Headache Basics

Overview

A headache is pain or discomfort anywhere in your head, scalp, or neck. It is one of the most common reasons people see a doctor or miss a day of work or school. Most headaches are not a sign of something serious. Many come from tight muscles around the head and neck, stress, tiredness, or the way your brain and nerves read pain signals. Some headaches, like migraine, follow their own pattern and can be very painful. A small number of headaches are caused by another health problem, which is why doctors look out for certain warning signs.

Yes. Almost everyone gets a headache at some point. Tension-type headache and migraine are among the most common health problems worldwide, and headache is one of the top reasons people visit their family doctor.

Anyone can get headaches, at any age. Tension-type headaches are common in adults. Migraine often starts in childhood or the teenage years and is more common in women, partly because of hormone changes. Cluster headache is much less common and affects more men than women. Children can get headaches too, but they may describe them differently.

Symptoms

Common symptoms

• A dull, aching pain, often on both sides of the head or like a tight band around the head
• Pain that gets worse with stress, tiredness, hunger, or long hours at a screen
• A throbbing pain, often on one side, that may come with feeling sick or being bothered by light and sound
• Tenderness in the scalp, neck, or shoulders
• Feeling tired, irritable, or finding it hard to concentrate
• Pain that lasts from 30 minutes to several days, depending on the type

Symptoms in children

• Young children may say their tummy hurts, feel sick, or vomit rather than say their head hurts
• Being quiet, clingy, or not wanting to play or eat
• Crying, holding the head, or rubbing the forehead
• Headaches after screen time, poor sleep, skipping meals, or stress at school
• Children with frequent headaches may miss school, so it is worth talking to a doctor

Symptoms in older adults

• A new headache starting after age 50 should always be checked by a doctor
• Headache with pain in the jaw when chewing, or blurred vision, needs same-day medical review
• Headaches can be linked to medicines, poor sleep, dehydration, or high blood pressure
• Older adults may describe headache differently, so family members noticing changes can help

Causes

Main causes

• Tension-type headache: tight muscles in the scalp, neck, and shoulders, often linked to stress, poor posture, or tiredness
• Migraine: a pattern of headache often with nausea and sensitivity to light or sound, linked to brain and nerve activity and often to family history
• Cluster headache: very severe pain around one eye, often with a watery eye or blocked nose, coming in bursts
• Medication overuse headache: daily headaches that get worse when pain relief is used very often
• Everyday triggers such as dehydration, skipping meals, poor sleep, alcohol, caffeine changes, or screen strain
• Hormone changes, such as around periods or menopause
• Jaw or neck problems, including teeth grinding
• Less often, another health problem such as an infection, very high blood pressure, a bleed in the brain, or (rarely) a brain tumour

Risk factors

• High stress, anxiety, or low mood
• Poor sleep or irregular sleep patterns
• Skipping meals or not drinking enough water
• Long hours at a screen without breaks
• Poor posture or neck and shoulder strain
• Regular or heavy use of pain relief medicines
• Caffeine or alcohol, especially changes in how much you have
• A family history of migraine
• Hormone changes, including periods, pregnancy, and menopause

When to see a doctor

See a doctor urgently if:

• Any of the emergency warning signs listed above — call your local emergency number right away
• A new headache after a head injury
• A new headache after age 50
• A headache that is getting steadily worse over days or weeks
• A headache with fever, a stiff neck, or feeling very unwell
• A headache during pregnancy or after childbirth
• A headache with new vision problems, confusion, or weakness
• A headache that is the worst you have ever had

Book a routine appointment if:

• Headaches that happen often enough to affect work, school, sleep, or mood
• Headaches that do not improve with simple self-care
• You are using pain relief medicine on most days
• You are unsure what type of headache you have
• Headaches started around the same time as a new medicine
• You feel worried about your headaches — that is reason enough to book a check-up

Diagnosis

Most headaches can be diagnosed by talking about your symptoms and having a physical check-up. Your doctor will ask where the pain is, what it feels like, how long it lasts, what makes it better or worse, and whether anything else happens at the same time. They will also look for warning signs that could mean a different cause, check your blood pressure, and examine your eyes, neck, and nerves. A headache diary you keep at home is often the most useful thing you can bring.

Tests that may be done

• Blood pressure check and a general physical examination
• A headache diary recording when headaches happen, how long they last, and possible triggers
• Blood tests, if the doctor wants to rule out other conditions
• A scan, such as a CT or MRI scan, only if there are warning signs or the examination is unusual — most people do not need one
• Rarely, other tests such as a lumbar puncture (a sample of fluid from the spine) if a serious cause is suspected

What to expect at your appointment

Your appointment is likely to be a conversation and a check-up rather than a scan. Write down your symptoms beforehand, including anything that happened just before the headache. If you are offered tests, ask what they are for and what happens next. It can take a little time to work out which type of headache you have, and your treatment plan may be adjusted over a few weeks.

Treatment

Treatment depends on the type of headache, how often it happens, and how much it affects your life. Most people do well with a mix of self-care, understanding their triggers, and simple pain relief used carefully. If headaches are frequent or severe, your doctor may suggest a daily medicine to prevent them, along with other approaches such as physiotherapy or talking therapy.

Self-care at home

• Rest in a quiet, dim room and try to relax your neck and shoulders
• Drink water and eat regular meals — low blood sugar and dehydration are common triggers
• Keep regular sleep and wake times, including at weekends
• Take short breaks from screens and stretch your neck and shoulders
• Try a cold or warm pack on your forehead or neck, whichever feels better
• Ask your pharmacist about suitable pain relief and how often it is safe to use it
• Keep a headache diary to help spot triggers and see what helps

Medical treatments

Doctors treat headaches in a few general ways. For an attack, they may suggest simple pain relief that you can buy from a pharmacy, used as directed and not on too many days each month. For people with frequent or very troublesome headaches, doctors may prescribe a daily medicine to reduce how often headaches happen. Other options include treatments delivered by specialists, such as nerve blocks or specific therapies for migraine, talking therapies such as cognitive behavioural therapy, physiotherapy for neck and jaw problems, and support with sleep, stress, or low mood. Your doctor will explain the benefits and side effects of any option and review how it is working. Always check with your pharmacist or doctor before combining medicines, and never take more than the label or your doctor advises.

When is surgery considered?

Surgery is almost never used for common headaches. In rare cases where a headache is caused by another problem that needs an operation, a specialist team will discuss this with you.

Living with this condition

Living with regular headaches usually means building a steady routine and learning your own patterns. Many people find that small, consistent habits — regular meals, sleep, water, and screen breaks — make a real difference. Keep your pain relief to the amount your pharmacist or doctor advises, because using it too often can cause more headaches. Tell your workplace or school if you need short breaks or a quiet space during an attack.

Lifestyle tips

• Keep a regular sleep schedule and aim for the amount of sleep that suits you
• Eat regularly and stay well hydrated through the day
• Build short, frequent screen breaks into your day
• Check your desk, chair, and posture, and try gentle neck and shoulder stretches
• Notice and manage stress with breathing exercises, gentle activity, or talking to someone
• Be mindful of alcohol and caffeine, and avoid sudden changes in either
• Keep a headache diary so you can see what helps and what does not

Diet and exercise

There is no special diet that cures headaches, but regular meals and steady hydration help many people. Some people notice certain foods or drinks as triggers — a diary can help you work out whether that is true for you, rather than cutting out lots of foods at once. Regular gentle exercise, like walking, swimming, or cycling, can reduce stress and improve sleep, and some people find it reduces how often they get headaches. Start slowly and drink enough water.

Mental health and emotional wellbeing

Ongoing headaches can wear you down and affect mood, sleep, and confidence. Stress, anxiety, and low mood can also make headaches more likely — it works both ways. This is common and treatable, so it is worth telling your doctor how you are feeling. If you ever feel hopeless or have thoughts of harming yourself, please reach out for crisis support right away — contact your local emergency number, a crisis line in your country, or a trusted person who can stay with you.

Prevention

You cannot always prevent headaches, but many people can reduce how often they happen. Regular sleep, meals, water, screen breaks, and stress management all help. If you get headaches often, your doctor may suggest a daily preventive treatment. Avoiding overuse of pain relief is one of the most important steps, because frequent use can itself cause headaches.

Screening programmes

There is no routine screening test for headaches. What matters is having your blood pressure checked as part of normal health care and seeing your doctor if your headache pattern changes or you notice any warning signs.

Complications

If left untreated

• Frequent headaches can affect sleep, concentration, work, school, and relationships
• Using pain relief too often can lead to medication overuse headache, where headaches become more frequent
• Stress and low mood can worsen, and headaches can become harder to manage
• Very rarely, a headache is a sign of a serious problem — this is why warning signs should never be ignored

Long-term outlook

The outlook is good for most people. Tension-type headaches and migraine usually improve with simple changes and, where needed, treatment from your doctor. Many people find that with time they learn their triggers and can reduce how often headaches get in the way. If one treatment does not work, there are usually others to try, so keep talking to your doctor.

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