Headache

Headache

Headache is the most common neurological disorder by far.

It affects everyone occasionally, becoming a significant problem for an estimated 40% of people in the UK at some time in their lives.

Migraines affect 15% of the UK adult population and up to 100,000 people are absent from work or school because of a migraine on any one day in the UK.

This represents an enormous cost burden to employers.

It is one of the most frequent causes of consultation in both general practice and neurological clinics, and there is evidence that headache disorders are under diagnosed and under treated.

As an isolated symptom, it is very rarely caused by tumours or a 'serious' underlying disease, but nevertheless it is often still a significant problem for the patient once these worrying considerations have been excluded.

Types of headaches

A headache is classified as 'primary' if there is not a structural abnormality (such as a tumour) or another clear trigger for it such as a head injury.

The most common primary headache conditions are migraines and tension type headaches.

  • Migraine headaches

Migraine headaches are usually one-sided, severe throbbing headaches with accompanying nausea. The discomfort is worsened by bright light and loud noise. They can last anywhere between four hours and three days and the headache needn't be the most troublesome symptom.

If in the last three months you have had a headache associated with a feeling of nausea; were troubled by bright light; and the symptoms limited your ability to work; then you probably had a migraine.

  • Tension headaches

Tension-type headaches in its 'episodic' subtype affects up to 80% of people from time to time and is often referred to as a 'normal' or 'ordinary' headache. Consequently, most are treated without reference to physicians, using over-the-counter (OTC) medications which are generally effective.

Nevertheless, it can be a disabling headache over several hours. The high prevalence of this disorder means its economic burden through lost work is significant and if OTC medications are taken too frequently, a medication overuse headache can occur.

  • Cluster headaches

Cluster headaches are much less common than migraines or tension headaches but are intense and frequently recurring.

  • Medication-overuse

Medication-overuse headaches are usually characterised by a chronic daily headache.

Medication-overuse is the most common cause of 'secondary' headache and often presents in combination with migraines, or mild head or neck injury.

Caffeine overuse or withdrawal and a number of other medical conditions such as anaemia and thyroid problems can also cause headaches.

Migraine information sheet

Headache can improve with some simple measures aimed at adjusting your lifestyle.

Lifestyle advice

The following are commonly prescribed medicines for chronic headache disorders

Amitriptyline

Topiramate

Propranolol

Valproic acid (sodium valproate)

Non-prescribed supplements for headache

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