Headache: Types & Treatments

Many people will, at some point, experience a headache. Headaches are a worldwide problem, says the World Health Organization: half to three-quarters of adults in the world have had a headache during the last year; and up to four per cent of the global population has a headache on 15 or more days every month (i).

There are two main types of headache: primary headache, which is a headache that isn’t due to any underlying health problem; and secondary headache, which is a headache caused by a separate illness or injury.

Primary headaches are much more common than secondary headaches – more than 90 percent of visits to GPs for headaches are thought to be for the primary kind, with fewer than 10 percent of visits for secondary headaches (ii).

Experts aren’t clear about what exactly causes primary headaches, though several things seems to trigger them, including stress, drinking too much alcohol, not drinking enough water (dehydration), not eating regularly and being tired after not getting a good night’s sleep.

Some other things that may trigger a headache include anger, poor posture, changes in the weather or stormy weather, bright lights, some smells (such as perfume, air fresheners and household cleaners) and even eating ice cream (ice cream headaches cause a sharp, stabbing pain in the forehead when you eat ice cream or ice lollies). Certain foods can also bring on a headache, though food triggers are normally associated with the type of headache known as a migraine Learn more about the symptoms and treatment of migraines in our guide.

 Meanwhile, causes of secondary headache include the following:

• Head and/or neck trauma.

• Cranial or cervical vascular disorders (including stroke).

• Disorders of the neck, eyes or ears.

• Sinusitis, colds and flu.

• Temporomandibular disorders (problems that affect the muscles and joints between the lower jar and base of the skull).

• Disorders of the teeth or jaws.

• Carbon monoxide poisoning.

• Drug withdrawal.

• Underactive thyroid. Discover more about thyroid disorders and remedies.

• Sleep apnoea (which interrupts normal breathing during sleep).

Types of headache

As well as primary and secondary, there are different types of headache (migraine is classed as a primary headache – click here to read more about it):

Tension headache

This is the everyday type of headache most people suffer from. The symptoms include a dull ache on both sides of the head, with a feeling of pressure around the head or behind the eyes. They can last anything from half an hour to several hours – although some tension headaches can last for days.

According to the NHS, moat people have had a tension headache at some point, with women tending to have more tension headaches than men. They can start at any age, but are more common in teenagers and adults. Most people get fewer than 15 tension headaches a month, which is called episodic tension headache. However some people have more than 15 tension headaches a month for at least three months in a row – this is called chronic tension headache (iii).

There are many causes, including stress, lack of sleep, skipping meals and not drinking enough (dehydration). Other triggers include bright sunlight, eye strain, loud noise, lack of exercise, poor posture and certain types of smells.

Cluster headache

Cluster headaches can be incredibly painful, so it’s good to know they’re fairly rare. Around one in 1,000 people are thought to be affected, with four times more men affected than women (iv). The symptoms typically include intense pain on one side of the head – usually around or behind one eye – that’s more severe than the pain of a tension headache or even a migraine.

If you’re affected by cluster headaches it’s likely you’ll get them every day for a few weeks or months at a time, after which they disappear for a while – several months or possibly even years – before starting again. According to the NHS, they often happen at the same time of year, most commonly during the spring or the autumn (v).

It’s generally thought that cluster headache is linked to a part of the brain called the hypothalamus. Experts have studied what happens in the brain during an attack, and some believe the hypothalamus releases chemicals called neurotransmitters. These may cause pain by stimulating nerve cells in the brain. Another theory is that cluster headache may also be caused by the widening of blood vessels in the brain, which causes pain by adding pressure to tissues in the brain.

Unfortunately, most cluster headaches don’t have any triggers, though some people who have them find things like alcohol, strong smells and being too hot can bring on an attack.

Hormone headache

Many women have headaches that are linked to their menstrual cycle (experts believe they’re caused by changes in hormone levels). Other triggers for hormone headaches include taking the combined contraceptive pill, pregnancy and menopause. Hormone headaches are also often referred to as menstrual migraines.

Medication and painkiller headache

Some headaches can be a side effect of taking certain medications, or can be caused by taking too many painkillers (or, rather, taking painkillers too often). The latter is often called medication-overuse headache or rebound headache, and according to experts from the National Institute of Health and Care Excellence (NICE), up to two percent of the population worldwide is affected by them, with women five times more likely to be affected than men (vi).

The International Classification of Headache Disorders defines medication-overuse headache as headache that occurs on 15 or more days of the month caused by regular overuse of headache medication for three months or longer.

Symptoms include having a chronic or continuous headache, a headache that may be worse during the mornings or a headache that gets worse when you’re active or exercising.

If you’re suffering from medication-overuse headaches, you must see your GP for advice on stopping taking painkillers (depending on the type of painkiller, you may have to stop immediately or gradually).
 

Meanwhile there are several other types of primary headache, including exertional headache (which is triggered by exercise), cough headache (brought on by coughing or straining), sexual headache (caused by sexual activity) and hypnic headache (a dull headache that can wake you up and lasts at least 15 minutes after waking).

Pain relief for headaches

Most tension headaches can be treated with simple pain relief medicines that you can buy over the counter (for cluster or hormone headache treatments, see your GP). But which one should you choose?

Paracetamol

Paracetamol is thought to act on the production of prostaglandins, substances produced by the body in response to injury that sensitise nerve endings involved in the process of inflammation.

It’s available in tablets, including effervescent/dissolvable tablets, or as a liquid. Dissolvable paracetamol may treat symptoms more effectively as the active ingredient is absorbed by the body faster compared with a tablet.

Combination remedies are also available for more persistent or severe headaches that contain both paracetamol and an opioid painkiller called codeine.

Paracetamol on its own is suitable for adults, children over the age of two months and pregnant women.

Ibuprofen

Ibuprofen is an anti-inflammatory painkiller that works by blocking a chemical called COX, an enzyme that helps your body produce prostaglandins. It may be a good option for headache sufferers who find paracetamol isn’t effective. However, it isn’t recommended for long-term use, as it can cause stomach-related side effects.

It’s available in tablets, caplets and capsules and is suitable for adults and children over the age of three months (older people should use ibuprofen with care).

Aspirin

Because aspirin can cause side effects in the stomach, it isn’t usually recommended for headaches. Aspirin is also found in pain relief medicines combined with other ingredients such as caffeine or paracetamol.

Do not give aspirin to children under the age of 16. It’s also not suitable for pregnant women or people who have asthma.

When is a headache serious?

While the vast majority of headaches aren't serious, a very small number may indicate an underlying health problem. These serious headaches are more common in older people, and can appear very quickly and become worse over time. Here are some of the main examples:

Meningitis

A severe headache can be a symptom of meningitis, which causes an infection and inflammation of the tissues around the brain. Other symptoms include a high temperature, vomiting, muscle and joint aches and pains, sensitivity to bright lights and a stiff neck. Around 3,200 people are thought to be affected by bacterial meningitis every year in the UK (vii), but figures for the more common and usually less serious viral meningitis are not available, since the symptoms are often similar to those of flu.

Haemorrhage

A sudden severe headache may also be a symptom of a subarachnoid haemorrhage, which is typically caused by an aneurysm. Thankfully, subarachnoid haemorrhages are very rare and are thought to affect just six to nine people in every 100,000 each year (viii). Other symptoms may include vomiting and seizures.

Temporal arteritis

Usually confined to people over the age of 50, temporal arteritis causes a frontal headache (behind the forehead) and is caused by inflammation in the arteries behind the eye and in the temples. People who are affected may also feel generally unwell and experience pain in their jaw muscles while chewing. If left untreated, temporal arteritis can lead to loss of vision in one or both eyes.

Tumour

Many people who have persistent, severe headaches fear the cause may be a brain tumour, but in reality this is very rare (the most current figures suggest just 13 per 100,000 adult men and 12 per 100,000 adult women develop brain and other central nervous system tumours each year in the UK (ix)). But if it is a tumour, you may also feel sick, and if you cough, sneeze or bend over, your headache may feel worse.

Thankfully most serious headaches aren’t at all common, but if any of the following applies to you, see your GP as soon as possible:

• Your headache comes on suddenly and severely (especially if you've recently suffered a knock to the head).

• Your headache is accompanied by a fever, convulsions, feelings of drowsiness or confusion, blurred vision or vomiting.

• There's a dramatic change in your normal headache pattern

 

Natural headache relief

Nutritional or herbal supplements and natural treatments that may help to alleviate headaches include the following:

Vitamin B complex

If you tend to get headaches when you’re under too much stress, you may find that vitamin B complex – a supplement that contains a combination of B vitamins – helps. That’s because certain B vitamins are thought to help the body to cope better with the negative effects of stress. There is some evidence to support this: for example, a study found that taking a B complex supplement for 90 days may lead to a significant reduction in the experience of stress at work (x).

 

PEA

Also known as palmitoylethanolamide, PEA is a type of fatty acid made naturally by the body and found in all cells, tissues and fluids including the brain (it’s also found in foods such as soya beans, peanuts, eggs, flaxseed and milk). Described as an endocannbinoid-like chemical that belongs to a family of fatty acid compounds called amides (xi), PEA is an alternative to CBD, since both substances are thought to have similar properties including the ability to reduce pain and inflammation. However researchers suggest PEA is safer than CBD, since it has been studied more extensively and has a more robust safety profile (xii) with no known side effects (xi).

Your body naturally increases its production of PEA when your cells are damaged or threatened. But in certain situations – such as when your body is experiencing chronic inflammation – the level of PEA in your cells drops (xi). When this happens, PEA supplements may be helpful. In fact a review of 16 clinical trials and meta-analysis of PEA suggests it does have analgesic actions – in other words it helps to relieve pain (xiii).

 

Sticks and strips

Designed to be applied directly to the forehead, these sticks and strips contain an ingredient called levomenthol (a type of peppermint). It’s thought that they may block pain signals caused by tension headaches and relax the muscles in the head. Alternatively you could apply diluted peppermint essential oil or Tiger Balm – a popular blend or aromatic substances – to your forehead .

Meanwhile natural treatments that may be worth trying for tension headaches include acupuncture, chiropractic, hypnosis, osteopathy and relaxation therapies.

Other things you can do to help relieve a headache include the following:

• Lie down in a dark, quiet room and try to relax your back, neck and shoulders.

• Try deep breathing – inhale and exhale to a slow count of five until you feel yourself relaxing.

• Drink a glass of water (a headache can be a sign that you’re becoming mildly dehydrated).

• Place a hot water bottle or ice pack at the back of your neck if your headache is accompanied by muscle tension.

• Try acupressure – find the spots just below the base of the back of the skull in the hollows on both sides of the neck, about three inches apart (in acupressure these spots are called GB20). Press and massage both spots with your thumbs, fingers or knuckles while breathing slowly and deeply for up to three minutes.

While dealing with headaches on a day-to-day basis can be stressful, these steps should help to ease some of the symptoms. For even more information on a range of other common health conditions, feel free to visit our health library.

 

References:

1. Available online: https://www.who.int/news-room/fact-sheets/detail/headache-disorders

2. Available online: https://patient.info/doctor/headache-pro

3. Available online: https://www.nhs.uk/conditions/tension-headaches/

4. Available online: https://patient.info/brain-nerves/headache-leaflet/cluster-headaches/

5. Available online: https://www.nhs.uk/conditions/cluster-headaches/

6. Available online: https://cks.nice.org.uk/headache-medication-overuse#!backgroundSub:2

7. Available online: https://patient.info/childrens-health/meningitis-leaflet

8. Available online: https://patient.info/doctor/subarachnoid-haemorrhage-pro

9. Available online: https://patient.info/doctor/brain-tumours-in-adults

10. Stough. C, Scholey. A, Lloyd. J, et al.The effect of 90 day administration of a high dose vitamin B-complex on work stress. Hum Psychopharmacol. 2011 Oct;26(7):470-6.

11. Clayton P. et al., Palmitoylethanolamide: A Natural Compound for Health Management. Int J Mol Sci. 2021 May;22(10): 5305. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8157570/

12. Clayton P. et al., Palmitoylethanolamide: A Potential Alternative to Cannabidiol. J Diet Suppl. 2021 Nov;28;1-26. Available online: https://www.tandfonline.com/doi/full/10.1080/19390211.2021.2005733

13. Gabrielsson . L, Mattsson. S, Fowler. CJ. Palmitoylethanolamide for the treatment of pain: pharmacokinetics, safety and efficacy. Br J Clin Pharmacol. 2003;110:359-362.Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094513/

 

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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.

 

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