Headache

Overview

A headache is pain or discomfort in the head, scalp, or neck. It is one of the most common health complaints and usually not a sign of a serious problem.

Very common. Almost everyone experiences a headache at some point in their lives.

Headaches can affect people of all ages, including children and older adults. Some types, like migraines, are more common in women.

Symptoms

Common symptoms

• Pain in the head – may be dull, sharp, throbbing, or constant
• Pressure or tightness around the forehead or back of the head
• Sensitivity to light or sound (common in migraines)
• Nausea or vomiting (common in migraines)

Symptoms in children

• Head pain that may be hard for them to describe
• Irritability or crankiness
• Wanting to lie down in a dark, quiet room
• Upset stomach or vomiting

Symptoms in older adults

• Headache that feels different from previous headaches
• New or worsening headache
• Headache with vision changes or difficulty speaking
• Headache after a fall or head injury

Causes

Main causes

• Tension – from stress, poor posture, or eye strain
• Migraine – a neurological condition with specific triggers
• Cluster headaches – intense pain around one eye, occurring in cycles
• Sinus problems – infection or allergies can cause pain in the face and head
• Dehydration, lack of sleep, or skipping meals
• Caffeine withdrawal or overuse of painkillers (medication-overuse headache)

Risk factors

• Stress and anxiety
• Family history of migraine
• Hormonal changes (e.g., during menstruation, pregnancy, menopause)
• Poor sleep habits
• Certain foods or drinks (e.g., aged cheese, alcohol)
• Skipping meals

When to see a doctor

See a doctor urgently if:

• If you have a sudden, severe headache unlike any you've had before
• If your headache comes with a stiff neck, fever, or confusion
• If you had a recent head injury and now have a headache
• If your headache is accompanied by weakness, numbness, or trouble speaking

Book a routine appointment if:

• If your headaches are frequent (more than a few times a month) and affect your daily life
• If you are using painkillers for headaches more than twice a week
• If your headache pattern changes (e.g., becomes more severe or occurs more often)
• If you have a headache that lasts for several days without getting better

Diagnosis

Your doctor will ask about your headache symptoms, when they happen, what triggers them, and any other health conditions. They may also do a physical exam, including checking your blood pressure and neurological signs.

Tests that may be done

• Usually no tests are needed for common headache types
• If there are warning signs, your doctor may recommend blood tests, a CT scan, or an MRI to rule out other causes

What to expect at your appointment

Your doctor will discuss a treatment plan based on your headache type and triggers. They may also refer you to a headache specialist if needed.

Treatment

Treatment depends on the type of headache and how often it occurs. The goal is to relieve pain and prevent future headaches.

Self-care at home

• Rest in a dark, quiet room
• Apply a cold or warm compress to your head or neck
• Drink plenty of water
• Eat regular meals and avoid skipping meals
• Practice relaxation techniques such as deep breathing or meditation
• Limit caffeine and alcohol

Medical treatments

For occasional headaches, pain relief is available from your pharmacist in the form of tablets or liquids. Your doctor can prescribe stronger treatments for migraine or cluster headaches, including medications that can be taken at the start of an attack or daily to prevent them. Some people benefit from nerve blocks or Botox injections for chronic migraines. Always follow your doctor's advice on how to take any medication.

When is surgery considered?

Surgery is not a typical treatment for headaches. In very rare cases, it may be considered if headaches are caused by a specific condition such as a brain aneurysm or tumour. Your doctor will explain this if it applies to you.

Living with this condition

Living with frequent headaches can be challenging, but with the right plan, most people can manage their symptoms and continue their daily activities. Keeping a headache diary can help you identify triggers.

Lifestyle tips

• Maintain a regular sleep schedule
• Manage stress through exercise, hobbies, or talking to someone
• Stay well-hydrated throughout the day
• Avoid known triggers such as specific foods or strong smells

Diet and exercise

A balanced diet with regular meals can help prevent headaches triggered by hunger. Some people find that certain foods like chocolate, cheese, or processed meats trigger migraines. Gentle exercise like walking or yoga can reduce stress and frequency of headaches.

Mental health and emotional wellbeing

Chronic headaches can cause frustration, anxiety, or low mood. It's important to talk to your doctor if you feel down or worried. Cognitive behavioural therapy (CBT) or relaxation techniques may help. If you are having thoughts of harming yourself, please reach out to a crisis helpline or your local emergency number immediately.

Prevention

Many headaches can be prevented by avoiding triggers and maintaining a healthy lifestyle. For frequent migraines, your doctor may prescribe preventive medications (taken regularly to reduce attacks) or recommend supplements such as magnesium or riboflavin. Always discuss with your doctor before starting any supplement.

Complications

If left untreated

• Chronic daily headaches that affect quality of life
• Overuse of painkillers can lead to medication-overuse headaches
• Rarely, an underlying serious condition may go undiagnosed (so it is important to see a doctor for new or changing symptoms)

Long-term outlook

For the vast majority of people, headaches are not dangerous and can be well managed. With the right treatment and lifestyle adjustments, most people experience fewer and less severe headaches over time. If you have a chronic condition like migraine, there are many effective options to help you live well.

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