Headache is pain in any region of the head. Headaches may occur on one or both sides of the head, be isolated to a certain location, radiate across the head from one point, or have a viselike quality. A headache may appear as a sharp pain, a throbbing sensation or a dull ache. Most types of headaches are harmless and go away by themselves.  APPOTEK can help you with headaches.


There are more than 200 types of headaches. Most are harmless and a few are life-threatening. Headaches are broadly classified as “primary” or “secondary”. 


Primary headaches are benign, recurrent headaches not caused by underlying disease or structural problems. For example, a migraine is a type of primary headache. While primary headaches may cause significant daily pain and disability, they are not dangerous. 


Secondary headaches are caused by an underlying disease, like an infection, head injury, vascular disorders, brain bleed or tumors. Secondary headaches can be harmless or dangerous.


More serious causes of secondary headaches include:


  • meningitis: inflammation of the meninges which presents with fever and meningismus, or stiff neck
  • bleeding inside the brain (intracranial hemorrhage)
  • subarachnoid hemorrhage (acute, severe headache, stiff neck without fever)
  • ruptured aneurysm, arteriovenous malformation, intraparenchymal hemorrhage (headache only)
  • brain tumor: dull headache, worse with exertion and change in position, accompanied by nausea and vomiting. Often, the person will have nausea and vomiting for weeks before the headache starts.
  • temporal arteritis: inflammatory disease of arteries common in the elderly (average age 70) with fever, headache, weight loss, jaw claudication, tender vessels by the temples, polymyalgia rheumatica
  • acute closed angle glaucoma (increased pressure in the eyeball): headache that starts with eye pain, blurry vision, associated with nausea and vomiting. The person will have a red eye and a fixed, mid dilated pupil.


Other causes include:


  • bad posture/ working position
  • drugs/alcohol
  • migraine
  • worry and stress
  • problems with the jaw
  • underlying illness, such as cold
  • dehydration.


Gastrointestinal disorders may also cause headaches, including Helicobacter pylori infection, celiac disease, non-celiac gluten sensitivity, irritable bowel syndrome, inflammatory bowel disease, gastroparesis, and hepatobiliary disorders.


The main symptoms of headache are: 


  • neck stiffness
  • dull, aching pain 
  • scalp tenderness
  • pulsating feeling in the head
  • nausea
  • pain on one side of the head
  • sensitivity to sound and light
  • severe, throbbing pain
  • vomiting

Prevention and protection

You can reduce the risk of headaches by starting relaxation exercises. Also try to:


  • reduce your stress
  • exercise
  • sleep properly
  • eat at regular times.


Primary headache syndromes have many different possible treatments.


Migraine can be somewhat improved by lifestyle changes, but most people require medicines to control their symptoms. Medications are either to prevent getting migraines, or to reduce symptoms once a migraine starts.


Preventive medications are generally recommended when people have more than four attacks of migraine per month, headaches last longer than 12 hours or the headaches are very disabling. Possible therapies include beta blockers, antidepressants, anticonvulsants and NSAIDs. The type of preventive medicine is usually chosen based on the other symptoms the person has.


Tension-type headaches can usually be managed with NSAIDs (ibuprofen, naproxen, aspirin), or acetaminophen.


Abortive therapy for cluster headaches includes subcutaneous sumatriptan (injected under the skin) and triptan nasal sprays. High flow oxygen therapy also helps with relief.


Treatment of secondary headaches involves treating the underlying cause. For example, a person with meningitis will require antibiotics. A person with a brain tumor may require surgery, chemotherapy or brain radiation.

When to consult a doctor

Seek medical help if you have sudden intense headaches, or:

  • your headache increases over several weeks
  • after a blow to the head you have a headache and feel lethargic
  • you get headaches with or without neurological failure
  • you get headaches with or without dizziness and confusion
  • you get headaches that you do not recognize before
  • you get a pain in one eye and altered vision
  • you are sore at the temples and jaws
  • you have difficulty speaking or moving.


Get emergency help if you experience sudden and intense headaches.

How APPOTEK can help

  • online consultations
  • psychological treatment
  • individual assessment and prescription medicines, if needed.
  • referrals to specialists

Vadym Diadiun, Doctor of Medicine, M.D.