Headaches are very common in the adult and adolescent population. Find out more about types of headaches, headache causes and treatment.

Causes of headaches

Most headaches are primary in origin – they are not serious and are not related to another disease process. However, they can be extremely unpleasant and for some can curtail their lifestyle. This article is concerned with primary headaches.

Occasionally headaches are secondary to a disease, such as a tumour, high blood pressure or a head injury. The underlying cause of the headache needs to be treated and these can be fatal. Therefore headaches should be taken seriously and if in doubt – get checked out by your family doctor.

Types of headache

Different types of headaches have different symptoms –

Tension headaches

This is the most common type of headache, experienced by most adults at one time or another. Some people get them often.

It is characterised by a dull ache felt around the head and is associated with stress and muscle tension in the head, neck, back and shoulders. Some people report a feeling of tightness around the head. They may last from a few hours to a few days.

Possible causes of the muscle contraction which result in tension headaches are:

  • Poor posture, particularly associated with computer use
  • Stress
  • Varying hormone levels throughout the menstrual cycle
  • Smoking, alcohol and caffeine
  • Poor eyesight
  • Tiredness

Tension headaches are not pulsating headaches and nor are they localised to one side of the head. They are also not described as severe.

They are most commonly treated by over the counter medicines, such as paracetamol, aspirin and ibuprofen.

Other non pharmaceutical remedies may also be helpful:

  • Gentle exercise
  • Food and fluids
  • Resting in a dark, cool room
  • Back, neck and shoulder massage
  • Avoiding triggers, such as alcohol and nicotine


Migraines are severe headaches which are often accompanied by nausea and vomiting. They may be brought on by certain foods (caffeine, alcohol, chocolate) or by lifestyle behaviours, such as tiredness or missing meals. For this reason it is worth keeping a diary of your migraines and foods you ate etc. to enable you to identify whether you have any triggers.

Approximately 1 in 10 adults get migraines and they are a lot more common in women than in men.

Classical migraines are preceded by an aura (flashing lights/numbness/slurred speech), common migraines are not.

Migraines may be caused by:

  • Changes in the size of blood vessels to the head
  • A decrease in the level of serotonin – a chemical in the brain – which causes dilatation of the blood vessels and is associated with the throbbing pain that characterises a migraine.

A migraine sufferer will often need to lie still in a darkened room, as bright lights and movement can make the headache worse. Often simple painkillers obtained from the pharmacy (paracetamol, ibuprofen) will be effective. Occasionally prescribed migraine medication will be necessary. Many people access natural health remedies for migraines too, such as acupuncture, aromatherapy and massage. Osteopathy may also help if muscles in the back or neck are out of alignment, triggering the headaches.

Migraines may only last a few hours, but can last up to 3 days.

Cluster headaches

These headaches are rarer than migraines, affecting 1 in 500 people. They are more common in men than women, particularly between 20-40 years.

As their name suggests they come in clusters, lasting on average around an hour. People may experience several a day, for several days, several weeks or several months. For some there is little break between headaches, for others they may not get headaches for many months between clusters of headaches.

The pain is one sided, over one eye, which may droop and become red and watery. Many experience an acute ‘stabbing’ pain which can wake them from their sleep. Like migraines people may notice triggers such as alcohol, certain foods, exercise or warm, stuffy atmospheres can set off a cluster headache.

Cluster headaches are not treated effectively by standard pain killers, as the headaches are usually short lasting anyway. Individualised, specialist advice is necessary to discuss whether preventative drugs should be prescribed, or whether cluster headaches should be treated with drug therapy once they have occurred. Some drugs that are used to treat migraines may also be effective for cluster headaches.

Headaches and sport

A few people report headaches related to sport, which come on after a period of intense aerobic exercise.

1 in 100 people get headaches on exertion, which begin as a throbbing pain and settle to a dull ache, probably due to changes in blood pressure and the blood vessels during exercise. They are treated with simple pain killers and some people take anti-inflammatory pain killers such as ibuprofen as a preventative analgesic, prior to sport.

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Paula Skelton is a qualified NZ nurse and midwife, a midwifery & childbirth educator and the mum of three lovely girls.

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