When you suffer a headache, the temptation is to reach immediately for the painkillers. But trying to pinpoint the cause might help reduce the pain – and even prevent the problem occurring again.
Headaches are one of the most frequent reasons for going to the GP or neurological clinics, says Giles Elrington, a neurologist at the Barts and London NHS Trust and trustee of the London Migraine Clinic.
‘In all headaches, and that includes migraines, the physiological explanation is the same,’ he says.
‘An electrical circuit at the back of the brain – known as the trigemino-cervical neurovascular pathway – fires off incorrectly, generating pain in the head. Think of a fire alarm ringing without the fire.’
The good news is that despite the universal fear, a headache is rarely the sign of a brain tumour. ‘Fewer than 1 per cent of people who consult their GP about a headache actually have something seriously wrong with them,’ says Mr Elrington.
‘Nevertheless, in all cases, it’s important to see your GP immediately if your headache occurs suddenly and severely, if it is accompanied by a fever, feelings of drowsiness or any neurological deficiency such as memory loss or a weakness on one side.
‘You should also see a doctor if you notice a dramatic change from your normal headache pattern.’
We all know that too many glasses of wine and stress can lead to headaches. But here, our experts detail the more surprising causes of that thumping pain.
GOING TO THE HAIRDRESSERS
A surprisingly common cause of head pain is an appointment with the hairdresser or barber.
It’s caused by having to hold your head back over the basin when having your hair washed.
This extends the neck awkwardly, stimulating one of the nerves that activates the trigemino-cervical neurovascular pathway. Pain can come a day or two afterwards, so the cause is often missed.
‘Other causes of these types of headache include cradling a phone between your shoulder and ear – and sitting on a chair without any lower back support,’ says Michael Gross, a neurologist and clinical director at Clementine Churchill Hospital, Middlesex.
COUGHING
While a coughing fit is likely to make any head pain worse, there’s actually a recognised headache known as ‘cough headache’. This is triggered by coughing and other types of straining – such as sneezing, blowing your nose or bending over.
Around 1 per cent of headaches are caused by coughing, with men more prone. They occur because of the pressure build-up in the brain. The pain is sharp, stabbing or splitting, and typically lasts a few seconds to a few minutes, usually most pronounced at the back of the head.
‘While in most cases the cause is unknown, some clinical research shows that about 10 per cent of cough headaches indicate another disorder, such as Arnold-Chiari malformation,’ says Mr Elrington.
‘Here when you cough, the pressure pushes the brain downwards into the upper spinal canal, causing the headache.’
The headache is usually accompanied by other symptoms such as neck pain, balance problems, vision problems, hearing loss, insomnia and a ringing or buzzing in the ears.
JOGGING ON THE TREADMILL
If you ever need an excuse not to go to the gym, it’s this – ‘exertion headache’.
‘Any type of physical exertion, such as jogging or pounding a treadmill, causes blood vessels in the head, neck and scalp to swell, producing a build-up in pressure,’ says Mr Gross.
The severe pain starts within seconds of exercising and can occur anywhere in the head. These headaches are most common in people susceptible to migraines.
Obviously, changing the type of exercise can help – perhaps swimming instead of running – but taking anti-inflammatories half an hour before exercising may be another option, as this can reduce swelling.
Although rare, if you do develop a sudden pain in the head when exercising, it’s important to go to the doctor to rule out other conditions, such as a brain tumour or a ruptured aneurysm – a swelling in one of the blood vessels in the brain.
AN ANXIOUS PERSONALITY
People with low self-esteem or anxious types are more likely to suffer from migraine-style headaches, according to a study at the Headache Centre of Turin University in Italy.
‘It’s thought this temperament makes people more vulnerable to stress, which lowers levels of the brain chemical serotonin. Low levels of this are thought to trigger the pain pathway,’ says Mr Elrington.
