(April 2011) by Dr Warwick Palmer

Headaches can have many causes, however serious causes of headaches are quite rare, and these often have clear signals that can be picked up by health professionals.

We need to be particularly careful if:

  • The patient is over 50 or under 10 years of age.
  • Headache is very severe, continuous or different from one’s usual headache.
  • Headache is getting progressively worse or has come on very suddenly.
  • Other symptoms can include nausea, vomiting, sensitivity to light and sound, numbness, pins and needles.

    By far the commonest type of headache is tension headache. Often the real cause can be difficult to isolate, but frequently problems with stress, tiredness, the upper back and neck can all contribute. It can be helpful to use a headache diary to see if there is any clear pattern, or other obvious exacerbating factors.

    Initially, simple pain killers such as paracetamol, or ibuprofen (Nurofen) can be very effective, but these may only provide short term relief and do not address underlying problems. Ongoing frequent use of pain killers can actually worsen the headache or create a “rebound headache” situation. Thus, it is best not to use pain killers more than 2 to 3 times per week and to avoid pain killers containing codeine.

    Tension headaches are frequently caused by muscle tightness and tension in the upper back, neck and head. Any identifiable problems with posture, neck, or the back should be addressed. A hot flannel, warm bath or massage can often relieve tightness and tenderness. Physiotherapy, an exercise programme, yoga, pilates, acupuncture or meditation can all be helpful.

    Identifying and addressing stresses is important. Talking about stress with a trusted family member, friend or health professional, and then making lifestyle changes may also help to relief stress.