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Headache: Is yours a sign of something serious? Tension, cluster and migraine explained

Headaches can last between 30 minutes and several hours, according to the NHS, and there’s a variety of different causes.

Drinking plenty of water, getting plenty of rest and taking paracetamol or ibuprofen are all treatment methods recommended by the health body.

But what treatment to opt for can depend on the type of headache you have.

The most common types of headache are tension headaches, cluster headaches and migraines – but are these the sign of anything serious? Dr Sarah Brewer  explains.


Headaches can last between 30 minutes and several hours, according to the NHS, and there’s a variety of different causes

Tension headaches

These are usually mild to moderate in intensity and felt on both sides of the head.

Dr Brewer explained: “It typically produces a steady ache rather than a throbbing pain, and often feels like a continuous pressure, or a tight, constricting band over the top of the skull, over the back of the head, or above both eyes. It’s not made worse by physical activity such as walking, and there is no nausea.

“Tension-type headache can occur at any age and is thought to result from tension in the neck and scalp muscles which affects blood flow within the skull.”

Advice by Dr Brewer is to avoid stress, poor posture, overwork and dehydration.

She said: “Don’t stoop, hunch your shoulders, clench your fists or grind your teeth.

“Ensure your work station is set up ergonomically and take regular breaks to walk around.

“Ask a friend to gently massage muscles in your neck, shoulders and upper back.

“There is an acupressure point situated directly between your eyebrows, where the bridge of your nose meets your forehead which, when managed gently can help to reduce tension headache.”

Headache: Is it a sign of something serious? Tension, cluster and migraine explained

Headache: Is it a sign of something serious? (Image: GETTY)

Cluster headache

Cluster headache is one of the most severe types of pain you can experience and has been referred to as suicide headache.

“One eye becomes congested and watery and the nostril on the same side is usually blocked, and you may experience facial sweating or flushing, and swelling of the eyelid,” said Dr Brewer.

“The pain lasts for up to three hours and comes on regularly – usually at the same time of day and often in the early morning, waking you from sleep for one to three weeks before disappearing.

“Although sufferers are perfectly well in between attacks, the pain is so severe that many live in fear of the next one occurring (melontophobia).

“The cause is unknown but involves over-activation of a part of the brain (posterior hypothalamic grey matter).”

Migraine

Migraine is a severe pain that is usually (but not always) worse on one side of the head, often centred around one eye.

Dr Brewer explained: “Most people with migraine (90 per cent) have the form known as Migraine without aura. This produces a severe, throbbing, pulsating or hammering headache along with nausea, vomiting, sensitivity to light and sound. Migraine without aura usually lasts between 4 hours and 72 hours and is made worse by physical activity. Migraine with aura is associated with visual symptoms such as shimmering or flashing lights, strange zigzag shapes (fortification spectra) or blind spots.

“Symptoms of migraine usually begin at puberty and cause recurrent attacks until middle age, when they often disappear. The cause is not fully understood but may be linked with changes in the dilation and constriction of blood vessels so that certain brain tissues become congested.

“Some researchers believe that everyone has the capacity to suffer from migraine, but that those who experience symptoms have a lower threshold at which an attack is triggered.

“This probably relates to genetic differences, hormone levels (migraine is three times more common in women than men) and susceptibility to environmental factors including foods.”

Keeping a headache diary may help to identify personal trigger factors, such as lack of sleep, stress, skipping meals, fatigue, relaxation after stress, certain foods or extreme emotions, says Dr Brewer.

She adds: “Often no one cause is involved, but multiple triggers which take you over the threshold to precipitate an attack.

“Episodic migraine refers to a headache which occurs on less than 15 days per month.

“Chronic (long-term) migraine is diagnosed when someone has migraine on 15 days or more per month.”

Headache: Is it a sign of something serious? Tension, cluster and migraine explained

Headache: Tension headaches are usually felt on both sides of the head (Image: GETTY)

Headache: Is it a sign of something serious? Tension, cluster and migraine explained

Headache: A cluster headache is one of the most severe types of pain (Image: GETTY)

Some of the recognised causes of headache include:

  • Sexual activity – researchers have found if you have sex when you have a headache, the pain can be re-triggered every time you make love for at least six weeks afterwards. In some cases, the re-triggering of headache effect lasts for a year or longer.
  • Coughing
  • Excess sleep (more than eight hours) at the weekend
  • Caffeine withdrawal
  • Rebound effect of excess use of paracetamol or ibuprofen (more than two or three times a week on a regular basis)
  • Alcohol
  • Phosphodiesterase inhibitors (eg sildenafil – Viagra)
  • Food additives (eg monosodium glutamate) in sensitive people
  • Premenstrual hormone swings
  • Eating ice-cream or other very cold foods
  • Carbon monoxide

Dr Brewer says it’s important to seek medical advice if someone has:

  • A severe sudden-onset headache
  • A headache that keeps getting worse and won’t go away or which changes dramatically
  • Experiences three or more headaches a week
  • Other symptoms such as a fever, stiff neck, rash, vomiting, confusion, drowsiness or unexpected symptoms affecting their eyes, ears, nose or throat
  • Headache plus dizziness, slurred speech, weakness, or changes in sensation (numbness and/or tingling)
  • A headache following a head injury
  • A headache triggered by exertion, coughing or bending
  • Or is pregnant (to rule out pre-eclampsia)

She added: “These additional features are red flags for potentially serious types of headache that need further investigation and treatment.”

Dr Sarah Brewer has worked as a GP and hospital doctor, and is now a medical and nutritional consultant, and author.  She can only provide general advice. Always seek individual advice from your own doctor for any persistent health problems that concern you. 

Migraines are common and usually begin in early adulthood. Some people experience them occasionally, while for others it’s more frequent. Some health experts recommend taking a supplement for relief – magnesium.


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