Headache

Headache is one of the commonest symptoms worldwide. Most headaches are primary — meaning the headache itself is the problem (tension-type, migraine, cluster). A minority are secondary — a warning sign of something else. Recognising the difference changes what to do.

Red flags — go to hospital / dial 112

• Sudden, severe, "worst-ever" headache — possible subarachnoid haemorrhage.
• Headache with fever, neck stiffness, rash, drowsiness — meningitis/encephalitis.
• Headache after head injury, especially with vomiting or drowsiness.
• New headache with weakness, numbness, trouble speaking, vision loss.
• New persistent headache in someone with cancer, HIV, or over 50.
• Headache with seizure, confusion, or new behaviour change.
• Headache waking from sleep / progressively worsening over weeks.
• Very high BP with severe headache.

Common primary headaches

• Tension-type — band-like pressure, both sides, mild-moderate; stress, sleep, posture.
• Migraine — throbbing, often one side, with nausea, sensitivity to light/sound; see Migraine page.
• Cluster — severe one-sided pain around the eye with tearing/congestion; in bouts.
• Medication-overuse headache — from painkillers/triptans more than 10-15 days/month.

What helps most headaches

• Identify triggers — poor sleep, skipped meals, dehydration, stress, screen time, caffeine withdrawal, posture, alcohol.
• Regular sleep, meals, water.
• Simple pain relievers or NSAIDs used sparingly (under 10 days/month).
• Address eye strain, refractive error — annual eye check if frequent.
• Regular exercise; stress reduction (yoga, pranayama, CBT).
• See a Health Expert for persistent or recurring headaches — don't live on painkillers.