Headaches and migraines
Most people will experience a headache at some point in their lives, but for some, they can become frequent and disruptive. Headaches can affect anybody and vary in cause, severity, and impact.
The main types are:
- Tension headaches
- Migraines
- Cluster headaches
- New daily persistent headaches
Understanding the type of headache you have is a vital step towards managing them. With an accurate diagnosis and appropriate care, many people are able to find effective relief and get back to doing the things they love.
At Affidea neuraCare, you’ll receive personalised care from a world-class team every moment of your journey. Backed by deep experience and the latest innovations, we work to bring you the full potential of modern medicine.
Learn about the different types, signs and causes, and the exceptional diagnostic and treatment options from leading neurologists at Affidea neuraCare.
Tension headaches
Tension headaches are the most common type of headache. Mild pain can happen in both sides of the head, face or neck and feel like a pressure or squeezing sensation. They’re usually manageable and can last anywhere from 30 minutes to several days, though most resolve within a few hours.
Common triggers include stress, too much caffeine, lack of sleep, and overusing painkillers over a long period of time.
Migraines
Migraines are a common neurological condition and vary in type, symptoms, and location. Pain is usually an intense throbbing that starts in one or both sides of the head and can travel. They can last between two hours to three days. Many people find their migraines get better as they age.
There are four stages to a migraine, each with different symptoms. Not everyone will experience every stage and there are ways to manage them.
- Prodrome – this can happen days or hours before a migraine starts and includes mood changes, food cravings, neck pain or stiffness, nausea, fatigue, or yawning more often.
- Aura – this can happen before or during a migraine with symptoms increasing in intensity over 20 to 60 minutes, such as seeing shapes or bright spots, tingling sensations in a limb, weakness or numbness in the face or one side of the body.
- Attack – this is the migraine episode, which can cause throbbing pain, increased sensitivity to your surroundings (light, sound, touch, and smell), nausea, or vomiting.
- Post-drome – after your migraine, it’s common to feel tired, have low energy, or feel confused for a few hours or days.
Some people find certain situations can trigger a migraine. These include hormonal changes, intense emotions, lack of sleep, neck or shoulder tension, alcohol, certain medications, and their environment (flashing lights, strong smells, second-hand smoke).
Cluster headaches
Cluster headaches are rare and one of the most painful types of headache. They’re a sudden, extreme pain on one side of the head, usually around the eye, and can last hours. You may have several a day over a few weeks or months, followed by a period without any episodes.
Unlike other headaches, cluster headaches happen at similar times each day, most often at night during sleep. During an episode, it’s common to feel restless with other symptoms on the affected side, such as:
- A red or very teary eye
- A blocked or runny nose
- Sweating from the forehead or face
- A swollen or drooping eyelid
The exact cause of cluster headaches is unknown. Though anyone can develop them, risk factors include being male and in your 30s or 40s, alcohol, smoking, and a family history.
New daily persistent headache
New daily persistent headache is a less common condition that starts without warning and continues every day without rest for at least three months. Each headache can differ in duration, intensity, and location. It can affect anybody, but often starts in children without a history of headaches.
Pain is often mild or moderate and feels like a tightening or pressing feeling. This can last for at least four hours a day. Other symptoms include difficulty sleeping, pain elsewhere in the body, dizziness, low mood, and sometimes nausea and sensitivity to light and sound.
Why some people develop new daily persistent headache is unclear. Despite this, there are treatments and support available to help effectively manage the condition and reduce its impact on you.
There isn’t a test to diagnose a headache or migraine. This is because imaging scans and pathology tests are usually normal in people with the condition. Instead, you’ll have an in-depth consultation with your neurologist to discuss your headache history.
If your neurologist suspects your headaches are symptoms of another medical condition, they may request an imaging scan, such as a CT scan or an MRI scan.
You may have a scan or further tests if:
- Your headache was very sudden, intense, and different to your other headaches
- Your headaches increase in frequency, duration, or intensity over time
- Your eyes or vision are affected, such as blurred vision, double vision, or a droopy eyelid, to rule out microvascular cranial nerve palsy
- You’ve experienced personality or mood changes following a headache
- You have or have had cancer
- Your headaches or a new headache type started after the age of 50
- You have other symptoms with your headache, such as a high fever or stiff neck
- Your headache is triggered by or gets worse when you cough, sneeze, or move
- You suffered a head injury in the last month
Further tests or scans help rule out other conditions or underlying causes behind your headaches, such as trigeminal neuralgia or occipital neuralgia (also called Arnold’s neuralgia) where a damaged nerve causes intense pain similar to a migraine or cluster headache.
Headache diary
It’s not unusual to forget certain details about your headaches when discussing them with your neurologist. A headache diary can be useful here, which is a detailed account of each headache you have. This can help us accurately diagnose your condition, as well as track your treatment progress.
For each headache, you or your family should record information about:
- Timings, such as when it happened and how long it lasted
- Pain, such as the intensity and location
- Auras – these are symptoms that can happen before or during a migraine, such as numbness or tingling, seeing shapes, or dizziness
- Triggers, such as what happened before it started
- Any medication you took to help
- Any other symptoms, such as nausea or light sensitivity
It’s important to record as much detail as you can remember, no matter how small it may seem. When we fully understand your symptoms and how they impact you, we can focus treatment where it’s most needed to help give you lasting relief.
While there are typical symptoms associated with headaches and migraines, everyone’s experience is different. For some, symptoms are mild and occasional, but for others, they can be persistent and difficult to manage.
That’s why we offer exceptional care for a wide range of headache disorders across all ages, from established therapies and support to next-generation treatments through clinical trials. We personalize your treatment to make sure you’re getting the care that’s right for you.
Common treatments may involve a combination of:
- Pain-relieving medication to take during a headache, such as triptans for migraines
- Preventative medication, which you take regularly to help prevent or reduce the severity of your headaches
- Neuromodulation devices, which help to relieve pain during a headache by blocking pain signals in your nervous system
- Neurological botox to help prevent or reduce the frequency and intensity of chronic migraines
- Monoclonal antibodies to help prevent cluster headaches or reduce the frequency and severity of migraines
- Greater occipital nerve injections of local anaesthetic with or without a steroid for cluster headache and migraine prevention, or to treat an underlying condition such as occipital neuralgia (also called Arnold’s neuralgia)
- Vitamin therapy to help prevent migraines when used in combination with other therapies
We take a comprehensive approach to treatment that puts you at the centre of your care. This means not only treating the condition itself, but also helping you manage factors that may influence it, such as stress, sleep, diet, and lifestyle.
Explore how we can support your treatment in other ways through our supportive care services.
