Headache: what makes a headache serious?
Headaches are very common and have many causes. Eight out of every 10 people will get at least one headache in a year. Every fortnight one in 4 people will take a painkiller because of a headache. Although they are a frequent source of stress and anxiety, headaches are only very rarely a sign of serious illness. Many headache sufferers worry about having a brain tumour, but this will be the cause in only one in every 10,000 people.
Tension headaches
The most common cause of pain in the head is tension headache. This may account for as many as 90 per cent of cases. These headaches are usually felt as a dull pain on both sides of the head, or as a feeling of having a tight band around the forehead. They usually appear around times of stress. They may come on with tiredness and sometimes after prolonged reading. Taking exercise or drinking alcohol does not usually make these headaches any worse.
Tension headaches are thought by many to be due to contraction (tightening) of the neck muscles. Simple over-the-counter painkillers such as aspirin or paracetamol usually relieve these headaches. Hot showers and massage may help. Chronic sufferers should beware of becoming too reliant on painkillers and look for ways of relaxing and avoiding stress.
Sinus headaches
Sinus headache is a common problem, which many people will recognise, particularly when they have a bad cold or flu. A ‘stuffy’ head and pain above or behind the eyes, or on either side of the nose, are the usual symptoms. Pain is often worse when the head is bent forward.
Migraine headaches
Migraine is a common cause of headache, affecting up to one in 8 people. This problem is thought to be due to changes in blood flow through the brain. The headache is often throbbing, one-sided, associated with nausea (feeling sick) and vomiting, and worse with bright light and noise.
Specific treatments are available for migraine. Many attacks, if recognised in their early stages, will disappear by taking a simple painkiller and lying down in a dark, quiet place.
Cluster headaches
Rather similar to migraines are cluster headaches. These are one sided, usually around the eye. There may be a feeling of a blocked nose and a watery eye. They affect men more than women and can be brought on by alcohol. They appear frequently for a few days then may disappear for weeks or months.
When to see your doctor
Despite this wide variety of non-serious headaches, sometimes a headache will be a sign of serious disease. See your doctor if any of the following applies to you:
- you start getting regular headaches after age 50;
- you get a sudden severe headache 'out of the blue';
- you have a constant headache, which is gradually getting worse;
- you develop a headache after exertion, straining, coughing or sexual activity; or
- you have a headache together with drowsiness, confusion, or memory loss.
Last Reviewed: 12 October 2004
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