Headaches: Insights into the triggers, symptoms, and treatments

Headaches are a common ailment experienced by many people at some point in their lives. While they can often be managed with simple lifestyle changes or over-the-counter medications, persistent or severe headaches may warrant further investigation.

Here, Dr Fahim Chowdhury, renowned GP, provides an expert guide to headaches, exploring their causes, types, and uncovering effective strategies for relief.

What are the possible causes of my headaches?

Headaches can have a variety of triggers, including:

• Stress: Emotional stress and anxiety can lead to muscle tension, triggering headaches.
• Muscle tension: Tightness in the muscles of the head, neck, and shoulders can cause tension headaches.
• Dehydration: Not drinking enough water throughout the day can cause dehydration, which may result in headaches.
• Sleep disturbances: Changes in sleep patterns, lack of sleep, or poor sleep quality can contribute to headaches.
• Hormonal changes: Fluctuations in hormone levels, particularly in women, such as during menstruation, pregnancy, or the menopause, can be associated with headaches.

Identifying and addressing the underlying cause of headaches is essential for effective management and prevention.

How can I differentiate between the various types of headaches?

There are several types of headaches, each with its own distinct symptoms:

• Tension headaches:

Characterised by a dull, aching pain that typically affects both sides of the head. Often described as a feeling of tightness or pressure in the forehead, temples, or back of the head. Usually mild to moderate in intensity.

• Migraine headaches:

Typically involve moderate to severe throbbing or pulsating pain, often on one side of the head. Accompanying symptoms may include sensitivity to light, sound, or smells. In some cases, people may experience visual disturbances (called aura) which involve flashing lights, blind spots, or zigzag lines, before the onset of the migraine headache.

• Cluster headaches:

Characterised by excruciatingly severe, piercing pain, which is usually centred around one eye or one side of the head. Attacks occur in clusters, typically lasting 15 minutes to 3 hours and recurring several times a day for weeks or months, followed by periods of remission. Associated symptoms may include a red or teary eye on the affected side, nasal congestion, facial sweating, or restlessness.

• Sinus headaches:

Often associated with sinus congestion or infection, resulting in pain and pressure in the forehead, cheeks, or bridge of the nose. This pain may worsen with movement or bending forward. Accompanying symptoms may include nasal discharge, facial tenderness, or fever.

Can headaches be a symptom of a more serious underlying condition?

In some cases, headaches may be a warning sign of an underlying medical condition that requires prompt attention. Some conditions that can cause headaches as a symptom include:

• Meningitis: Inflammation of the membranes surrounding the brain and spinal cord, which can cause severe headaches, fever, stiff neck, and sensitivity to light. Meningitis is a medical emergency.
• Brain tumour: While rare, a brain tumour can cause persistent, progressively worsening headaches, along with other symptoms such as seizures, changes in vision, weakness, or neurological deficits.
• Stroke: Sudden, severe headaches, especially when accompanied by weakness on one side of the body, slurred speech, loss of consciousness, or other neurological symptoms, may indicate a stroke and require urgent medical attention.
• High blood pressure (hypertension): Hypertension can cause headaches, particularly in the back of the head, along with other symptoms such as dizziness, blurred vision, or chest pain.

While these conditions are relatively uncommon, it’s essential to pay attention to any changes in the frequency, severity, or pattern of headaches, especially if they are accompanied by other concerning symptoms.

What are the treatment options for headaches?

The choice of treatment depends on the type of headache, its underlying cause, and the patient’s individual health profile. Some common treatment approaches include:

• Lifestyle modifications: Managing stress through relaxation techniques, mindfulness, or meditation. Maintaining a regular sleep schedule. Staying hydrated and avoiding known headache triggers. Practising good posture and ergonomics.
• Physical therapy: Techniques such as massage, stretching exercises, and postural correction may help alleviate tension headaches and improve overall muscle relaxation.
• Botulinum toxin (Botox™) injections: Botox™ may be recommended for chronic migraines that haven’t responded to other treatments. Botox™ injections are typically administered every 12 weeks by a healthcare professional.
• Surgery: In rare cases, surgery may be considered for people with certain types of headaches, such as occipital nerve stimulation for chronic cluster headaches or decompression surgery for occipital neuralgia.

Are there any medications I can take to alleviate my headaches?

Yes, there are several medications available over-the-counter and by prescription that can help alleviate headaches. The choice of medication depends on the type of headache and the patient’s individual health profile.

• Analgesics: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as paracetamol, ibuprofen, or aspirin. These medications help reduce inflammation and relieve pain associated with tension headaches, migraines, and other types of headaches.
• Triptans: Prescription medications such as sumatriptan or rizatriptan are specifically designed to treat migraines by narrowing blood vessels in the brain and reducing inflammation, which can help alleviate migraine symptoms.
• Preventive medications: Certain medications, such as beta-blockers, antidepressants, or anticonvulsants, may be prescribed to reduce the frequency or severity of headaches in people with chronic or recurrent headaches.

How often should I follow up with you regarding my headaches?

The frequency of follow-up visits for headaches will depend on the patient’s symptoms, treatment plan, and response to therapy. In general, it is recommended to follow up with a healthcare professional if:

• Headaches become more frequent or severe
• There is a change in the character or pattern of headaches
• Headaches aren’t adequately controlled with initial treatment
• New symptoms develop or existing symptoms worsen
• There are concerns about potential side effects of medications

A healthcare professional can help monitor the patient’s progress, adjust treatment as needed, and provide additional support and guidance for managing headaches effectively.

To schedule an appointment with Dr Fahim Chowdhury, head on over to his Top Doctors profile today.