Headache is one of the most common reasons patients seek help from care providers. However, most headaches are not serious and can be safely treated at home. The most common headaches, tension headache and migraine headache, can be classified as primary. Some headaches are secondary; they are symptoms of other problems such as eyestrain, infections (especially colds and flu), allergies, neck muscle strain, other head and neck injury (including concussion), hormonal changes, and high blood pressure.
For any headache, seek immediate help for any of the following:
- A very sudden pain that you might describe as “the worse headache of your life”
- A headache that occurs with:
- Fever, confusion, and stiff neck
- Weakness, paralysis, slurred speech, seizures, and confusion
- Recent trauma to the head, such as a fall
- Physical exertion, such as exercise or physical activity
- A severe headache that does not respond to home therapy
- A headache that awakens you from a sound sleep
Two common classifications of headaches are tension headaches and migraine headaches.
More than 90% of all headaches are tension headaches (also called stress headaches). Patients often describe them as dull, constant ache on both sides of the head. Others also experience a squeezing sensation, as if the head were a vice. Other symptoms may include tightness and pain in the neck and shoulders. The pain can range from mild to severe.
- Be attentive to your sleep needs. Most people need at least 8 hours a night, optimally with the same sleep and wake times nightly.
- Find ways to help manage emotional stress. Relaxation techniques and exercise often help.
- Limit your alcohol and caffeine intake. Cut down slowly to avoid increasing headache frequency.
- Practice proper posture. When sitting for prolonged periods, take breaks every 30-45 minutes to loosen neck and shoulder muscles.
- Use a nonprescription pain reliever such as Tylenol® or Advil®. If the headache keeps recurring over days, consult with a medical provider. Taking these medications on a regular basis for too many days in a row can actually cause headaches, a syndrome called “rebound headache”.
- Lie down in a dark room with a cool cloth on your forehead and relax your head and neck muscles.
- Have someone lightly massage your neck muscles.
Migraine headaches are severe often throbbing headaches that usually occur on one side of the head and can last anywhere from a few hours to days. Other common symptoms include nausea, vomiting, and sensitivity to loud sounds and bright lights. Warning signs, called auras, may occur 15 to 30 minutes prior to the onset of head pain. Auras can include blurred vision with bright spots, numbness or tingling of the face or arms, weakness, or even strange smells. Although migraines can occur in men and women at any age, they are more common in females between the ages of 15 and 40.
It is not known exactly what causes migraine headaches. For some people, triggers are fairly predictable
Some common triggers include:
- Bright lights
- Loud noises
- Hormonal changes (such as during menstruation)
- Food such as chocolate, red wine, hard cheese, and caffeine
- If you are diagnosed with migraine headache, work with your medical care provider to learn to recognize and respond in a timely way to your symptoms.
- It can be helpful to develop a migraine treatment plan. This usually encompasses a combination of prevention (prophylactic) and treatment (abortive) strategies, sometimes tiered by intensity of headache.
- As a general rule, treatments are most effective when used early in a migraine episode.
- Rest in a dark, quiet place. Try to sleep, as this can sometimes resolve migraines.
- Apply a cool washcloth or cool pack to your forehead.