In this article:
- Headaches, or experiencing pain in the head, are extremely common.
- Headaches usually resolve on their own and do not require medical attention. However, chronic headaches may indicate severe problems and should be checked by a doctor.
- A headache can result from any factor that acts on the pain receptors in your head or neck region.
- Generally, there is no single cause behind a headache. The presence of multiple factors at once causes a headache.
- Usually, the problem of headaches can be resolved with medications available over the counter. Making changes in your lifestyle, such as staying hydrated and taking proper rest, can also help in relieving headaches.
- People often experience headaches when starting a ketogenic diet as their body tries to adapt itself to a new source of energy, that is, fat instead of carbohydrates.
What Is a Headache?
A sensation of pain or uneasiness in the head is termed as a headache. Headaches can occur in different areas of the head and can vary in intensity. The incidence of headaches also varies greatly.
Headaches are very common. A headache may affect one or both sides of the head. It can be minor or chronic.
While most headaches are generally not indicative of a life-threatening medical condition, headaches do have an effect on daily life.
The incidence of headaches increases when you enter your twenties. The rate of occurrence of headaches steadies by the time you reach the age of 40-50 and decreases after that.
According to the World Health Organization, around 50% of adults worldwide will experience at least one headache a year. (1)
Types of Headache
Headaches can be broadly classified into primary headaches and secondary headaches.
Primary headaches are not caused by an underlying medical problem and occur independently. Causes of primary headache include:
- Migraine: During a bout of migraine, you may experience vomiting, photophobia (sensitivity to light), and lightheadedness along with a throbbing headache. A migraine can also cause some visual problems.
- Tension headache: More than 70% of adults suffer from tension headaches. These headaches are characterized by pain in both sides of the head, resulting in a tightening sensation. They can occur frequently and continue for a few minutes or even days. Tension headaches can result from a bad posture or excessive stress. (4)
- Cluster headache: A condition where severe headaches that last for short durations but occur multiple times in a day is called a cluster headache.
Symptoms of Tension and Migraine Headache
Experiencing pain in only one side of the head is common in patients suffering from tension headaches and migraines.
Pain on the left part of the head may be caused by stress, whereas pain on the right side could be due to a neurological condition.
Your doctor may evaluate your medical condition by doing a physical exam, conducting tests, and studying your medical history. If he/she concludes it as a primary headache, no further testing is required.
However, if you have a secondary headache, further tests will help in determining the cause of your headache.
Symptoms of Cluster Headache
Cluster headaches have a lower incidence than the other types of primary headaches and only affect 1 in 1000 adults. Individuals above 20 years of age are more prone to cluster headaches.
These headaches are generally focused around one eye. They can cause reddening in the eye, a drooping eyelid, and a runny nose.
Secondary headaches result from an underlying disease or head injury that causes pressure on or displacement of pain-sensitive nerve endings. Thus, the pain occurs in parts of the head that have pain-sensitive nerve endings or muscles.
The brain tissue lacks such nerve fibers. Pain, signaled by tissues surrounding the brain, blood vessels in the skull region, and some nerves originating in the brain, can present as a headache.
Sinus problems, dental problems, and tension in the muscles of the neck and scalp can also cause headaches.
Causes of secondary headache include:
- Crying for a long time
- Genetics (migraine headaches can be hereditary)
- Stress and tension
- Extreme cold or hot temperature
- Eye strain (looking at the television, computer, or mobile screens for long durations)
- Strain on the neck
- Carbon monoxide poisoning
- Altitude sickness (lack of oxygen)
- Hormonal imbalance
- Using tight goggles
- Medication overuse
- Side effects of medication
- Excessive smoking or drinking
Diagnosing a Headache
An analysis of your symptoms can help your doctor in diagnosing the kind of headache you have.
For better diagnosis, you can maintain a headache journal where you record the pattern, duration, and pain level of your headaches. Complete information helps in identifying what type of headache you have, what triggers it, and what to avoid. It also aids in prescribing the most suitable treatment.
Headaches produce different symptoms that can help your doctor identify which particular headache you have as treatments for each type can differ.
The treatment of a headache depends on its type and cause. Maintaining a headache journal can help you in determining the reason behind your headache.
Headaches caused by dehydration or a stiff neck can be avoided by making changes in your lifestyle.
Over-the-counter medications such as paracetamol/acetaminophen and ibuprofen can be used to relieve headaches. It is important to read the labels properly and not overuse the medications.
If you need to use over-the-counter medications for more than 2 days a week or if they fail to work, you should visit your doctor. He/she may prescribe you medications that are specific to migraines.
Note: Aspirin is not recommended for children and adolescents as it can cause Reye syndrome, which can be fatal.
Living with Headaches: Self-Care Measures
Making changes in your daily routine can help in the management of headaches. Some measures that can be taken include the following:
- Take adequate rest and sleep for 6-7 hours to avoid sleep deprivation.
- Take a bath with warm water.
- Avoid things that trigger your headache. These may include some drinks such as red wine or foods such as dried fruits with sulfates or certain cheeses.
- Do not stay hungry. Avoid fasting and eat at regular intervals.
- Sleep comfortably. Change your bedding or sleeping position if needed.
- Maintain good posture at all times.
- Do not strain your eyes. Get an eye checkup and wear prescription glasses if required.
- Practice meditation to help reduce the incidence of headaches.
- Exercise regularly. This helps in stress reduction and releases endorphins (your body’s natural pain killers). Exercising also helps you obtain better-quality sleep. (2)(3)
- Use a mouth guard if you grind your teeth.
- Avoid alcohol consumption.
- Use biofeedback techniques such as abdominal breathing.
- Use heat therapy to manage tension headaches. It may also be used for migraine attacks. However, heat may be a headache-trigger for some.
Seven Natural Ways to Get Relief from a Headache
Here are some natural pain-relieving techniques that you can try.
1. Increase Your Water Intake
Headache can commonly result from dehydration. (17)
Dehydration occurs due to less fluid intake or excessive fluid loss, resulting in decreased body water content. Constant thirst, dryness in the mouth, and lethargy are symptomatic of dehydration. (18)(20)
To relieve a headache caused by dehydration, you need to increase your intake of fluids. Drink water, oral rehydration solution (ORS), or coconut water in small sips throughout the day. You can also consume water-rich foods.
2. Apply an Ice Pack to Your Neck
Headaches may be due to inflammation.
Applying an ice pack helps in reducing the inflammation. An ice pack also helps in numbing the pain of a sudden-onset headache.
A study published in 2013 in the Hawaii Journal of Medicine and Public Health reported the effective use of a frozen neck wrap for alleviating migraine headaches. (7)
How to use:
- Wrap ice cubes in a washcloth and apply it to the back of the neck.
- Alternatively, pip a washcloth in ice-cold water and place it on your head for 5 minutes.
- You can also use a packet of frozen vegetables instead of an ice pack.
An ice pack is a home remedy that can be used alongside the prescribed medical treatment. It should not be used to replace medications.
3. Consume Ginger
Ginger is an anti-inflammatory agent that acts on the blood vessels in the head, thus helping alleviate a headache. Ginger has also been used to treat migraine headaches as it has prophylactic and abortive properties.
A double-blind placebo-controlled randomized clinical trial published in 2019 in Cephalalgia demonstrated the use of ginger for migraine treatment. The patients were divided into two groups. One group was given a placebo and the other was given 400 mg ginger extract. Both groups were also given an intravenous drug to treat the migraine attack. (9)
The patients belonging to the ginger-consuming group experienced greater reduction in pain and improved functionality.
Thus, the use of ginger as an adjunct to nonsteroidal anti-inflammatory drugs for migraine treatment can be considered. (9)
4. Use Essential Oils for Massage and Aromatherapy
A study published in the Journal of Korean Biological Nursing Science in 2010 showed the use of lavender, rosemary, rose, and basil essential oils for alleviating headaches. (14)
The scent of lavender essential oils can help to alleviate tension headaches. The pain-relieving activity of lavender oil was published in Evidence-Based Complementary and Alternative Medicine in 2013. (11)
The use of lavender oil has been found to be safe and effective against migraine headaches. Patients registered a reduction in pain and symptoms associated with migraines 15 minutes after inhalation of lavender oil. The oil was rubbed onto their upper lips in the initial phases of the attack. (10)(11)
The menthol in peppermint helps to relieve headaches, such as tension or stress headaches, that are caused by the constriction of blood vessels. Menthol dilates the blood vessels and also has pain-relieving properties.
A study conducted in 2016 showed that a 10% peppermint oil solution prepared using ethanol can be used for the treatment of tension headaches in individuals older than 6 years. (12)
Most essential oils have analgesic and anti-inflammatory properties that can help in relieving headaches when applied topically.
How to use: Mix a few drops of essential oil in a carrier oil and use it to massage your head, neck, or shoulder muscles.
Note: Oral consumption of essential oils should be avoided. Before using essential oils, check for possible allergies. People suffering from high blood pressure and epilepsy should avoid the use of rosemary oils.
5. Consider Acupressure
The technique of applying pressure to specific points, known as acupoints, is known as acupressure. Acupressure is a part of traditional Chinese medicine.
Acupressure helps in releasing muscle tension and enhances blood circulation, thus helping in relieving pain and other problems.
Consult an expert for an acupressure therapy.
6. Increase Your Magnesium Intake
A study published in 2015 in Nutrients reported a link between low levels of magnesium and chronic diseases such as migraine. (15)
It is necessary to include magnesium in your diet if you suffer from frequent migraine headaches.
Research has shown that the use of magnesium is an effective and safe preventive measure against migraine. It may also be helpful in relieving primary headaches. (16)
A study published in the Journal of Neural Transmission in 2012 showed that around 50% of patients with migraine had a magnesium deficiency. (16)
Magnesium, available in oral and intravenous forms, is highly useful for magnesium-deficit patients. Thus, preliminary treatment with oral magnesium is recommended for people suffering from migraine.
7. Do yoga
A study compared patients with migraine using conventional care versus conventional care plus yoga 5 days a week for 6 weeks. The group that used conventional migraine treatments plus yoga experienced fewer migraine headaches and less severe headaches when they did occur. (19)
What Is Occipital Neuralgia?
Inflammation or injury in the occipital nerves can cause severe headaches. This condition is termed as occipital neuralgia.
The occipital nerves run from the top of the spinal cord to the scalp. Occipital neuralgia produces a throbbing, chronic pain, which may occur at the back of the head, around the ears, or in the upper neck.
Can Menstruation Cause a Headache?
A change in hormone levels can trigger headaches. The levels of estrogen and progesterone change before your periods, causing headaches.
This is more prominent in women who complain of a migraine.
The headache may be accompanied by joint pain, acne, and fatigue.
Ketogenic Diet and Headache: Is There a Link?
A keto diet works by reducing the amount of carbohydrates that you consume in a day.
The sudden switch from using starch as an energy source to utilizing the fat stored in your body requires adjustment. This transition period may be associated with a headache.
Headaches caused by a keto diet may last for 1 day to 1 week. If your headache does not subside after that, consult your doctor.
Headache Accompanied by a Stomachache
A headache and stomachache may occur together due to various reasons. These include infections in the stomach, gastroenteritis (stomach flu), abdominal migraine, kidney diseases, and even excessive alcohol intake.
To find the underlying cause of the headache, the following tests are done based on the information you provide your doctor:
- Sinus X-rays
- Blood tests
- Magnetic resonance imaging (MRI)
- Computed tomography scan (CT scan)
When to See a Doctor
It is recommended to seek medical help when your headaches are highly recurrent or do not subside using home remedies or OTCs. These headaches may be indicative of a severe medical problem.
Consult your doctor if your headache is associated with any of the following problems:
- Changes in vision or speech
- Loss of motor function
- Stiffness in the neck
- Weight loss
You should seek medical help if you observe a change in the pattern or intensity of your headaches. Get regular follow-ups for the management of your headache if you suffer from an immune disorder or cancer.
What you may ask your doctor:
- What could be triggering my headache?
- Should I use over-the-counter medications?
- Is the problem genetic?
- Do I need to undergo any tests to determine the type of headache?
- Can headaches result from exercising?
- Should I change my diet?
- When will the problem subside?
- Can I work while having a headache?
What your doctor may ask you:
- Have you identified anything that triggers your headache?
- How frequently do your headaches occur?
- Is the pain mild or severe?
- Do you take any medicines?
- Are you allergic to anything?
- Have you been under stress lately?
- In what part of the head do you feel the pain?
- What is the average duration of your headaches?
- What kind of diet do you consume?
- Do you get enough sleep?
- Have you ever had any injury to the head?
Expert Answers (Q&A)
Answered by Dr. Ramon Rodriguez, MD (Neurologist)
Headaches are very common, and while most headaches do not have major implications and are benign, the presence of fever, chills, nausea, vomiting, changes in vision, weakness or changes in body sensation could suggest a serious headache.
In a case like this, I recommend a patient to have an MRI of the brain to assess in detail whether there might be any changes consistent with inflammatory disorders in the brain or brain vessels.
Another headache that can be serious is any headache in a person older than 50 years with no previous history of headaches.
Yes, hormonal changes can be associated with headaches. Fluctuating levels of hormones, such as estrogens and progesterone, may trigger headache in females.
Another headache that can be attributed to hormonal imbalance is the catamenial migraine, defined as migraine headaches that can begin 2-3 days before the onset of the menstrual cycle and may last up to three days after the menstrual cycle. Paying careful attention to the cyclic nature of the symptoms can help with the diagnosis.
This is a very interesting question. Let’s begin with high blood pressure headache. While headaches are not a typical manifestation of high blood pressure, when a headache occurs secondary to high blood pressure, it raises the concern for malignant hypertension.
Elevated blood pressure might be associated with other conditions such as heart attacks or strokes, besides headaches.
Low blood pressures are typically not associated with headaches but can be associated with dizziness, especially upon standing and possibly fainting.
Migraines are more popular than what people tend to believe. The typical migraine headache has three phases: premonitory phase when the person feels they are going to have a “migraine or headache day.” It sometimes consists of changes in mood or irritability.
Then, the painful phase occurs, where the headache is typically unilateral, throbbing, behind the eye, associated with nausea, vomiting, sensitivity to light or sound, and the patient typically prefers to stay in a dark room.
After the painful phase (headache) is over, patients may suffer a postdrome, which can be associated with fatigue and malaise even for a day or two after the resolution of the headache.
Some migraines can have a little variability form the description provided, but most of them are associated with it. A regular headache tends to be all over the head or may be triggered by muscle spasms.
I recommend an evaluation with a neurologist because advances in medicine have provided information about the triggers and etiologies of many headache syndromes, and proper assessment can help choose the correct treatment.
As strange as it may sound when a person has a headache, it is not typically the brain that hurts, but the vessels and muscles surrounding the brain that irritates the nerve terminals and this is what causes the pain. Many theories exist about what causes it, including inflammation and dilation of the vessels.
It could be. A person with a headache that is not improving with medications and continues to persist must be evaluated to rule out a structural lesion such as a brain tumor or checked for other conditions that may cause either elevated or decreased intracranial pressure.
When a person suffers from headache, the most important is to pay attention to triggers of headaches. Unfortunately, most people don’t pay attention to the particular situations that provoke a headache, and many times the solution to make the problem better is there itself.
For example, stress, sleep deprivation, hunger, certain smells, some medicines, and even certain foods might be the headache trigger. Frequently, avoiding exposure to these issues can be all that is needed.
When a headache occurs, try to position yourself in a dark room, quiet and even try to take a nap. Sleep is one of the best treatments for headaches. Avoid stressors. I know this is easier to be said than done, but small changes may create a long term impact.
Medications like acetaminophen or ibuprofen can be good first choices, keep a journal of the time you are having headaches, situation and things you might believe can be the triggers and share with your doctor. For those where a headache has a change in nature, brain imaging is advised.
About Dr. Ramon Rodriguez, MD: Dr. Rodriguez is a board-certified neurologist with extensive experience in clinical care, research and education. He has traveled the world teaching other doctors and students about the proper diagnosis of neurological disorders and conducting research ethically.
He has been awarded multiple accolades for his teaching skills, for his bedside manners, and providing compassionate care to patients with neurological disorders.