Headache is one of the most common health complaints. The WHO estimates that approximately 50% of the global adult population has experienced a headache in the past year. While most headaches are benign and treatable, it is important to know when a headache may signal something more serious.
Types of Headache
Tension-Type Headache
The most common type of headache:
- Mild to moderate pain on both sides of the head
- Described as a "tight band" or "pressure" around the head
- Not usually worsened by physical activity
- No nausea or sensitivity to light/sound (or mild only)
- Can last 30 minutes to several hours
Common triggers: Stress, poor posture, skipping meals, dehydration, eye strain, insufficient sleep
Migraine
A neurological condition causing moderate to severe headache episodes:
- Usually one-sided throbbing or pulsating pain
- Nausea or vomiting
- Sensitivity to light and sound (photophobia and phonophobia)
- Worsened by physical activity
- Lasts 4-72 hours if untreated
- Some people experience aura (visual disturbances such as flashing lights, zigzag lines, or blind spots) before the headache
Migraines affect approximately 1 in 7 people worldwide and are three times more common in women than men.
Medication Overuse Headache
- Caused by taking painkillers too frequently (more than 10-15 days per month)
- A common cause of chronic daily headache
- Treatment involves gradually reducing the overused medication with medical support
Cluster Headache
- Very severe, one-sided pain (usually around the eye)
- Episodes last 15 minutes to 3 hours and can occur multiple times daily
- Associated with red, watery eye, nasal congestion, and restlessness
- More common in men
Migraine Triggers
Common triggers (which vary between individuals):
- Stress (or the "let-down" period after stress)
- Hormonal changes (menstruation, oral contraceptives)
- Dehydration (very common in the UAE climate)
- Irregular meals (skipping meals or fasting)
- Sleep changes (too little or too much)
- Alcohol (especially red wine)
- Caffeine (withdrawal or excess)
- Strong smells (perfume, paint, smoke)
- Weather changes
- Screen time and bright lights
Keeping a headache diary for 6-8 weeks can help identify your personal triggers.
Treatment
Tension Headache
- Simple painkillers: paracetamol or ibuprofen
- Adequate hydration
- Stress management
- Regular exercise
- Improving posture and workspace ergonomics
Migraine - Acute Treatment (NICE CG150)
- Take painkillers early (at the first sign of an attack)
- First-line: NSAID (ibuprofen or aspirin) with an anti-sickness medication if needed
- Triptans: Specific migraine medications (e.g., sumatriptan) for moderate to severe attacks or when simple painkillers are ineffective
- Rest in a dark, quiet room
- Avoid overusing painkillers (no more than 10-15 days per month)
Migraine - Preventive Treatment
Considered when migraines are frequent (4 or more per month) or significantly disabling:
- Propranolol (beta-blocker) - first-line preventive
- Topiramate (anti-seizure medication; not suitable in pregnancy)
- Amitriptyline (low-dose tricyclic antidepressant)
- Non-drug prevention: regular exercise, stress management, adequate sleep, regular meals
Red Flags - When to Seek Urgent Medical Attention
Seek immediate medical attention if you experience:
- Thunderclap headache: Severe headache that peaks within seconds to minutes - the worst headache of your life
- Headache with fever, stiff neck, and rash (possible meningitis)
- New headache with visual changes, scalp tenderness, or jaw pain (especially if over 50 - possible giant cell arteritis)
- Headache with weakness, numbness, speech problems, or confusion (possible stroke)
- Progressive worsening headache over days or weeks
- Headache that worsens with coughing, sneezing, or bending over (possible raised intracranial pressure)
- New headache in someone with cancer or HIV
- Headache after head injury
This article is for informational purposes only and does not replace professional medical advice. Always consult your doctor for personalised guidance.