Headache for 2 weeks

Migraines and several other headache disorders are a real source of pain, but most of the time, they’re not signs that you have a serious medical problem. But when you have new symptoms or problems that are more severe than normal, it’s worth talking to your doctor.

Know your personal headache symptoms — what’s normal for you and what’s not, and when you need emergency help.

The following headache symptoms mean you should get medical help right away:

A sudden, new, severe headache that comes with:

  • Weakness, dizziness, sudden loss of balance or falling, numbness or tingling, or can’t move your body
  • Trouble with speech, confusion, seizures, personality changes, or inappropriate behavior
  • Blurry vision, double vision, or blind spots
  • Fever, shortness of breath, a stiff neck, or rash
  • Headache pain that wakes you up at night
  • Severe nausea and vomiting
  • Headaches that happen after a head injury or accident
  • A new type of headache that starts for the first time after age 50
  • Have headaches that are triggered by coughing, bending, sexual activity or other intense physical activity
  • Have a history of headaches but have noticed a recent change in your symptoms or pattern of attacks

These migraine or headache symptoms don’t need urgent care, but you should let your doctor know if you:

  • Have three or more headaches per week
  • Have headaches that keep getting worse and won’t go away
  • Need to take a pain reliever every day or almost every day for your headaches
  • Need more than two to three doses of over-the-counter medications per week to feel better
  • Have headaches that interfere with your family, work or social life

Long-Lasting Headache: What It Means and What You Can Do

A variety of treatment options, including home treatments and medical care, can help relieve symptoms of a prolonged headache.

Rebound headaches

Overusing OTC pain medications can actually cause headaches. If you’re experiencing ongoing rebound headaches, you can start addressing your symptoms at home by reducing the amount of OTC medications you take.

You shouldn’t take medicine for pain for more than 15 days out of every month, and prescription pain medications shouldn’t be used for more than 10 days out of every month.

Your doctor or pharmacist can guide you regarding medication ingredients and potential side effects.

If you continue to experience chronic headache pain, your doctor may be able to help. Make an appointment to speak with them about preventative medicines.

Ask your healthcare provider alternative treatment options for headaches and migraines, like antidepressants for headaches caused by chronic tension.

Waiting until your headache starts could keep you in a cycle of OTC treatment, so prevention is key.

Migraines

To address your migraine symptoms at home consider building a predictable schedule that minimizes stress and keeps you in a routine. Focus on adhering to regular mealtimes and a solid sleep schedule.

Exercise can help prevent migraines, but be sure to warm up slowly before diving right in, as too much strenuous exercise can cause a headache.

Prescriptions containing estrogen, like the birth control pill, could also contribute to your migraines. You might need to speak with your doctor about stopping or changing those medications.

Your doctor may prescribe medications specifically for migraines that can prevent the headaches from occurring. They may also prescribe pain medications that are stronger than OTC options to stop your symptoms once they’ve begun.

Anti-nausea medication, opioids, or corticosteroid treatments are sometimes prescribed by physicians for migraine symptoms as well.

Headaches related to stress or mood disorders

Work to reduce stress and promote relaxation in your environment. Self-massage or massage therapy may help ease the tension that causes ongoing headaches. You may also benefit from reducing stimuli and resting in a dark, quiet room.

Your doctor can help you address your stress, anxiety, or mood disorder through a combination of cognitive behavioral therapy and medication.

Your doctor may prescribe antidepressants or anti-anxiety medications that can help relieve the tension and stress causing your prolonged headaches. Some medications for anxiety also work to reduce headache.

Cervicogenic headaches

Because cervicogenic headaches can be caused by injuries or issues in the neck, the underlying cause must be addressed to relieve your headache. Your doctor will examine you to rule out other types of headaches arising from other sources, like tension headaches.

Once the cause of pain is identified, your doctor may prescribe pain medication or nerve blocks to manage pain. They may also recommend physical therapy or a therapeutic exercise routine for pain management.

Concussions and other head injuries

While post-concussion syndrome does not have a specific treatment regimen, your doctor will work with you to address your specific symptoms. You can also take comfort measures at home to reduce your pain, like resting and limiting stimuli when you’re hurting.

Your doctor might advise you to take OTC medication for mild pain, or they may prescribe stronger pain management medication for headaches.

However, remember that overuse of pain medication can contribute to rebound headaches. So discuss with your doctor if you feel you’re taking too much.

Unexplained or general headaches

For unexplained, ongoing headaches, you may be able to manage or ease your symptoms at home through comfort measures, rest, and responsible use of medication.

Massage therapy can ease muscle tension that contributes to headaches, or you can perform self-massage techniques at home.

Managing your stress can help reduce your pain. Also consider reducing the intensity of your exercise schedule or focusing on your form while exercising.

If your headache continues to persist, see your doctor. You may have an underlying condition that they can diagnose. With proper treatment, you’ll be able to address your persistent headache pain and return to your normal quality of life.

What different types of headaches are there?

A primary headache is one that is not caused by another condition — it is the condition itself. Examples include migraine and tension headache.

1. Migraines

Share on PinterestMigraines are categorized as a primary headache, and are often accompanied by visual disturbances.

A person who has a migraine will characteristically feel an intense throbbing pain on just one side of the head.

The person may experience a heightened sensitivity to light, sound, and smell. Nausea and vomiting are also common.

Around a third of people experience an aura before the onset of a migraine. These are visual and sensory disturbances that typically last between 5 and 60 minutes. They can include:

  • seeing zig-zagging lines, flickering lights, or spots
  • partial loss of vision
  • numbness
  • pins and needles
  • muscle weakness
  • difficulty speaking

Be aware that aura symptoms could also indicate stroke or meningitis. Anyone experiencing them for the first time should see a doctor immediately.

Migraines tend to be recurrent, and each attack may last up to 3 days. For many, it is a life-long condition.

Although a migraine can occur in both adults and children, it is three times more likely to develop in females than males. Attack frequency can range from several times a week to once a year.

The causes of migraine are not fully understood. However, it often runs in families. Migraines are also more common in people with certain pre-existing conditions, such as depression and epilepsy.

Triggers of migraine could include:

  • stress and anxiety
  • sleep disruption
  • hormonal changes
  • skipped meals
  • dehydration
  • some foods and medications
  • bright lights and loud noise

Over-the-counter (OTC) painkillers, such as ibuprofen or aspirin, can stop headaches or reduce pain and duration.

Doctors can prescribe an antiemetic drug to relieve nausea and vomiting, such as metoclopramide or ondansetron. Migraine-specific combination drugs are also available.

Attacks may also be eased by:

  • resting in a dark, quiet place
  • placing an ice pack or a cold cloth on the forehead
  • drinking water

For more difficult-to-treat migraines, doctors may prescribe a type of drug called a triptan, such as sumatriptan or rizatriptan. A person should take all medications as soon as migraine symptoms begin for best effect.

People with chronic migraine should see a doctor about preventive treatment. A doctor may diagnose a person with chronic migraine if they have experienced headaches:

  • on more than 15 days per month
  • over a period of 3 months
  • of which at least eight show symptoms of migraine

Drug options for migraine prevention include topiramate, propranolol, and amitriptyline. Other management choices to consider are dietary supplements, meditation, acupuncture, and neuromodulation therapy, which involves applying mild electrical pulses to the nerves.

2. Tension headaches

Tension headaches are very common, and most people will experience them occasionally. They present as a dull, constant pain felt on both sides of the head. Other symptoms can include:

  • tenderness of the face, head, neck, and shoulders
  • a feeling of pressure behind the eyes
  • sensitivity to light and sound

These headaches normally last from 30 minutes to several hours. Severity can vary, but they rarely prevent normal activities.

The cause of tension headaches is unclear, but stress, anxiety, and depression are common triggers. Other potential triggers include:

  • dehydration
  • loud noise
  • lack of exercise
  • poor sleep
  • bad posture
  • skipped meals
  • eye strain

OTC painkillers, such as ibuprofen, acetaminophen, and aspirin are usually very effective in stopping or reducing pain. Individuals experiencing a headache on more than 15 days per month over 90 days should see a doctor.

Lifestyle changes and some treatments may help prevent tension headaches. These can include:

  • getting enough sleep
  • regular exercise and stretching
  • improving sitting and standing posture
  • having an eye test
  • management of stress, anxiety, or depression
  • acupuncture

3. Cluster headaches

Share on PinterestCluster headaches may cause a painful burning sensation behind the eyes.

Cluster headaches are severe and recurrent headaches that are six times more likely to develop in men than in women. People describe an intense burning or piercing pain behind or around one eye.

Other symptoms can include:

  • watering eye
  • swollen eyelid
  • a blocked or a runny nose
  • sensitivity to light and sound
  • restlessness or agitation

Cluster headaches are usually sudden, without warning, and last between 15 minutes and 3 hours. People can experience up to eight attacks a day.

Attacks tend to occur in daily clusters that can persist for weeks or months. They typically take place at the same time of day, which can often be a couple of hours after falling asleep at night.

Any person experiencing these symptoms — which can sometimes be mistaken for hay fever — should consult their doctor.

The cause of cluster headaches is unclear, but they are more likely to occur in smokers. People should avoid alcohol during attack periods.

Treatment aims to reduce the severity and frequency of the attacks. Options include:

  • topiramate
  • sumatriptan
  • verapamil
  • steroids
  • melatonin
  • oxygen therapy
  • lithium

Doctors may suggest surgery in very difficult-to-treat cases.

4. Exertional headaches

Exertional headaches are brought on by strenuous physical exercise and can be triggered by:

  • running
  • jumping
  • weight lifting
  • sexual intercourse
  • bouts of coughing or sneezing

These headaches are usually very short-lived but can sometimes last up to 2 days. They present as a throbbing pain felt throughout the head and are more common in those with a family history of migraine.

Individuals experiencing cluster headaches for the first time should see a doctor, as they could be a sign of something serious.

Most attacks can be treated with OTC painkillers. Taking a nonsteroidal anti-inflammatory drug (NSAID) or a beta-blocker before exertion can help prevent the headaches, as can warm-up exercises.

5. Hypnic headaches

A hypnic headache is a rare condition that usually begins for the first time in a person’s 50s but can start sooner. Also known as “alarm clock” headaches, they wake people during the night.

A hypnic headache consists of a mild-to-moderate throbbing pain usually felt on both sides of the head. It can last for up to 3 hours, and other symptoms may include nausea and sensitivity to light and sound.

People can experience several attacks each week. The cause of hypnic headaches is not understood, and there are no known triggers.

Although hypnic headaches are harmless, an older person who experiences any new kind of headache for the first time should see a doctor. Migraine and cluster headaches also need to be ruled out.

The leading treatment choice is caffeine, taken as tablets or as cups of coffee before bedtime. Other drug options include indomethacin, melatonin, and lithium.

When a Headache Won’t Go Away

Healthy habits could help cut severe headaches short. Thinkstock

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The average tension headache — the most common type of headache — lasts about four hours. But for some people, severe headaches drag on much longer, sometimes for several days. And these “never-ending headaches” can even cause anxiety.

“Typically, headaches that are longer than a day and disabling are migraines,” says headache expert Peter Goadsby, a neurologist at the University of California San Francisco. “The median duration for migraines is about a day.” In fact, some migraines can last up to 72 hours, according to the American Migraine Foundation.

Severe Headache and Your Quality of Life

Although a long headache may be tiring and frustrating, it’s likely not fatal, says Dr. Goadsby. “Having an attack that’s longer than a day doesn’t necessarily mean anything dreadful,” he says. But a headache that persists can take a real toll on your quality of life.

For example, migraineurs know that when their headache begins they may lose a day of productive work or family time. According to the Migraine Research Foundation, 90 percent of migraine sufferers can’t work or function during a migraine. Arranging for strategies to deal with that one day might be bearable, but being out of commission for two or even three days can be more difficult. Even the worry over an impending migraine, especially for those whose headaches are long or severe, can interfere with daily life.

Here are some possible causes for a headache that never seems to end:

  • Rebound headache If you’ve been taking a lot of over-the-counter medications to relieve headache pain, you may experience another kind of low-grade headache every time the medication wears off. These kinds of headaches may seem to come and go.
  • Depression It can be a contributing factor to long-term headaches in a number of ways. Generalized aches and pains are often among the symptoms of depression, and depression may also interfere with your ability to maintain a healthy routine, such as getting enough sleep and maintaining a healthy diet, which can help prevent migraines and headaches. A study published in October of 2017 in the International Review of Psychiatry showed that people with migraines were two to four times more likely to develop a major mood disorder in their lifetime.

How to Cope

Here are ways to cope with a headache that never seems to end:

  • Treat the pain. If you don’t have a prescription and are relying on over-the-counter (OTC) medications, follow the dose recommendations carefully. If you find yourself taking these more than two days a week, prescription medication may be a better option. Bear in mind, too, that taking OTC pain medication more than three days per week may trigger rebound headaches. If you have been prescribed a medication for headache or migraine pain, take the amount your doctor has recommended. But check in with your medical team before you take more than the prescribed amount, even if that dose doesn’t appear to be working.
  • Treat related problems. Attend to other health concerns, such as sleep disturbances, and get any needed depression treatment, such as antidepressants.
  • Rest and relax. Sleep disorders and migraine appear to have a bidirectional relationship, according to a paper published in Therapeutic Advances in Neurological Disorders in December 2017. Insomnia is more likely if you have migraines, and migraines are more likely if you aren’t getting enough sleep. Even if you can’t fall asleep, resting and using relaxation techniques may help you feel better.
  • Get the support you need. If your headache lasts for two (or more) days, you may need to enlist some help from family and friends while you recover.

Preventing Long Headaches

The best strategy for headaches is to avoid them if you can. Here are some prevention tips:

  • Maintain a healthy weight. Although being overweight doesn’t cause migraines, it can increase your chances of developing a migraine, according to the American Migraine Foundation.
  • Try preventive medications. Talk to your doctor about medications that can prevent migraines, rather than treating the pain when it comes. While preventative treatments rarely eliminate migraine, they can reduce the frequency and severity of attacks.
  • Avoid triggers. Pay attention to the things that seem to set off a headache. Triggers can include certain foods, drinking too much alcohol or not getting enough sleep. Migraines can also be triggered by change, says Goadsby, so it’s a good idea to stay well-balanced and make healthy choices.
  • Seek depression treatment. If depression or anxiety is a problem for you, therapy may help. Cognitive behavioral therapy (CBT) is an approach that can help with headache prevention and coping. A metanalysis published in the British Journal of Pain in November 2015 showed that CBT can improve some headache-related outcomes.

Though it’s rare, a severe headache can indicate a life-threatening emergency, such as an infection, or bleeding in or around the brain. According to the Mayo Clinic, you should seek immediate medical attention if your headache comes on all of a sudden, appears after an injury, or is accompanied by any of these signs or symptoms:

  • Fever
  • Stiff neck
  • Confusion
  • Seizure
  • Double vision
  • Difficulty speaking
  • Weakness and numbness

Almost everyone will experience headaches at some time. Most headaches are not caused by serious or sinister conditions. However, people understandably worry if headaches seem different (either particularly severe, particularly frequent or unusual in any other way). The most common worry is that the headache is a symptom of a brain tumour.

This leaflet discusses headache generally. It explains the different types of headache you may experience and describes those very rare situations where a headache is, in fact, a symptom of serious disease.

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Types of headache

Headaches can be primary, or they can be secondary which means they are a side-effect of a separate illness or injury.

Your doctor can generally tell the likely cause of your headache from talking to you and examining you. Once he or she has discovered the cause then you will be able to decide how to reduce or stop the headaches. This may involve taking medication only when you get the headaches, taking daily medication to prevent them or, sometimes, stopping medication you are already taking.

Very occasionally, headaches need further investigation to rule out more serious underlying causes.

Primary headaches

The most common types of headache, by a very long way, are tension headaches and migraines.

Tension headaches
Tension headaches are usually felt as a band or across the forehead. They can last for several days. They can be uncomfortable and tiring, but they do not usually disturb sleep. Most people can carry on working with a tension headache. They tend to worsen as the day progresses and are not usually made worse by physical activity, although it’s not unusual to be a bit sensitive to bright light or noise. Read more about tension headaches.

Migraines
Migraines are also very common. A typical migraine is one-sided and throbbing. Indeed, headaches that are one-sided, headaches that throb and headaches that make you feel sick are more likely to be migraines than anything else. Migraines are often severe enough to be disabling. Some patients need to go to bed to sleep off their headache. See the separate leaflet called Migraine.

Cluster headaches
Cluster headaches are very severe headaches, sometimes called ‘suicide headaches’. They occur in clusters, often every day for a number of days or even weeks. Then they disappear for months on end. They are uncommon and tend to occur particularly in adult male smokers. They are severe, one-sided headaches, which are really very disabling (they prevent regular activity). People often describe them as the worst pain they have ever felt.

Cluster headaches are usually one-sided. Patients often have a red watery eye on the affected side, a stuffy runny nose and a droopy eyelid. Read more about cluster headaches.

Chronic tension headaches
Chronic tension headache (or chronic daily headache) is usually caused by muscle tension in the back of the neck and affects women more often than men. Chronic means that the condition is persistent and ongoing. These headaches can be started by neck injuries or tiredness and may be made worse by medication overuse (see below). A headache that occurs almost every day for three months or more is called a chronic daily headache. Read more about chronic tension headaches.

Medication-overuse headaches
Medication overuse headache (medication-induced headache) is an unpleasant and long-lasting headache. It is caused by taking painkilling medication – usually for headache. Unfortunately, when painkillers are taken regularly for headaches, the body responds by making more pain sensors in the head. Eventually the pain sensors are so many that the head is super-sensitive and the headache won’t go away. People who have these headaches often take more and more painkillers to try to feel better. However, the painkillers have often long ceased to work.

Medication-overuse headaches are the most common cause of secondary headache. Read more about medication-overuse headaches.

Exertional headaches/sexual headaches
Exertional headaches are headaches associated with physical activity. They can become severe very quickly after a strenuous activity such as running, coughing, having sex (intercourse), and straining with bowel movements. They are more commonly experienced by patients who also have migraines, or who have relatives with migraine.

Headaches related to sex particularly worry patients. They can occur as sex begins, at orgasm, or after sex is over. Headaches at orgasm are the most common type. They tend to be severe, at the back of the head, behind the eyes or all over. They last about twenty minutes and are not usually a sign of any other problems.

Exertional and sexual intercourse-related headaches are not usually a sign of serious underlying problems. Very occasionally they can be a sign that there is a leaky blood vessel on the surface of the brain. Therefore, if they are marked and repeated, it is sensible to discuss them with your doctor.

Primary stabbing headaches
Primary stabbing headaches are sometimes called ‘ice-pick headaches’ or ‘idiopathic stabbing headache’. The term ‘idiopathic’ is used by doctors for something that comes without a clear cause. These are short, stabbing headaches which are very sudden and severe. They usually last between 5 and 30 seconds, at any time of the day or night. They feel as if a sharp object (like an ice pick) is being stuck into your head. They often occur in or just behind the ear and they can be quite frightening. Although they are not migraines they are more common in people who have migraines – almost half of people who experience migraines have primary stabbing headaches. They are often felt in the place on the head where the migraines tend to occur.

Primary stabbing headaches are too short to treat, although migraine prevention medications may reduce their number.

Hemicrania continua
Hemicrania continua is a primary chronic daily headache. It typically causes a continuous but fluctuating pain on one side of your head. The pain is usually continuous with episodes of more severe pain, which can last between 20 minutes and several days. During these episodes of severe pain there may be other symptoms such as watering or redness of the eye, runny or blocked nose, and drooping of the eyelid, all on the same side as the headache. Similar to migraine, there may also be sensitivity to light, feeling sick (nausea) and being sick (vomiting). The headaches do not go away but there may be periods when you don’t have any headaches. However hemicrania continua headaches respond to a medicine called indometacin.

Trigeminal neuralgia
Trigeminal neuralgia causes facial pain. The pain consists of extremely short bursts of electric shock-like sensation in the face – in the area of the eyes, nose, scalp, forehead, jaws and/or lips. It is usually one-sided and is more common in people over the age of 50. It can be triggered by touch or light breeze on the face. See the separate leaflet called Trigeminal Neuralgia.

Headache causes

Sometimes headaches have underlying causes, and treatment of the headache involves treating the cause. People often worry that headaches are caused by serious disease, or by high blood pressure. Both of these are extremely uncommon causes of headache – indeed high blood pressure usually causes no symptoms at all.

Chemicals, drugs and substance withdrawal

Headaches can be due to a substance, or its withdrawal – for example:

  • Carbon monoxide (which is produced by gas heaters which are not properly ventilated).
  • Drinking alcohol (with headache often experienced the morning after).
  • Lack of body fluid (dehydration).

Headaches due to referred pain

Some headaches can be caused by pain in some other part of the head, such as tooth or ear pain, pain in the jaw joint and pains in the neck.

Sinusitis is a common cause. The sinuses are ‘holes’ in the skull which are there to stop it from being too heavy for the neck to carry around. They are lined with mucous membranes, like the lining of your nose, and this produces mucus in response to colds or allergy. The lining membranes also swell up and may block the drainage of the mucus from the space. It then becomes thickened and infected, leading to headache. The headache of sinusitis is often felt at the front of the head and also in the face or teeth. Often the face feels tender to pressure, particularly just below the eyes and beside the nose. You may have a stuffy nose and the pain is often worse when you bend forwards. Acute sinusitis is the type that comes on quickly in association with a cold or sudden allergy. You may have a temperature and be producing a lot of mucus. Chronic sinusitis can be caused by allergy, by overusing decongestants or by an acute sinusitis that doesn’t settle. The sinuses become chronically infected and the sinus linings chronically swollen. The contents of the sinuses may be thick but often not infected.

Acute glaucoma can cause severe headache. In this condition the pressure inside the eyes goes up suddenly and this causes a sudden very severe headache behind the eye. The eyeball can feel very hard to touch, the eye is red, the front of the eye (cornea) can look cloudy and the vision is usually blurred.

What types of headache are serious or dangerous?

All headaches are unpleasant and some, such as headache from medication misuse, are serious in the sense that when not tackled properly they may never go away. However, a few headaches are signs of serious underlying problems. These are uncommon – in many cases very rare.

Dangerous headaches tend to occur suddenly, and to become progressively worse over time. They are more common in older people. They include the following:

Bleeding around the brain (subarachnoid haemorrhage)

Subarachnoid haemorrhage is a very serious condition which occurs when a small blood vessel bursts on the surface of the brain. Patients develop a severe headache and stiff neck and may become unconscious. This is a rare cause of severe headache.

Meningitis and brain infections

Meningitis is infection of the tissues around and on the surface of the brain and encephalitis is infection of the brain itself. Brain infections can be caused by germs called bacteria, viruses or fungi and they are thankfully rare. They cause a severe, disabling headache. Usually patients are sick (vomit) and cannot bear bright light (this is called photophobia). Often they have a stiff neck, too stiff for the doctor to be able to bend the head down so that the chin touches the chest (even if you try to relax). Patients are usually also unwell – hot, sweaty and ill.

Giant cell arteritis (temporal arteritis)

Giant cell arteritis (temporal arteritis) is, generally, only seen in people over the age of 50. It is caused by swelling (inflammation) of the arteries in the temples and behind the eye. It causes a headache behind the forehead (a frontal headache). Typically the arteries in the forehead are tender and patients notice pain in the scalp when they comb their hair. Often the pain gets worse with chewing. Temporal arteritis is serious because if it is not treated it can cause sudden loss of eyesight. Treatment is with a course of steroids. The need to continue these steroids is usually monitored by your GP through blood tests, and they are typically needed for many months.

Brain tumours

Brain tumour is a very uncommon cause of headaches – although most patients with long-lasting, severe or persistent headaches start to worry that this may be the cause. Brain tumours can cause headaches. Usually the headache of brain tumours is present on waking in the morning, is worse on sitting up, and gets steadily worse from day to day, never easing and never disappearing. It can sometimes be worse on coughing and sneezing (as can sinus headaches and migraines).

When do I need to seek medical advice about a headache?

Dr Sarah Jarvis MBE

When should I be worried about a headache?

Most headaches don’t have a serious underlying cause. However, healthcare professionals are trained to ask you about the signs and symptoms that might suggest your headache needs further investigation, just to make sure it’s nothing serious.

The things which would suggest to your doctor and nurse that your headache might need further investigation include the following. They do not mean that your headache is serious or sinister, but they mean that the doctor or nurse might wish to do some further checks to be sure:

  • You have had a significant head injury in the previous three months.
  • Your headaches are worsening and accompanied by high temperature (fever).
  • Your headaches start extremely suddenly.
  • You have developed problems with speech and balance as well as headache.
  • You have developed problems with your memory or changes in your behaviour or personality as well as headache.
  • You are confused or muddled with your headache.
  • Your headache started when you coughed, sneezed or strained.
  • Your headache is worse when you sit or stand.
  • Your headache is associated with red or painful eyes.
  • Your headaches are not like anything you have ever experienced before.
  • You have unexplained vomiting with the headache.
  • You have low immunity – for example, if you have HIV, or are on oral steroid medication or immune suppressing drugs.
  • You have or have had a type of cancer that can spread through the body.

Summary

Most headaches, whilst unpleasant, are harmless and respond to simple measures. Migraine, tension headache and medication-overuse headache are all very common. Most of the population will experience one or more of these. Working out the underlying cause of any headaches through discussion with your doctor is often the best way to solve them. It is possible to develop a persistent (chronic) and continuous headache through taking simple painkilling medicines which you took to get rid of your headache. Your doctor can support you through the process of stopping painkillers if this is the case.

Headaches are, very rarely, a sign of a serious or sinister underlying condition, and most headaches go away by themselves.

If you have a headache which is unusual for you then you should discuss it with your doctor. You should also talk to your doctor about headaches which are particularly severe or that stop your regular activities, those which are associated with other symptoms like weakness or tingling, and those which make your scalp sore (especially if you are over 50 years of age). Finally, always talk to your doctor if you have an unremitting morning headache which is present for more than three days or is getting gradually worse.

Remember that headaches are less likely to occur in those who:

  • Manage their stress levels well.
  • Eat a balanced, regular diet.
  • Take balanced regular exercise.
  • Pay attention to posture and core muscles.
  • Sleep on two pillows or fewer.
  • Drink plenty of water.
  • Have plenty of sleep.

Anything that you can do to improve any of these areas of your life will improve your health and well-being and reduce the number of headaches you experience.

The person in the airplane seat next to yours is wearing strong perfume and, minutes after takeoff, you get a headache. A week after a cold, your sinuses remain clogged and you get a headache. The barometric pressure drops as summer cools into fall, and pain jabs through your head again.

Conventional wisdom holds that those are three different causes of three different headaches. But now researchers say those episodes were most likely going to happen anyway.

“Most of the things that people have thought of as triggers—stress, weather fronts, diet—when we have studied them, we’ve come up empty-handed every time,” says Christopher Gottschalk, MD, a neurologist and director of Yale Medicine’s Headache and Facial Pain Center. “It’s not that they cause headaches, but that when you’re getting a headache, weather changes and perfumes feel worse.”

According to Dr. Gottschalk, that means that almost all headaches are best treated as migraines — recurring and often debilitating headaches that often last from 4 to 72 hours. Migraines are associated with nausea, light sensitivity and moderate to severe pain, often on one side of the head, that can throb and that usually worsens with activity. (Women are more susceptible to migraine than men.)

In a well-known study of 1,203 adult patients from more than 15 countries, including the United States, 94 percent of patients complaining of recurrent headaches met formal criteria for a diagnosis of migraine. “That means that almost every other diagnosis typically offered to patients—‘tension,’ ‘sinus,’ ‘stress’—wasn’t even on the table,” says Dr. Gottschalk. What’s more, migraine medications cure both “tension” headaches and migraines—and the “tension” types respond more quickly.

Don’t dwell on the cause—act

There are few health complaints more common than a headache: In a given year, half of Americans will experience at least one. But it is still one of the most underdiagnosed and undertreated medical conditions, in part because cause and effect can be jumbled. For most headaches, doctors have not yet pinpointed the cause.

Dr. Gottschalk explains a pain-killing therapy to a patient.

Here’s what they do know. During a migraine, a patient’s brain stem is activated, sensitizing nerves in abnormal ways and setting off a reaction of pain elsewhere in the brain.

The effect is often so profoundly painful that patients who are suffering tune out some of the confusing names and explanations, says Dr. Gottschalk. They just want relief.

“I see people who are in tears, who say, ‘This is robbing me of my ability to take care of my kids,’” he says. “They say that ‘I can’t play. They’ve given up on me, they know that mommy’s going to be sick or can’t hear any noise.’ Their biggest regret is not just the pain, but how it interferes with their ability to interact with people.”

There is no real reason for patients to wait out headache pain, he says. “If you treat a migraine-type headache when it’s mild,” he says, “you’ll get better quicker.” The available treatments work more effectively on mild headaches than they do on severe ones.

So focus on just one question: Does your headache interfere with your normal functioning? If so, see a doctor.

Understanding—and addressing—the pain

There are a variety of ways to treat migraine, since it’s a chronic condition that also has acute flare-ups. Yale Medicine neurologists choose from preventive options, including antiseizure medications such as topiramate, low doses of tricyclic antidepressants such as amitriptyline, or high doses of beta blockers. There are also acute medications, which fall into three main classes: triptans, such as Imitrex, higher doses of NSAIDs such as ibuprofen or naproxen, and antinausea drugs. Since migraine attacks can slow the digestive process, Dr. Gottschalk often advises patients to administer drugs via a nose spray or injection. Injections of onabotulinumtoxinA, commonly known as Botox, are also used as a preventive treatment for chronic migraines.

For migraine sufferers, devices such at Spring TMS provide non-drug therapies for treating auras that signal the onset of the condition.

The Headache and Facial Pain Center also helps patients to understand that what they once thought of as “triggers” are actually warning signs of impending headaches. In so doing, they can treat pain before it starts, preventing headaches from becoming debilitating. It does take time for a doctor to reorient a patient to this approach, Dr. Gottschalk says, but “just presenting the perspective goes a long way to changing someone’s understanding.”

Once that happens, a patient’s observations are often remarkable. One woman told Dr. Gottschalk: “You’re right! My dog stinks when I have a migraine!” Asking colleagues, friends and family members to help spot warning signs can also help.

Dr. Gottschalk also treats some rarer types of headaches in his office, too. For migraine headaches that start with an aura—a special case that includes a visual display of flashing lines about 20 minutes prior to the headache—patients can now use a portable brain stimulator that they can apply to the back of their heads “and give themselves a zap.”

And, if at any point, medications aren’t working, an acute treatment room that’s quiet and dim awaits patients at Yale Medicine’s Headache and Facial Pain Center. There is space for two patients to recline in cushioned chairs while specially trained nurses administer an intravenous treatment of migraine medication, NSAIDs, a steroid and/or a nerve blocker.

Dr. Gottschalk is also pursuing the next generation of treatment, through game-changing research and clinical trials now underway. He is especially excited about a breakthrough medication that helps the body’s immune system target a protein in the brain that is triggered by migraine. Soon, Yale Medicine patients may be eligible for a clinical trial in which they would get an infusion of this antibody every month—in effect, stopping headaches before they start.

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Headache Overview

Medically reviewed by Drugs.com. Last updated on Jan 13, 2020.

  • Health Guide
  • Care Notes
  • Medication List
  • Q & A

What Is It?

The International Headache Society classifies headaches into two main types: primary headache and secondary headache.

Primary headache includes:

  • tension-type headaches

  • migraines

  • cluster headaches.

Typically, tension-type headaches cause mild to moderate pain, usually on both sides of the head. There is a pressing or tightening sensation. It is not pulsating and is not accompanied by nausea. The headache does not get worse with routine physical activity.

The typical migraine headache is throbbing or pulsating, and often is associated with nausea and changes in vision. While many migraine headaches are severe, not all severe headaches are migraines, and some episodes of migraine can be quite mild. Most people who have migraine experience repeated attacks of headaches that occur over many years.

Cluster headaches are very intense headaches. They usually start in the area around one eye, then spread to nearby areas of the face. Each headache lasts about a half-hour to three hours. Episodes can occur several times over 24 hours (in clusters). This happens daily, lasting several weeks to months. Cluster headaches are much more likely to happen in men than women.

There are many potential reasons for secondary headache, such as:

  • trauma or injury to the head or neck

  • blood vessel disorders in the head or neck, such as a brain aneurysm, a carotid artery tear, or inflammation (temporal arteritis)

  • infection, such as meningitis or encephalitis

  • medication related. The medication may be the direct cause of headaches. For example, headache is a side effect of the blood pressure medicine nifedipine.

  • withdrawal headache. Headaches can occur when a substance or medication is suddenly stopped. Examples include caffeine withdrawal headache or headache after abruptly stopping long term use of pain relievers.

By definition, a headache is a pain in the head. But the type, location, and severity of pain are highly variable. And for migraine, there can be profound symptoms without a headache.

A person can simultaneously have multiple reasons for headaches. It’s common for a person to have both migraine and tension-type headaches. And the symptoms of tension-type headaches and migraine headaches can overlap. For example, both types of headaches may be made worse by bright lights or loud noises.

In general, migraine headaches tend to throb. Tension-type headaches tend to cause a more constant pain. But the pain of either a migraine or a tension-type headache can be steady or throbbing, or can alternate between the two.

Diagnosis

Most often, people can make a self-diagnosis of a tension-type headache or migraine. However, the onset of a new, very severe headache should prompt an urgent visit for clinical evaluation. The doctor will often be able to make the diagnosis based on your description of the headache, your medical history, and the results of a physical examination.

A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan of the head may be ordered. These imaging tests may be used to investigate headache pain that is associated with unexpected or unusual symptoms.

Expected Duration

Headaches can last from a few minutes to an entire day, and even for many consecutive days.

A chronic headache or persistent migraine can last for part or all of the day for most days of the week. The pain can also be continuous. The intensity of pain may fluctuate during that time.

Prevention

Relaxation techniques and avoidance of stressful situations may help to prevent headaches. Many things can trigger a headache. Identifying and correcting one or more triggers may reduce headache frequency and severity.

People with frequent or severe migraine attacks often benefit from taking preventive medication daily. Examples include:

  • Beta blockers, such as propranolol (Inderal) or nadolol (Corgard)

  • Calcium-channel blockers, such as verapamil (Calan, Isoptin)

  • Anticonvulsants, such as valproate (Depakote, other brand names) or topiramate (Topamax)

  • Tricyclic antidepressants, such as amitriptyline (Elavil) or venlafaxine (Effexor).

Treatment

For infrequent headaches, over-the-counter pain relievers are convenient, effective, and relatively safe. Examples include aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen (Aleve). Some people get more pain relief with combination pain relievers that contain caffeine.

To be most effective, a pain reliever medicine should be taken immediately when the headache starts.

The use of any over-the-counter pain reliever should be limited to no more than two or three days per week. If pain medications are used more frequently than that, “rebound” headaches may occur on the days that medications are not taken.

To abort a migraine, several prescription drugs are available:

In addition, people who experience nausea with a migraine (with or without vomiting) can also take an anti-nausea pill or suppository.

Frequent episodic and chronic headaches are more difficult to treat. Rebound headaches are common when pain relievers are stopped. Therapy to prevent the headache before it starts is a better strategy than taking pain relievers after the headache is present. There are several medications that can break the cycle of recurrent headaches, such as naproxen (Naprosyn, Aleve, generic versions) and amitriptyline (Elavil, generic versions).

Some people are able to treat their headaches without medications. You can apply an ice pack or heating pad to any tight areas in the neck and shoulders. You can also try massaging the area.

When To Call A Professional

Most headaches are harmless. It’s reassuring if you are able to relieve your headaches without medications or with only occasional use of a pain reliever.

Headaches are rarely caused by a serious medical problem. However, you should call or visit your doctor if you have

  • a headache that occurs after a head injury

  • a headache accompanied by fever or vomiting

  • a headache associated with:

    • blurred vision

    • difficulty speaking

    • numbness or weakness of the arms or legs

  • headaches that are increasing in intensity or frequency over time

  • a very severe headache that comes on suddenly (“thunderclap” headache) or headache associated with loss of consciousness

  • headaches that require daily use of pain-relieving medications.

Prognosis

Infrequent episodic headaches can usually be treated successfully with pain-relieving medication. But finding the right combination of therapies to relieve frequent episodic and chronic headaches may take several months. Over time, most people will have fewer and less severe headaches.

Learn more about Headache

Associated drugs

  • Headache

IBM Watson Micromedex

  • Tension Headache

Mayo Clinic Reference

  • Tension headache

External resources

National Headache Foundation
820 N. Orleans, Suite 411
Chicago, IL 60610-3131
Phone: (312) 274-2650
http://www.headaches.org/

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

People with hemicrania continua describe a dull ache or throb that’s interrupted by pain that is:

  • Jolting
  • Sharp
  • Stabbing

These attacks usually happen three to five times a day.

Some people will have these headaches steadily for months or years. For others, the pain will last for at least 3 months and then will go away for weeks or months, then come back.

The headaches often have some of the same symptoms as other kinds of headaches. This overlap can make them tricky for doctors to diagnose.

Like migraines, they can cause:

  • Nausea or vomiting
  • Sensitivity to noise or light
  • Throbbing pain

Hemicrania continua also shares features of cluster headaches. For example, people who have it may have problems with how part of their nervous system works. That causes symptoms that happen on the painful side of the face and head, including:

  • Stuffy or runny nose
  • Nosebleeds (which are rare)
  • Tearing, redness, or irritation of the eyes
  • Drooping eyelids
  • Sweating

Some things tend to make symptoms worse, such as:

  • Stress
  • Changes in sleep patterns
  • Bright lights
  • Fatigue
  • Overdoing exercise
  • Alcohol

Some people have symptoms when they:

  • Feel pressure on their neck
  • Flex or rotate their neck

Doctors can make a diagnosis of hemicrania continua if you’ve had pain consistently, without it switching sides or disappearing even briefly, for at least 3 months.

Headache since 2 weeks. Since morning.

Headache can be caused by many causes. Even hangover causes headache vomiting but it won’t last for more than 2-3days.. Types of headache include cluster headache, tension headache, migraine, neuralgia.. causes of headache are many like fatigue, sleep deprivation, stress, the effects of few medications, the effects of recreational drugs, viral infections, common colds(most common cause of headache), head injury, teeth or sinus diseases, refractive error, any bleeding in brain or infection or tumors of brain, nerve compression in neck.. Headache not only affect your physical well being even disturb your social health also, can affect your relationship with people. Chronic headache can cause severe depression.. Headache cause can be usually accessed by history but if headache persists longer or is very severe then it has to be evaluated properly by mri to rule out any brain pathology. Treatment of headache depends on type of headache. Lifestyle changes, relaxation exercises, sleeping atleast 6-7hours per day, healthy food habits, avoid smoking, avoid recreational drugs and avoid alcohol, avoid stress environment. You can go for counseling if you have any personal issues causing you headache.. Nsaids like paracetamol, diclofenac can help you. But avoid taking too many tablets as they can affect your health. Headache can be associated with other symptoms like nausea , vomiting and neck pain ,bodypain , fever , chills if it is viral fever. I suggest you to take tablet paracetamol for a day and if stil it doesn’t alleviate your symptoms then please consult nearest physician.

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