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​Headache

Evidence-based OverviewsTypes of Headaches Videos & Podcasts | Self-ManagementDecision Aids and Toolkits
Work Accommodation | Headache Organizations | Research on Headaches

Most people will experience one or more headaches in their lifetime. The WHO has reported estimates that almost half the population (47%) experience headache symptoms at least once per year making them one of the most common health complaints. But most are not serious and are easy to treat.

In many cases, you can treat your headaches at home with over-the-counter painkillers and lifestyle changes.

However, it's a good idea to see your primary care provider if your headaches aren't relieved by over-the-counter treatments, or if they're so painful or frequent that they affect your daily activities or are causing you to miss work.

Some of the main types of headaches and common causes of headaches are described below.

Causes of Headaches

Headaches can also have a number of other causes, including:

  • drinking too much alcohol
  • a head injury or concussion
  • a cold or flu
  • temporomandibular disorders – problems affecting the "chewing" muscles and the joints between the lower jaw and the base of the skull
  • sinusitis – inflammation of the lining of the sinuses; read more about sinus headaches
  • carbon monoxide poisoning
  • sleep apnea – a condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing
  • epidural injections during spinal anesthesia

Could it be something serious?

In the vast majority of cases, a headache isn't a sign of a serious problem. But, rarely, it can be a symptom of a condition such as a stroke, meningitis, or a brain tumour.

A headache is more likely to be serious if:

  • it occurs suddenly and is very severe – often described as a blinding pain unlike anything experienced before
  • it doesn't go away and gets worse over time
  • it occurs after a severe head injury or other trauma
  • it's triggered suddenly by coughing, laughing, sneezing, changes in posture, or physical exertion or sexual activity
  • you have symptoms suggesting a problem with your brain or nervous system, including weakness, slurred speech, confusion or trouble understanding speech, memory loss, drowsiness, numbness, weakness or paralysis on one side of your body
  • trouble seeing (vision loss), trouble speaking, or trouble walking
  • you have additional symptoms, such as a fever with a high temperature greater than 102 F to 104 F, a stiff neck, a rash, jaw pain while chewing, vision problems, a sore scalp, or severe pain and redness in one of your eyes, unrelenting diarrhea
  • Unexpected symptoms affecting your ears, nose, throat or eyes that accompany your headache
  • Nausea or vomiting (if not clearly related to the flu or a hangover)
  • The characteristics of your headaches change
  • The symptoms of your migraine attacks change

If you're concerned that your headache might be serious, you should seek immediate medical advice and assistance or go to your nearest emergency department.

Evidence-based Overviews 

  
  
Global WHO Report – Headache DisordersWorld Health Organization
HeadacheNational Institute of Neurological Disorders and Stroke [US]
HeadachesNational Health Service (UK)
HeadachesHealthLink BC
Medline Plus: HeadachesNational Institutes of Health (US)
What Is Headache?Headache Australia / Brain Foundation (Australia)

​Types of Headaches   

Tension headaches 

Tension headaches are the most common type of headache and are what we think of as normal, "everyday" headaches. They feel like a constant ache that affects both sides of the head, as though a tight band is stretched around it.

A tension headache normally won't be severe enough to prevent you doing everyday activities. They usually last for 30 minutes to several hours, but can last for several days. The exact cause is unclear, but tension headaches have been linked to things such as stress, poor posture, skipping meals and dehydration.

Tension headaches can usually be treated with ordinary painkillers such as paracetamol and ibuprofen. Lifestyle changes, such as getting regular sleep, reducing stress and staying well hydrated, may also help.

Resources

Migraines 

Migraines are less common than tension headaches.

An estimated 14% of the world's population have suffered from migraine at some point in their life.  Studies consistently show that women are more likely than men to experience migraine.

Prevalence of migraine

In a 2010/2011 study conducted by Stats Canada, over 2.7 million people in Canada over the age of 15 reported being diagnosed with migraine headaches. Migraine headaches affect more of the population than any other neurological conditions. This likely underestimates migraine prevalence. Research indicates that some people who experience migraine do not seek professional help, and therefore, would not have a diagnosis to report.

Migraine sufferers typically report severe, throbbing pain usually at the front or side of the head. Some people also report other symptoms, such as nausea, increased sensitivity to light or sound, vomiting.

Migraines are usually more severe than tension headaches and may stop you carrying out your normal daily activities. They typically last at least a couple of hours, and some people find they need to stay in bed in a dark room until it subsides.

Most people can treat their migraines successfully with over-the-counter medication. But if they're severe, you may need stronger medication that's only available on prescription. This may be able to relieve and prevent your migraines.

Resources

Cluster headaches 

Cluster headaches are a rare type of headache that occur in clusters for a month or two at a time around the same time of year.

They're excruciatingly painful, causing intense pain around one eye, and often occur with other symptoms, such as a watering or red eye and a blocked or runny nose.

Pharmacy medications don't ease the symptoms of a cluster headache, but a doctor can prescribe specific treatments to ease the pain and help prevent further attacks.

Resources

Medication and painkiller headaches  

Some headaches are a side effect of taking a particular medication. Frequent headaches can also be caused by taking too many painkillers. This is known as a painkiller or medication-overuse headache.

A medication-overuse headache will usually get better within a few weeks once you stop taking the painkillers that are causing it, although your pain may get worse for a few days before it starts to improve.

Resources

Hormone headaches  

Headaches in women are often caused by hormones, and many women notice a link with their periods. The combined contraceptive pill, the menopause and pregnancy are also potential triggers.

Reducing your stress levels, having a regular sleeping pattern (see Sleep Hygiene), maintain good hydration and ensuring you don't miss meals may help reduce headaches associated with your menstrual cycle.

Resources

Videos and Podcasts 

  
  
Acupuncture for tension-type headache & Acupuncture for migraine prophylaxisCochrane
Dealing with Triggers and LifestyleInternational Headache Society
Excersize and ArthritisUniversity of Washington
How your Brain can Control Pain
Is it Migraine?International Headache Society
Migraine - You Are Not AloneInternational Headache Society
Migraine in WomenInternational Headache Society
Neuroplasticity Made Simple
Preventing the Migraine AttackInternational Headache Society
The Migraine AttackInternational Headache Society
Treating the Migraine AttackInternational Headache Society
WWDPI webinars – Chronic Pain and Mental HealthWork Wellness and Disability Prevention Institute
WWDPI webinars - Self-ManagementWork Wellness and Disability Prevention Institute

​Work Accommodation 

  
  
Employees with Migraine HeadachesU.S. Department of Labor
Migraine in the Workplace (pdf)Migraine Action (UK)
Workplace ManagementHeadache Australia / Brain Foundation (Australia)

​Decision Aids and Toolkits 

  
  
Canadian Pain Toolkit - People in Pain NetworkPeople in Pain Network
Do You Have a Migraine? 30-Second Migraine Diagnosis TestNational Migraine Centre (UK)
Headache Diaries (one month and one year)National Migraine Centre (UK)
Headache TestsNational Migraine Foundation (US)
Help Your Doctor Treat Your Headache Questionnaire (pdf)Headache Australia / Brain Foundation (Australia)
Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach WorkbookJohn D. Otis
Talking to Your Headache DoctorNational Headache Foundation (US)
The Mindfulness Solution to Pain: Step-by-Step Techniques for Chronic Pain Management
When to See a Physician for Your HeadacheNational Migraine Foundation (US)
Youth Pain ToolkitPeople in Pain Network

​Headache Organizations  

  
American Headache Society (US)
Canadian Pain Society
Dieticians of Canada
Migraine Research Foundation (US)
Myalgic Encephalomyelitis Fibromyalgia Society of BC
National Migraine Centre (UK)
The Migraine Trust (UK)
World Headache Alliance

Last Modified: 9/30/2015 4:09 PM

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