Headache - overview

Headaches are the most common type of pain. Read about the different types and when to seek help.

Headaches are a major reason why people miss work or school. Although most headaches are nothing to be concerned about, if you keep getting them you should talk to your healthcare provider about them.

There are 2 main categories of headache:

  • Primary headache disorders which have no clear underlying cause, trauma or systemic illness. These include tension headaches, migraine and cluster headache.
  • Secondary headache disorders have a clear underlying cause and could have very serious consequences if the cause is missed.

(Ted-Ed, 2018)

Image credit: Canva

What can I do if I have a headache?

The treatment of your headache will depend on the cause and will vary depending on the specific type of headache. Here are a few general things you can do.

  • Drink a large glass of water as you may be dehydrated.
  • Take pain relief medication:
  • Rest in a dark, quiet room.
  • Have someone give you a head, neck and shoulder massage.
  • Relax in a warm bath.
  • If you keep getting headaches or migraines, track them with a headache diary to help you look for triggers or patterns. This can also be useful to show your doctor.

If you get headaches 3 or more times a month, your doctor may recommend preventive treatment.

When to get help

Usually, headaches go away given time, rest and/or treatment with a pain relief medication

Contact a healthcare provider or call Healthline 0800 611 116 for advice if:

  • your headaches remain frequent, persistent or worsen
  • you get no relief from simple pain relievers
  • you take simple pain relievers more than twice a week
  • you were headache-free but now get them
  • your headache is triggered by standing up, coughing, straining, physical exertion or sexual intercourse
  • you are over 50 and start to get regular headaches or there is face or jaw pain.

Call 111 and ask for an ambulance or go to the nearest hospital if:

  • a really severe headache comes on suddenly and gets worse within minutes
  • you have changes in your vision or eyesight or changes in consciousness
  • you are feeling sick (nausea), have a stiff neck, rash, fever, shakes or sensitivity to light (these are warning signs of meningococcal disease or meningitis)
  • you have red eye, are feeling sick (nausea) or being sick (vomiting) – these are signs of some types of glaucoma
  • your headache follows a head injury.

There are many types of headaches. These vary in their causes, how they feel, how severe they are, how long they last and how they respond to different treatments. Read more about the different types of headache and what causes them.

How can I describe my headaches?

  • Where is the pain? Is it on one side or both, behind your eye(s), forehead.
  • How severe are they? You can describe how severe your pain is using on a scale of 1 to 10. See ways to describe pain.
  • What do they feel like? Is it vice-like, stabbing, throbbing, splitting.
  • How long do they last? This could be minutes, hours or days.
  • How often do they occur?  Are they daily, monthly, only at certain times of the day, only on weekends or weekdays?
  • When do they occur? Is it on waking, in the afternoon or at work?
  • How do they start? Does the pain develop over hours or does it begin suddenly?
  • When did you start getting headaches? Was it childhood, adolescence or middle age?
  • What triggers them? This could be some foods, alcohol, caffeine, exertion, noise, bright light, hunger, stress, tiredness, weather.
  • What else do you feel? This may include neck or shoulder tension, sinus pain, tender scalp, jaw pain, being sick (nausea or vomiting).
  • Is your vision affected? For example do you have blind spots, strange lights or patterns?
  • What treatment do you take?
  • How effective was the treatment?

When should I have an imaging test for headaches?

Not everyone with headaches needs to have an imaging test. In some cases, you may need a CT or MRI scan if:

  • your doctor could not diagnose your headache based on your history and examination
  • your doctor finds something abnormal in your examination
  • you have unusual headaches or headaches caused by a more serious problem. 

Your doctor will advise what is best for you. Read more about when you should have an imaging test for headaches Choosing Wisely, NZ

What can I do to prevent headaches?

Lifestyle changes can help prevent headaches. Getting more exercise, avoiding known stresses or triggers, improving your sleep and diet can all help a lot.

  • Avoid triggers
    • If you know what causes your headaches (eg, alcohol, chocolate, cheese) it’s best to avoid these things if you can.
  • Change what you eat
    • Keep your blood-sugar levels even by eating small amounts of a healthy, balanced diet regularly.
    • You may find keeping a headache diary useful to work out whether certain foods trigger your headaches and need to be avoided.
  • Reduce stress
    • try to make time in your day to do something you find relaxing – have a bath, go for a walk, laugh with friends.
  • Get regular exercise
    • Activities such as swimming or vigorous walking can help reduce how often you get headaches and how bad they are.

Learn more

Headache Ministry of Health, NZ
Range of migraine and headache topics American Migraine Foundation, US

References

  1. Diagnosing and managing headache in adult in primary care BPAC, NZ, 2017
  2. Headache in primary care BPAC, NZ, 2007

Reviewed by

Dr Pyari Bose is a neurologist with special interest in headache disorders. He did headache research at King's College London, looking into the postdrome (recovery) phase of migraine using functional brain imaging.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Pyari Bose, Consultant Neurologist, Auckland City Hospital Last reviewed: 04 Nov 2021