Headaches and Migraines

As many as 8 out of 10 people have occasional tension type headaches from time to time, and around 1 in every 5 women and around 1 in every 15 men suffer with migraines.

The most common headache is tension-type headache; the one we think of as ‘ordinary’ or ‘everyday’ headache. Tension headache tends to be mild to moderately severe and affects both sides of the head. It usually feels ‘pressing’ or ‘tightening’ and is not affected by routine daily activities.

Migraine is a moderate or severe throbbing headache affecting one or both sides of the head and made worse by ordinary daily activities.

There are several types of migraine, including:

• migraine with aura – where there are specific warning signs just before the migraine begins, such as seeing flashing lights
• migraine without aura – the most common type, where the migraine happens without the specific warning signs
• migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache does not develop

Less common causes of headache These include cluster headache (a severe or very severe pain around and above the eye), headache from overusing pain killers (affecting about one to two out of 100 people), inflamed blood vessels, and raised pressure inside the head (for example from a bleed or tumour).

Although headaches can severely affect your life, they’re rarely serious or life-threatening. Most get better by themselves, often within 24 hours.

How can I avoid triggers/ suggested lifestyle changes

It may be possible to ease your symptoms by making a few simple changes to your diet and lifestyle.

• Regular exercise and relaxation – are important measures to help reduce stress and tension which may be causing headaches. Maintaining good posture and ensuring you’re well rested and hydrated can also helps
• Diet and fluids – Drink at least 6 to 8 glasses of fluid (ideally water) a day. Avoid alcohol and take regular meals
• Migraine triggers – Migraines can have many triggers, such as certain foods, stress, hunger, tiredness and can get worse during menstrual changes or when taking the combined oral contraceptive pill. Try to avoid these triggers wherever possible.
• Headache diary – you may wish to try keeping a headache diary and record how often you get headaches, how long they last, and whether they are mild, moderate or severe. This can be helpful to decide whether your headaches follow a particular pattern and shows how they respond to treatment, which is useful when you need to discuss them with a health professional. A useful online version for monitoring migraine headache is available at Keeping a headache diary – The Migraine Trust

How do I treat?

Try lifestyle changes first, but if these don’t work alone, you may wish to try treating with medication. There are a variety of products available to treat the headaches and migraines many of which can be bought from a supermarket, shop or pharmacy.

• Pain killers – There are various different pain killers available without prescription from your pharmacist. Choosing a preparation often comes down to personal preferences and needs to take into account other medical conditions you may have, other medicines you may be taking and the risk of potential side effects. Specific migraine medications are available for treating migraine attacks.
  • Paracetamol and Ibuprofen are the most common drugs used to treat headaches and
    migraines. These can be bought from supermarkets/ shops and Pharmacies
  • Stronger medication can be bought from pharmacies if required, your pharmacist will advise.

Avoid taking painkillers for headaches for more than 10 to 15 days per month.

• Other treatments – Acupuncture can help with migraine and tension type headache. Manual therapy may help if you also suffer from neck aches.
• Speak to your pharmacist – for advice if you’re not sure which type of medicine is best for you and your symptoms.

When should I seek advice?

Seek medical advice if over the counter treatments don’t relieve your symptoms, or if you find it difficult to get on with your daily activities or go to work. Also speak to a health professional if you notice any of the following:

• Frequency – Your headaches become more and more frequent. If you have frequent migraines (on
  more than 5 days a month), even if they can be controlled with medicines, you may benefit from
  preventative treatment.
• Additional symptoms – You vomit for no apparent reason or have a high fever. You develop a stiff
  neck or feel drowsy.
• After head injury – You suffer from persisting headaches after a blow or other injury to your head
  (though a mild headache for one to two days after a minor head injury is common and harmless).
• Sleep – Your headache prevents you from getting to sleep or wakes you.
• Certain situations – Your headache is worse on coughing, straining, bending, lying flat or laughing.
• Speech and personality – You notice a change in speech or personality.
• Odd sensations – You develop weakness, numbness or other odd sensations anywhere on your body, or you feel unsteady on your feet.
• Severity – You develop a sudden severe headache, like ‘being hit with a hammer’.
• Eyes – Your eyes feel really uncomfortable when looking at bright light, or you suffer other new eye
  symptoms, such as sudden blind spots.
• Other symptoms – You have muscle pains, pain on chewing, a tender scalp, or feel unwell.

You should call 999 for an ambulance immediately if you or someone you’re with experiences:

• paralysis or weakness in 1 or both arms or 1 side of the face
• slurred or garbled speech
• a sudden agonising headache resulting in a severe pain unlike anything experienced before
• headache along with a high temperature (fever), stiff neck, mental confusion, seizures, double vision and a rash

Where can I get more information?

• NHS Choices
• Visit your local pharmacy for advice