Headaches are incredibly common, but when they start affecting your day-to-day life, it’s important to understand the underlying cause and explore effective treatment options.
The Most Common Types of Headaches
There are several types of headaches, each with unique symptoms and causes. The most common include:
- Tension headaches: The most frequent type, causing a dull, aching pain and a feeling of tightness around the head. They are often triggered by stress, poor posture, or fatigue.
- Migraines: Characterised by intense, throbbing pain usually on one side of the head, and often accompanied by nausea, vomiting, and sensitivity to light or sound. Some people may also experience visual disturbances (aura) before the headache.
- Cluster headaches: Severe, one-sided pain around the eye, typically occurring in cycles or clusters. These headaches are intense and often accompanied by redness or tearing in the affected eye, nasal congestion, or a runny nose.
- Sinus headaches: Caused by sinus infections, these headaches produce a dull ache in the forehead, cheeks, or around the eyes, often accompanied by other sinus symptoms such as congestion or nasal discharge.
Migraine Symptoms to Know
Migraine symptoms can vary widely between individuals. Common symptoms include throbbing or pulsing head pain, sensitivity to light, sound, or smells, nausea, vomiting, and visual disturbances. Some people may experience difficulty concentrating during an attack. Migraines can last anywhere from a few hours to several days and may be disabling.
Red Flags: When to Worry About a Headache
Seek urgent medical advice if your headache is accompanied by any of the following:
- A sudden, severe headache (often described as a “thunderclap headache”)
- A headache that wakes you from sleep or is worse in the morning
- A headache following a recent head injury
- A stiff neck, fever, or rash
- New confusion, slurred speech, or weakness in the face or limbs
- Blurred or lost vision
- A new or unusual headache, especially if you are over the age of 50
Simple Home Treatments
For mild headaches or migraines, some simple steps may help reduce symptoms. Resting in a dark, quiet room, applying a cold compress to the forehead, staying well-hydrated, and doing gentle neck and shoulder stretches can all provide relief. Over-the-counter painkillers such as paracetamol or ibuprofen are often effective. Fast-acting or soluble versions tend to work quicker.
Foods That Can Trigger Migraines
Certain foods and drinks are known to trigger migraines in some people. While not everyone is affected by food triggers, it can be useful to keep a migraine diary to identify any patterns. Common culprits include aged cheeses (such as cheddar or brie), processed or cured meats that contain nitrates or nitrites, chocolate, and alcohol—particularly red wine, beer, and champagne. Excessive caffeine intake or sudden caffeine withdrawal can also provoke migraines. Artificial sweeteners like aspartame, monosodium glutamate (MSG) found in processed foods and takeaways, pickled or fermented foods such as soy sauce or kimchi, and nuts—especially peanuts and almonds—can also be triggers.
Tips for Managing Dietary Triggers
Everyone’s triggers are different – what affects one person may not affect another
Don’t skip meals – fasting or irregular eating can trigger attacks
Stay hydrated – dehydration is a common migraine trigger
Keep a headache diary to identify your personal food triggers
Acute Treatments for Migraine Relief
The most effective way to manage a migraine attack is to begin treatment as early as possible—ideally within the first hour of symptom onset. For many, over-the-counter painkillers such as paracetamol or ibuprofen are sufficient. Fast-acting or soluble preparations are usually more effective. It is best to avoid codeine-containing medications like co-codamol, as regular use can lead to medication overuse headaches.
If standard painkillers are not enough, a class of medication known as triptans may be prescribed. Triptans work by reversing the temporary widening of blood vessels in the brain and blocking pain signals. Examples include sumatriptan, zolmitriptan, and rizatriptan. They are most effective when taken at the start of the headache phase, rather than during aura. Triptans are available in tablet form, as nasal sprays, or as injections, depending on your needs and severity of symptoms.
Anti-nausea medications such as metoclopramide or prochlorperazine can be used alongside pain relief, especially if nausea or vomiting is a major feature of your migraine. Some combination treatments are available that include both a painkiller and an anti-nausea agent in one preparation.
If you find that you are using acute treatments more than ten days a month, you may benefit from preventive treatment. In this case, speak to your GP about long-term management options.
Preventative Medication for Migraines
If migraines are frequent or significantly impact your quality of life, your doctor may suggest preventive treatment. Preventative medications can help reduce the frequency and severity of attacks, making them less disruptive.
Common types of preventative medications include:
- Beta-blockers (e.g. propranolol, metoprolol) – Often used to treat high blood pressure, they can also help reduce the frequency of migraines.
- Antidepressants (e.g. amitriptyline) – Low doses can be effective for some people in preventing migraines, as they also help manage the associated pain.
- Anti-seizure medications (e.g. topiramate, valproate) – These medications can reduce migraine frequency in some people.
- CGRP inhibitors (e.g. erenumab, fremanezumab, galcanezumab) – A newer class of medication specifically designed to prevent migraines by targeting the CGRP protein involved in migraine attacks. Usually under the supervision of a specialist.
- Botox injections – For chronic migraines, botulinum toxin injections may help reduce headache frequency when administered by a healthcare professional.
Preventive medications typically need to be taken daily or administered regularly, and it may take several weeks to notice a reduction in migraine frequency. If you find that acute treatments aren’t providing enough relief, or your migraines are becoming more frequent, discussing preventive options with your GP may be the next step.
If you experience frequent, severe, or disabling headaches, we can help. Book a consultation to explore your symptoms, rule out serious causes, and build a personalised treatment plan that works for you.
