is a well-known trigger for cluster attacks and sufferers are advised not to drink alcohol, particularly during a cluster headache period. Other causes include strong smells such as petrol and paint fumes. Being overheated, exercise and smoking are other well-recognised triggers. So it's advisable to stop smoking or at least cut down.
Treating cluster headaches
Regardless of the duration of cluster headaches, treatment for cluster headaches aim to either reduce the frequency or act quicker than over-the-counter medication.
Sinuses are the cavities behind your nose, eyes and cheeks. Sinus headaches can occur as a result of inflamed sinuses and the build-up of mucus. This causes pressure in the cavities which can then lead to pain. For those who suffer, these headaches may be more severe in the mornings. This is because mucus drainage is poor at night, so more can build up over this time.
Some headaches suffered by women are hormone-related headaches. These can include menstrual migraines. In fact, more than 50% of women who suffer migraines have noticed a link with their periods.
Hormone headaches can occur during a woman's period as a result of falls in the level of the hormone oestrogen. There can be other hormone-related reasons too:
- Some women have fewer headaches when on the combined oral contraceptive pill, although others may experience headaches more frequently
- As women get closer to the menopause, they may find that headaches can worsen. This might come as a result of more frequent periods and disruption in the normal hormone cycle
- In pregnancy, headaches may worsen in the early weeks, but usually improve or even stop in the last months of pregnancy
Preventing and treating hormone headaches
Migraine type hormone headaches may be prevented by attention to diet, a regular sleep pattern and avoiding stress.
Migraine treatments can provide pain relief. But treatment needs to be suited to a woman's individual requirements. So for further advice, consult your doctor if you think you may have a hormone-related migraine or other types of hormone headache.
What other factors can cause headaches?
These include headaches associated with excessive alcohol intake, colds and flu, a ‘temporomandibular disorder’ affecting the chewing muscles in your jaw, and also obstructive sleep apnoea (OSA). A head injury, concussion and carbon monoxide poisoning may also be causes of headaches.
How to help prevent headaches
So, you were working half the night, you’re running late for an important meeting and that report still isn’t finished. No wonder you have a tension headache!
Hectic days coupled with lack of sleep can send stress levels soaring, which can be a cause for primary headache which have an impact on your performance at work, as well as throwing your body out of balance. To help keep your workplace a headache-free zone, try the following tips.
Make a daily game plan
Creating a daily ‘to-do’ list can help you to re-organise your thoughts and set priorities for the day ahead. Start by assessing when you are most productive – are you a morning or evening person? Plan your day so the most challenging tasks are tackled when you’re at your best.
Set some boundaries
When work starts to pervade your personal life, stress levels can increase and tension headaches can become more frequent. One way to maintain a healthy work-life balance is to set distinct boundaries. Easier said than done? Start by taking it one step at a time – keep your computer switched off at home, make time for your favourite hobby or organise catch-ups with friends and family.
Connect with people
Building connections with people and forming good relationships, with family and friends, have a positive impact on mental wellbeing. If you’ve had a tough day or feel overwhelmed, get some fresh perspective by calling a good friend and talking it over. It’s also important to have a support network within the workplace, so grab a coffee and share a laugh with a colleague.
Move your body
If you’re sitting in front of a computer all day, chances are you may not be getting enough exercise – a factor strongly associated with headaches. Physical activity can boost mood and energy, as well as help to reduce stress and tension. Taking a short walk during your lunch break or even simple exercises such as yoga or gardening can be enough to improve your fitness and help keep those tension headaches at bay.
Don't skip meals
We all know that nutrition is a key to good health, but when you’re busy it can be hard to find time to choose the right foods or eat at all. The reality is that missing a meal reduces your blood sugar levels, which can sometimes act as a headache cause or exacerbate a tension headache you already have. Get each day off to a good start by enjoying a healthy breakfast – which can help to reduce stress and improve work performance.
Sleep away stress
Feeling tired can be a common trigger of tension headaches. Getting more sleep can help reduce your risk of a tension headache. That’s because sleep helps to relax the muscle in your head and neck.
Have trouble getting to sleep in the first place? Then try changing your routine. Going to bed at a regular time each night and avoiding caffeine in the evening can help. You could also try a new pillow or changing your sleeping position.
Check your posture
Back pain is not the only result of poor posture – simply setting your desk and chair up properly can also help to reduce the risk of headaches. Using an ergonomic chair helps your spine to hold its natural curve, which can help relieve muscle tension in your neck, shoulders and back.
You can also adjust your computer monitor so it’s at eye level or slightly lower to help improve posture. Bright lights can also be a headache trigger, so try using an anti-glare screen on your computer monitor, and be sure to take regular screen breaks to give your eyes a rest.
When to consult a doctor
We have looked at several different types and causes of headaches here. But if you are ever in any doubt about your headaches, always get advice from a healthcare professional. If your headache has come on following a head injury, if it becomes severe, or if you experience visual problems, fever, nausea or slurred speech, seek medical assistance immediately.