According to data from the World Health Organization, between 30 and 50% of people suffer from headaches. These may be mild and short-lived, caused by everyday problems, or they may appear as a symptom of more serious conditions. Below you can find out why they occur, how they manifest and how you can treat them.
Causes of headaches
Headaches can affect any part of the head, on the sides or only at a single point, in one area. The International Headache Society (IHS) has divided headaches into primary, when they are not caused by another condition, and secondary, when they appear as a symptom of another health problem.
Primary headaches occur because of overactivity in the brain or as a result of hypersensitivity to pain in the blood vessels, muscles and nerves of the head or neck.
Secondary headaches, by comparison, occur when other health problems stimulate the pain-sensitive nerves in the head. There are a large number of secondary factors that could lead to a headache. Below are some of the most common:
- hangover;
- a blow to the head;
- dehydration;
- hunger;
- tiredness;
- glaucoma;
- polluted air or the presence of irritants in the air;
- flu;
- carbon monoxide poisoning;
- temperatures that are too high or too low;
- overuse of painkillers;
- panic attacks;
- sinusitis;
- dental problems;
- incorrect lighting – too much or too little light can cause headaches;
- stress;
- excessive consumption of coffee or nicotine;
- ear infections;
- poor posture – can lead to both headaches and dental pain – these can be corrected by adopting a correct posture and, if necessary, wearing insoles;
- high blood pressure;
- pressure from wearing a protective helmet that is too tight;
- stroke;
- brain tumours;
- blood clots.
A headache may be felt generally, in one area or at a single point, or as a sensation of pressure in the skull, possibly accompanied by neck and shoulder pain.
As a rule, headaches go away on their own; however, if you notice that your headache behaves differently, gets worse even if you take medication, or if other symptoms appear, it is advisable to see your doctor.
Types of headache
Headaches can be divided according to two criteria. Depending on intensity and cause, they can be primary or secondary, and depending on location, they can be frontal headaches, headaches on the sides of the head, at the back of the head, in the jaw area, in the eye area, or generalised headaches.
By intensity and cause
Primary headaches can be classified into four categories:
- Tension-type headache – the most common primary headache; it mainly affects women. It can be episodic, when it occurs on fewer than 15 days a month and affects up to 70% of adults, or chronic, when it occurs on more than 15 days a month, lasts at least three months and affects 1-3% of adults;
- Migraine – a moderate to severe headache, preceded by photophobia (sensitivity to light), phonophobia (sensitivity to noise), nausea and vomiting. It is a recurrent condition that affects more women than men and mostly adults aged between 35 and 45;
- Cluster headache – one of the most severe headaches. It affects 1-2 people in every 1,000 and often has genetic causes;
- Sinus headache – in addition to the headache, there is a sensation of pressure in the forehead and cheeks. Moreover, the pain intensifies with sudden movements of the head. It occurs with sinus infections (for example, in sinusitis) and with colds or allergies.
Secondary headaches can be caused by dehydration, lack of sleep or stress, but also by more serious conditions such as encephalitis, high blood pressure, head injuries or brain haemorrhages.
By location
Depending on where they are felt, headaches can be divided as follows:
- Frontal headaches – occur in the forehead, above the eyebrows. Most of the time these are tension headaches affecting the areas of the frontal and temporal muscles. They occur with colds, flu or sinusitis;
- Headaches on the sides of the head – these are tension headaches, located on the left or right side of the head, of low to medium intensity. They do not interfere with daily activities;
- Headaches at the back of the head – these are pains associated with tension-type headache and can lead to spasms of the neck muscles. They can also occur with conditions of the spine (for example, when there is a herniated disc);
- Headaches in the jaw area – occur with dental conditions and originate in the dental pulp. A dental infection can cause pain that seems to extend along the whole jaw;
- Headaches in the eye area – this type of pain occurs because of eye problems, lack of sleep or sinusitis;
- Generalised headaches – can have several causes: a head injury, low or high blood pressure, a cold, flu or various allergies.
What conditions can headaches conceal
Headaches can be a first sign of much more serious health problems, such as:
- Eye conditions (especially short-sightedness or presbyopia) – on the one hand, headaches often appear as a first symptom in children who are short-sighted. On the other hand, glaucoma causes headaches as well as narrowing of the visual field, which can lead to blindness, affecting mainly people over 60;
- Cerebral oedema – occurs when an artery in the brain ruptures, as a result of a tumour, meningitis or even exposure to high altitude. In this case, the headaches are accompanied by vision problems, seizures, numbness and difficulty with coordination;
- Brain tumours – the intensity of the headache depends both on the size and location of the tumour and on when it is detected. If the headache is accompanied by symptoms such as personality changes, hearing, vision or speech disturbances or memory problems, it could be a brain tumour;
- Aneurysm – occurs as a result of the dilation of an artery. If it occurs too close to the brain, it can cause a stroke or even a brain haemorrhage. A cerebral aneurysm manifests itself through headaches and vision and speech problems;
- Sinusitis – sinus infections cause frontal headaches that vary in intensity and become stronger when you bend forward;
- Hormonal imbalances – in addition to headaches, these can cause weight gain and behavioural changes. The most common hormonal imbalances occur premenstrually and at the menopause;
- Unbalanced diet – an unhealthy diet based on ultra-processed foods and lacking in vitamins and minerals can cause headaches. Moreover, a lack of vitamin D and magnesium causes migraines, drowsiness, dizziness and irritability.
Headaches in children
Headaches in children are transient and can be caused by ear infections, sinus conditions or vitamin or mineral deficiencies (especially vitamin B). In order to rule out more serious causes, parents are advised to monitor:
- the frequency, duration and intensity of the headache;
- when the pain occurs;
- whether other symptoms appear – for example, nausea, vomiting or fever.
If the headaches do not go away, it is advisable to see a paediatrician to determine their cause and to recommend a treatment suitable for your child.
Investigations for headaches
If the headache does not go away on its own or if over-the-counter medicines have no effect, it is advisable to talk to your doctor about carrying out the investigations needed to establish the cause of the pain. In order to make a diagnosis and establish appropriate treatment, one or more of the following tests may be recommended:
- Computed tomography of the head (CT) – helps detect tumours, brain bleeds or other abnormalities of the blood vessels that could be causing the headaches;
- Magnetic resonance imaging (MRI) – provides a detailed image of the brain and the structures around it;
- Sinus X-ray – helps detect any sinus infections. These can also be detected by CT or MRI scans, so it is up to the doctor whether to recommend this test;
- Electroencephalogram – helps investigate the electrical activity of the brain. The test detects the presence of epilepsy, tumours, head injuries, stroke or encephalitis;
- Blood tests – help determine whether there are vitamin deficiencies that could explain the headache. For example, an abnormal blood sugar level can cause headaches in patients with diabetes;
- Specialist consultations – the ENT, dental or ophthalmology departments can help clarify the cause of the headache, as all of these areas (ears, teeth, eyes) can be the source of the pain.
Treatment of headaches
Drug treatment for a headache depends very much on its cause and location. Based on these, a headache can be treated as follows:
- For cluster headaches and migraines – triptan-based medicines are indicated, on prescription from your doctor;
- For tension-type headache – analgesic and anti-inflammatory medicines – for example, ibuprofen, paracetamol or aspirin (adults only);
- For sinus headaches – nasal decongestants or antibiotics, but only after a specialist consultation and only on the doctor's recommendation.
Other solutions
Supplementing with magnesium or vitamin B complex helps reduce headaches. Similarly, following the recommendations below can reduce migraines:
- Apply a warm or cold compress to the forehead or neck, but avoid extreme temperatures;
- Learn to manage and reduce stress through breathing exercises, yoga or meditation;
- Adopt a balanced lifestyle, eat at least three meals a day and keep your blood sugar level within normal limits;
- Avoid foods that could trigger headaches – this category includes chocolate, peanuts, yoghurt, mature cheese and Chinese cuisine. These foods contain nitrates, phenylethylamine, salicylates, tannins, thiamine, monosodium glutamate etc., which can lead to headaches. Even red wine contains thiamines, histamines and sulphites which, in large quantities, can lead to migraines;
- Exercise regularly and get enough rest;
- Avoid showers that are too hot, as these make the pain worse.
When a headache becomes a cause for concern
Headaches can have the most varied causes, but if they persist or other symptoms appear, there may be reason for concern. It is advisable to see your doctor if the headache is accompanied by symptoms such as:
- confusion;
- loss of consciousness;
- fever above 40 degrees Celsius;
- nausea and vomiting;
- numbness in parts of the body;
- stiff neck;
- difficulty moving;
- difficulty speaking or understanding;
- vision problems.
Likewise, if painkillers have no effect, if the pain seems to intensify over time or if it prevents you from carrying out your daily activities, it is advisable to see a doctor.
Headaches during pregnancy
Headaches during pregnancy are perfectly normal. They occur because of the natural changes the body goes through during pregnancy. These changes, which can cause headaches, include:
- hormonal changes;
- dehydration;
- high blood pressure;
- stress;
- lack of sleep;
- giving up coffee.
Headaches in pregnant women occur mainly in the first and third trimesters. It is worth knowing that if, in addition to headaches, you experience symptoms such as swelling of the feet and hands, frequent vomiting and drowsiness, you may be suffering from pre-eclampsia, a condition that also involves a rise in blood pressure. During pregnancy, this condition can endanger the life of both the baby and the mother, so it is advisable to see a doctor if you notice these symptoms.
Treating headaches during pregnancy should not involve medication, only natural remedies such as:
- rest;
- light physical exercise – for example, walking or swimming (if your doctor approves);
- adequate hydration;
- applying cold or warm compresses to the forehead;
- gentle massage of the temples, shoulders and neck;
- limiting the consumption of foods that could increase the frequency of headaches (for example, peanuts, yoghurt, chocolate and mature cheese).
If the pain persists or even intensifies despite following these suggestions, it is advisable to talk to your doctor urgently.
Preventing headaches
Most of the time, and when headaches are not a symptom of another condition, migraines can be prevented. Below are some natural measures you can take to prevent headaches:
- Limit stress factors – loud noises, pungent smells, bright light;
- Stay hydrated according to your body's needs and your weight – for example, a person weighing 45 kg needs 1.9 l of water a day, while a person weighing 100 kg needs 4.3 l of water a day. Extra water should be added to this amount if you exercise for at least 30 minutes a day. In this case, it is advisable to drink 400 ml of water one hour before exercise, 200 ml of water five minutes before physical activity, and 200 ml of water every 15 minutes during the workout;
- Eat three meals a day and two snacks;
- Take frequent breaks and rest properly;
- Drink calming teas to ward off headaches – this category includes chamomile, lavender, lime blossom or mint tea – these help decongest the nasal passages and make it easier to sleep;
- Relax with a gentle walk in the park, a massage session or a book read in peace;
- Avoid excessive coffee – drinking more than six cups of coffee a day can lead to chronic headaches. Limiting yourself to two or three cups a day can help;
- Exercise for at least 30 minutes three times a week to reduce stress.
Headaches can be either a sign from your body that you need to take things easier, eat more healthily, exercise more and rest more, or a warning that there is a more serious problem. If the headache persists, intensifies or is accompanied by other symptoms, it is advisable to see a doctor.
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