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Headaches are an extremely common complaint with a variety of causes. Diagnosis can be difficult, and will be based on the location, type of pain, severity and frequency of the pain, as well as other associated symptoms.


Tension headaches are the most common type of ‘primary’ headache and are usually treated with over-the-counter pain-relievers. Other types of primary headache include migraine, cluster headache, chronic headache, and headaches brought on by exertion, eye strain and even eating something very cold like ice cream. ‘Secondary’ headaches are so called because they are a symptom of an injury or an underlying illness.



What causes headaches?


  • Muscle tension in the head, neck and shoulders
  • Eye strain from long hours working at a computer or reading in poor light
  • Lifestyle factors like stress, certain foods, heavy smoking, fasting, lack of sleep
  • ‘Hangovers’ after consuming a lot of alcohol
  • Dehydration
  • Anxiety and depression
  • High blood pressure
  • Bleeding in the brain
  • Tumour
  • Certain diseases like meningitis and encephalitis



What causes migraines?


Migraines are caused by enlargement of blood vessels in the head and the release of chemicals from nerve fibres that coil around the blood vessels. Migraine attacks affect the part of the nervous system that controls primitive responses to stress and pain, (the ‘fight or flight’ response) and can cause nausea, vomiting and diarrhoea, poor circulation of blood, sensitivity to light and sound, and blurred vision as well as a throbbing headache.


A migraine can be ‘triggered’ by stress, sleep disturbances, fasting, hormonal fluctuations, bright or flickering lights, odours, cigarette smoke, alcohol, aged cheeses, chocolate, monosodium glutamate, nitrites, aspartame, and caffeine.



When should I see the doctor?


  • If you experience a severe headache ‘out of the blue’
  • If you have frequent migraines
  • If you have a persistent headache
  • If a headache is brought on by exertion, coughing, bending over or sex
  • If you also have nausea and vomiting, a fever or stiff neck
  • If you have a fit
  • If you have a head injury or a fall (you may have concussion or bleeding in the brain)
  • If you also have blurred vision, slurred speech, weakness or loss of movement in your arms, legs or fingers
  • If your headache is getting worse or you need more than the recommended dose of over-the-counter pain-relievers



What is the treatment?


Most headaches are not serious and can be successfully treated with over-the-counter pain-relievers like paracetamol or ibuprofen, or a combination of both Paracetamol 500mg + Ibuprofen 150mg . If you have frequent migraines, there are a variety of migraine-specific medications available on prescription from your doctor.


However, some headaches may be a sign of another health problem like eye trouble or high blood pressure. Your doctor will examine you and may order some tests to find out what the underlying problem is. For example, if you have high blood pressure, your doctor may prescribe anti-hypertensive medication and you will probably find the headache disappears with this treatment.





More Information

American Headache Society


National Headache Foundation (USA)


EMedicine Health – Headaches
enter “headache”



Any medical information in this website is not intended as a substitute for professional medical advice, it is of a general nature only.  Please consult with a health care professional if you have a specific problem. 


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