I Have A Headache, What Should I Do?

I have a headache, what should I do? It is a very common question in a doctor’s life. It is a simple question but the answer to this is complex. Everybody experiences headaches at some point in their life. The cause behind this headache can be a very simple one e.g. lack of sleep or a very complex one e.g. brain tumor. So, first thing first, you have to know about the red flags of headaches. If you have any red flags then immediately seek medical attention. 

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Red flags of headache

  • Headache associated with loss of consciousness
  • Headache + loss of vision
  • Headache with fever or stiff neck
  • Sudden onset very severe headache
  • Headache with fits
  • Headache associated with weight loss
  • Pattern change of previous episodes of headache
  • New-onset headache after 50 years of age
  • Headache with loss of muscle power in any parts of the body or sensory abnormality or psychiatric abnormality
These red flag symptoms are often present in serious medical conditions. Therefore, call your doctor as soon as possible.

Causes of headache

Now let us assume, you don’t have any red flags of headache. Headache doesn’t always happen due to problems in your brain. Problems outside your brain may also cause headaches, for example, sinusitis. Therefore, all headache patients will not be treated by neurologists. Here are some common causes of headache:

  1. Tension type headache
  2. Migraine headache
  3. Cluster headache
  4. Sinusitis
  5. Meningitis
  6. Subarachnoid hemorrhage
  7. Glaucoma
  8. Ear infection
  9. Head trauma
  10. Carbon monoxide poisoning
  11. Smoking
  12. Substance abuse and withdrawal (e.g. alcohol withdrawal)
  13. Insomnia
  14. Fibromyalgia
Basically, the causes of headaches are endless. Thousands of pages of information about headaches are written in neurology books. We are going to discuss tension-type headache and migraine headache in this article. We have already discussed sinusitis in this article: Sinusitis – the ultimate In-depth article, symptoms, causes, treatment, home remedy.
i have a headache

Tension type headache

The characteristics of tension-type headache is a diffuse moderate pain all around your head that feels like a tight band is constricting your head from all directions. It is the commonest type of headache and its causes are poorly understood. But certain factors (triggers) are associated with tension-type headaches. These are:

  1. Lack of sleep
  2. Stress
  3. Eyestrain
  4. Decreased water intake
  5. Certain foods like caffeinated beverages, chocolate, etc. 
  6. Hunger
  7. Anxiety
  8. Depression
  9. Low iron level in blood
  10. Poor posture

Tension-type headache can also cause:

  1. Irritability
  2. Tiredness
  3. Memory impairment
  4. Trouble concentrating
  5. Nausea

I have a headache (tension type), how can I treat it?

First of all, if you know any triggers of tension type headache then try to avoid it. Lead a healthy lifestyle by

  1. Healthy and balanced diet. 
  2. Exercising daily (at least 30 minutes of walking per day).
  3. Maintaining good posture. 
  4. Meditation or yoga to reduce stress.
  5. Drinking plenty of water. 
  6. Your eye problem or ear problem if you have any.

You can also take over-the-counter medications e.g. paracetamol, aspirin, ibuprofen, naproxen, etc. 

If these medications don’t help you then visit your doctor to get some prescription medications:

  1. Ketorolac
  2. Indomethacin
  3. Opioids
  4. Tricyclic anti-depressants
  5. Selective serotonin reuptake inhibitors
Some alternative treatments can also help you. These are:
  1. Acupuncture
  2. Massage therapy
  3. Biofeedback
  4. Cognitive behavioral therapy

Migraine headache

It is a severe type of headache characterized by throbbing pain over one side of the head. Common symptoms of migraine headache are 

  1. One-sided pulsatile headache
  2. Nausea/ vomiting
  3. Vomiting
  4. Extreme sensitivity to noise and light  
  5. Eye-watering and redness

A migraine headache can also be preceded by an aura (also called classical migraine). An aura is a sensory disturbance where you can see zig-zag lines, light flashes, or dots in your vision. You can also have a tingling or funny sensation over your tummy, hands, and feet. 

Migraine may present in various ways, for some women migraine headache occurs during menstruation only (menstrual migraine). Rarely migraines may also cause weakness over one side of your body, slurred speech, and difficulty swallowing. 

If you are having the symptoms of migraine headache please visit your doctor. Your doctor may give you a CT scan of head just to exclude other grave causes of headaches. 

Migraine triggers

Common triggers of migraine headache are:

  1. Loud sound
  2. Bright light
  3. Foods e.g. chocolate, sugary food, chocolate, ice cream, lemon
  4. Alcoholic beverages
  5. Cigarette smoking
  6. Vinegar
  7. Processed meat 
  8. Insomnia                

I have a headache (migraine), how can I treat it?

Do the following lifestyle changes:

  1. Avoid the known triggers
  2. Have some relaxation by doing yoga or meditation
  3. Do regular physical exercise
You can also try some OTC medications, for example:
  1.  Paracetamol
  2. Aspirin
  3. Ibuprofen
  4. Naproxen
You can also try some prescription medications with the help of your doctor:
  1. Beta-blockers e.g. propranolol 
  2. TCA e.g. amitryptylline 
  3. Ergots e.g. Bromocriptine
  4. Opioids e.g. codeine 
  5. Anticonvulsants 

Some different types of therapy can also help you if your doctor permits it:

  1. Transcutaneous supraorbital nerve stimulation (t-SNS)
  2. Learning to cope (LTC)
  3. Acupuncture

EndNote

Headache once in a while may not be unusual. But you are having regular headaches then it’s time to visit the GP. Your GP will refer you to the relevant specialist. If you have sinus infection then your headache may be treated by ENT specialists instead of neurologists. 

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