Understanding Headaches


Types Of Headaches

types of headaches

Headaches are one of the most common conditions that people suffer, as a general rule most are not serious and can be treated with over the counter medications and lifestyle changes.

  • Simply increasing your fluid intake and getting plenty of rest can help prevent, or decrease the severity of many headaches.


Even severe headache pain isn’t usually the result of an underlying disease, but some headaches can indicate serious medical conditions such as a brain tumor or aneurysm (rupture of a blood vessel)

If you experience Any Of The Following Seek Emergency Medical Care:

  • A very sudden, severe headache
  • A headache accompanied by nausea, vomiting, fever, numbness, a stiff neck, seizures, speaking difficulties, confusion or vision problems (these may be signs of more severe problems such as stroke, encephalitis, meningitis or brain tumor)
  • A headache after any form of head injury – no matter how minor
  • A headache that changes in pattern and worsens
  • A headache triggered by coughing, sneezing, laughing, physical exertion or changes in posture.


Tension Headaches

A tension headache feels like an elastic band is tightening around the head causing a mild to moderate, dull pain.

Although a tension headache can be debilitating the pain is not usually severe enough to prevent you doing your normal activities. They usually last around thirty minutes to two hours, but in some rare cases the pain can last for days.


Causes Of Tension Headaches

The exact cause of a tension headache is unknown, but they have been linked to things like:

  • High stress levels
  • Skipping meals
  • Dehydration
  • Poor posture
  • Sunlight
  • Noise


Treating Tension Headaches

Tension headaches are usually controllable with relaxation techniques and over the counter pain medication, such as paracetamol and ibuprofen.

  • You can help prevent tension headaches by staying hydrated, reducing stress and getting plenty of good quality sleep.



Migraines are not as common as tension headaches. They are usually felt as a moderate to severe, throbbing pain felt at the front or side of the head, and often include other symptoms such as nausea, vomiting and sensitivity to sound and/or light. A migraine can be unrelenting and last from hours to days.


Causes Of Migraine

Initially migraines are thought to be triggered by a chemical reaction in the brain.

Other triggers may include:

  • Hormonal changes (menstruation and menopause are high risk times)
  • Low blood sugar / hypoglyceamia
  • High sugar intake
  • Emotional anxiety
  • Exercise
  • Dehydration
  • Alcohol
  • Medicines (including contraceptives)
  • Poor diet


Treating Migraines

The best method of treating a migraine is avoidance. Understanding what triggers your migraine will allow you to prepare and move to an environment with minimal auditory or visual sources which can prevent the migraine entirely, or reduce its severity.

  • Some migraines may respond to over the counter pain medication but it’s a good idea to talk to your doctor about an appropriate management plan and prescription medication if needed.


Cluster Headaches

Cluster headaches are one of the most painful types of headache and occur in clusters or cyclic patterns, these clusters can last from weeks to months, followed by a period of remission when the headaches stop. The exact cause is still unknown but the pattern of headaches suggests a problem in the body’s biological clock (hypothalamus). Unlike other headaches or migraines there appears to be no association with triggers such as hormonal changes, foods or stress.

Cluster periods usually last from six to 12 weeks and the starting time and duration are generally consistent. For example you may get cluster headaches at the beginning of spring which last for 8 weeks, then go into a remission period until next spring when the headaches start again.


During A Cluster Period:

  • Headaches can occur every day, sometimes more than once.
  • A cluster headache can last from 15 minutes to three hours.
  • Cluster headaches may occur at the same time each day.
  • Most attacks occur at night after you go to bed


During A Cluster Headache You May Experience:

  • Excruciating pain, usually in or around one eye, but can radiate to other areas of your head, face, neck and shoulders
  • Pain on one side only
  • Restlessness
  • Excessive tearing
  • Red eye on the affected side
  • Runny or stuffy nose
  • Sweating around the forehead or face
  • Pallor (Pale skin) or flushing on your face
  • Swelling around the affected eye
  • Drooping eyelid


Treating Cluster Headaches

There’s no cure for cluster headaches but some prescription medications can decrease the severity of the pain. Over the counter medication is generally ineffective.

If you have just started to have cluster headaches it is important to see your doctor. They can provide a professional diagnosis and effective treatment plan.


Painkiller headaches (Rebound Headaches)

As the name suggests painkiller headaches occur after prolonged use of painkiller medications.


Painkiller headaches only develop in people taking painkillers for headaches. They do not occur in people taking painkillers over an extended period of time for any other condition, like back pain or arthritis.


What causes painkiller headaches?

The usual cause of painkiller headaches is simply the prolonged use of pain medication. Exceeding the recommended daily dose is not a factor.

If you have headaches and are taking pain medication over a prolonged period of time (more than two times per week for over three months) you are in the high risk category of getting painkiller headaches.


A Vicious Cycle

  • Your body gets used to the pain medication
  • If you don’t take another painkiller within a day or so a rebound headache develops
  • You assume it’s just another headache and take more pain medication
  • When the effect of the painkiller wears off another rebound headache occurs
  • And the cycle goes on


All common over the counter pain medication can cause rebound headaches, including:

  • Paracetamol
  • Codein (the most likely drug to lead to painkiller headaches)
  • Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen
  • Triptans (a group of medications specific to migraines) like sumatriptan


Preventing Painkiller Headaches

  • Do not take painkiller medications for headaches more than twice in one week
  • Do not take painkiller medications for headaches for more than two consecutive days
  • Try to avoid any medication containing codeine


Treating Painkiller Headaches

The treatment for painkiller medication overuse headaches is simple – stop taking painkillers.

Even if you have been dependent on pain medication for years the most effective treatment plan is to stop abruptly. Your headaches will probably worsen initially and you may feel sick and have trouble sleeping, but after about 10 days when your body is free of the pain medication YOU WILL FEEL BETTER.


Hormonal Migraines

For women, changing hormone levels can play a major role in getting chronic headaches and menstrual migraines.

This hormonal change happens during the menstrual cycle, pregnancy and menopause.

Oral contraceptives and hormone replacement therapies (HRTs) also effect hormone levels and have the potential to cause hormonal migraines.


Causes Of Hormonal Migraines

Hormonal migraines have been linked to the estrogen hormone. Estrogen controls the chemicals in the brain responsible for the sensation of pain. Even a minor drop in estrogen levels can cause a migraine.


What Can Cause A Drop In Estrogen Levels?

Menstrual cycle 

Just prior to menstruation estrogen and progesterone levels drop to their lowest.



In pregnancy estrogen levels rise so hormonal migranes generally disappear, however, in some women migraines can appear through early pregnancy and disappear after the first trimester.

After the birth of a child is a high risk time for hormonal migraines as estrogen levels drop rapidly.


Perimenopause and Menopause

Changing hormone levels throughout perimenopause (the years leading up to menopause) may cause an increase in migraines, but for most women these  will improve as they reach menopause.

For women using hormone replacement therapies these migraines may actually worsen due to the fluctuation in hormone levels.


Oral Contraceptives And Migraines

Birth control pills can cause hormone levels to fluctuate. Women who experience migraines from oral contraceptives usually get them in the last week of the cycle, when the pills have no hormones.

In addition to hormones people who suffer headaches/migraines tend to have multiple triggers which may include:

  • Poor diet – missing meals
  • Having poor sleep patterns
  • Very intense sounds or smells, and/or bright lights
  • Severe changes in the weather
  • Drinking alcoholic, especially red wine
  • Drinking too much caffeine or withdrawal from caffeine
  • Stress
  • Eating processed meats, smoked fish and hard sausages
  • Eating monosodium glutamate (MSG)
  • Eating aged cheeses
  • Soy products
  • Artificial sweeteners


Symptoms Of Hormonal Migraines

The main symptom of a hormonal migraine is obviously the migraine; these are almost the same as a regular migraine but may or may not have an aura present.


Other Symptoms May Also Be Experienced Which Include:

  • Loss of appetite
  • Feeling fatigued
  • Painful joints
  • Coordination problems
  • Decreased urination
  • Constipation
  • Cravings which can include salt, chocolate or alcohol
  • Acne


Treatment For Hormonal Migraines

  • Stay hydrated – drink plenty of water
  • Try to rest in a quiet, dark room
  • Use a cold cloth or ice pack on your head
  • Massage any painful areas
  • Utilize relaxation techniques
  • Take an over the counter pain medication


If you are experiencing frequent hormonal headaches/migraines see your doctor, they can give a definitive diagnosis and design a treatment plan to include both preventive and acute treatment.