Headaches: causes, symptoms & treatment

Abstract

• Headaches include all pain sensations in the area of the head.
• Doctors distinguish between primary headaches (as a disease) and secondary headaches (as a side effect of another disease).
• Headaches can be caused by stress, lack of fluids, certain foods, tense muscles, hormonal imbalances or other causes.
• Painkillers for headaches should be taken as early as possible, but not more than ten days a month.

Definition

The diagnosis of headache covers over 180 different types of headache. The brain itself is not affected by headaches as it has no pain receptors of its own.

What hurts are:

• Blood vessels in the head
• The skullcap
• Cranial nerves and membranes
• The upper spinal nerves

If these structures become irritated, this triggers the headache.

Causes

It is often not possible to pinpoint the cause of headaches. Sometimes it is a combination of different factors. In addition, there are some illnesses that can trigger headaches secondarily.

Possible causes are, for example

• Neurological factors such as traumatic brain injury or epilepsy
• ENT-related factors such as sinusitis
• Psychogenic factors such as stress and lack of sleep
• Substances such as alcohol, the intake of certain medications or certain foods
• Stresses such as noise, sleep deprivation, poor air quality or a lack of fluids in the body
• Mental stress
• Internal factors such as hormonal disorders and allergies
• Orthopaedic factors such as tense neck and throat muscles

Symptoms

The individual symptoms experienced by patients depend on the type of headache.

The following table gives you an overview of the typical symptoms of the most common types of headache:

Diagnosis

With regard to the diagnosis, a distinction must first be made between tension headaches and migraines.

Headaches can be distinguished from migraines by the following characteristics:

• Exercise often has a beneficial effect on headaches, making migraines worse.
• Headaches feel dull and oppressive, whereas migraines are throbbing and pulsating.
• Headaches affect the entire head, while migraines usually only occur on one side.

Keep a headache diary

It is helpful for the diagnosis to keep a headache diary. In it, you can record your meals, the weather, how you feel, your sleeping times and other information. These notes will help the doctor to determine whether there are certain triggers that are causing your headaches.

Important: Smartphone apps such as the “Migraine App” help to document all the important data for this.

Treatment

Especially with moderate to severe headaches, everyday life can hardly be managed without treatment. Patients are therefore dependent on using the right medication to relieve the headache. Many sufferers resort to painkillers on their own.

Recommended painkillers for migraines and headaches

According to the recommendation of the German Migraine and Headache Society (DMKG), a combined painkiller is usually best for migraines and headaches:

• Acetylsalicylic acid (ASS)
• Paracetamol
• Caffeine

Painkillers with the active ingredient ibuprofen are also the first choice. Here too, a stronger and faster effect is seen in combination with caffeine.

Rules of thumb for self-medication

1. If you wait to take the medication, the painkillers usually have less of an effect in advanced headaches. As a result, it is often necessary to increase the dose even further. You should therefore take your painkillers as soon as you notice the first signs.
2. Do not take painkillers more than ten days a month. Excessive use can lead to a drug-induced headache.

When should I see a doctor if I have a headache?

Most headache patients treat their symptoms themselves with painkillers. However, if these do not work well or if you suffer from headaches particularly frequently, a visit to the doctor is recommended.

If you notice these warning signs, you should go to the emergency room:

• For sudden headaches of extreme intensity.
• If a stiff neck, epileptic seizures, numbness in one half of the body and other neurological deficits or high fever are accompanying symptoms.

Questions and answers

I have a headache – which doctor is responsible for me?

The first point of contact for all health issues is a family doctor. They can then decide whether you need a referral to a specialist. This may include neurologists and pain therapists.

Is it possible to take sick leave by telephone for headaches?

Yes, a sick note by telephone is generally possible under certain conditions. However, TeleClinic does not issue a certificate of incapacity for work by telephone, but patients can receive an electronic sick note for headaches for up to three days via video call at the doctor’s discretion.

Where can I get a prescription for medication for headaches?

The majority of painkillers for headaches and migraines are available over the counter from pharmacies. However, if you need an e-prescription for prescription headache tablets, you can contact a doctor here at TeleClinic.