Headaches: types, causes and warning signs

What are the common types of headache?

The NHS says the main symptom of a tension headache is pain on both sides of the head, face or neck, which lasts at least 30 minutes and can last much longer. NHS Cheshire and Merseyside describes tension-type headache as the most common headache, usually mild to moderately severe, with a pressing or tightening feel. The NHS says stress is a common cause of tension headaches.

The NHS describes migraine as a throbbing headache that can be severe, is often on one side of the head and can be worse when moving around. Other migraine symptoms include feeling sick and sensitivity to light and sound.

Some people also get an aura, such as seeing zigzag lines or flashing lights. NHS inform says migraine affects around 1 in 5 women and 1 in 15 men. NHS inform describes cluster headaches as rare, coming in bouts of short daily headaches that last a month or two, with pain usually around the eye.

Can painkillers cause headaches?

Great Ormond Street Hospital describes medication overuse headache as a headache that develops and gets worse with frequent use of medicines taken for pain. Great Ormond Street Hospital says medication overuse headache occurs in people who already have tension-type headache or migraine. A Nottinghamshire NHS pathway says headache from overusing painkillers improves or resolves within 3 months of stopping them.

Which headaches need a 999 call?

The NHS says to call 999 or go to A&E for a headache that comes on suddenly and is extremely painful, or one that follows a serious head injury. NHS inform lists other reasons to call 999 or go to A&E, including signs of stroke such as weakness on one side or slurred speech, signs of meningitis or sepsis, and being drowsy or confused.

Which headaches need an urgent GP visit?

NHS inform lists a headache set off by coughing, sneezing, a change in posture or effort as a reason to contact the GP practice urgently, or phone NHS 111 if it is closed. A headache that wakes someone from sleep, or keeps getting worse despite treatment, is listed under contacting the GP practice. NHS inform lists a sore scalp or jaw pain when chewing in someone over 50 as a reason to contact the GP practice urgently, or phone NHS 111 if it is closed. NHS inform lists changes in vision, or a new or worsening headache with dizziness, vomiting or weakness, as reasons to contact the GP practice urgently, or phone NHS 111 if it is closed. An NHS formulary guideline describes giant cell arteritis, also called temporal arteritis, as a medical emergency that needs prompt assessment and immediate steroid treatment to prevent permanent loss of vision.

How is migraine treated?

The NHS describes triptans as a painkiller made specifically for migraine, available as tablets, injections and nasal sprays. NHS inform says a GP may recommend a triptan if over-the-counter medicines are not helping. Anti-sickness medicines can help during a migraine even without nausea, and the NHS says they work better when taken as soon as symptoms begin. The NHS lists stress, tiredness, skipping meals and too much caffeine among common migraine triggers.

When is a routine GP visit sensible, and what might the GP do?

The NHS says tension headaches can be treated with painkillers, but advises seeing a GP for several headaches a week or severe ones. A GP may suggest keeping a migraine diary. There is no specific test for migraine, so the GP looks for a pattern of recurring headaches with the typical symptoms. The NHS says an antidepressant medicine called amitriptyline is sometimes recommended to help prevent tension headaches.