Headaches

Headache symptoms vary considerably depending on the type of headache. Headaches can be diffuse or localised, mild or intense, pulsating or pressing. Here is a detailed description of the symptoms according to the different types of headache:

Tension headache: This is the most common type of headache. It manifests as mild to moderate pain, often described as pressure or tightness around the head, sometimes in the form of a headband. Tension headaches can last from 30 minutes to several days. The pain is usually bilateral, affecting both sides of the head, and is not exacerbated by physical activity.

Migraine: Migraine is a recurrent headache characterised by pulsating pain, often unilateral. Migraine attacks are often associated with symptoms such as nausea and vomiting, as well as increased sensitivity to light (photophobia) and noise (phonophobia). The pain can last between 4 and a few days and is often aggravated by physical exertion. Some patients experience prodromal symptoms (warning signs) before the attack, such as visual disturbances.

Cluster headache: Cluster headaches are characterised by very intense pain, localised around one eye. These pains are often accompanied by autonomic symptoms such as redness of the eye, lacrimation, nasal congestion and sometimes drooping of the eyelid (ptosis). Attacks may occur several times a day for weeks, followed by long periods of remission.

Medication-induced headache: This type of headache occurs in people who frequently take painkillers to treat their headaches. It manifests itself as persistent, daily pain, often oppressive and present as soon as you wake up.

Trigeminal neuralgia: This is a particular form of headache characterised by intense, brief pains, often described as electric shocks, affecting one or more branches of the trigeminal nerve (which innervates the face). These pains can be triggered by mild stimuli, such as brushing the teeth.

The causes of primary headaches are complex and sometimes poorly understood. Migraines, for example, can be triggered by the activation of deep mechanisms in the brain, causing the release of inflammatory substances around nerves and blood vessels. Other types, such as tension headaches, are often associated with stress, fatigue or musculoskeletal problems. Secondary headaches, on the other hand, can be caused by infections, head trauma, vascular disorders or even overuse of medication.

The main risk factors for headaches include :

• Gender and hormones: Migraines affect women more frequently, due to hormonal influences, particularly oestrogen fluctuations.
• Stress and anxiety: These factors are particularly involved in tension headaches, but they can also trigger migraines.
• Lifestyle: Excessive consumption of caffeine, alcohol and tobacco, as well as an unbalanced diet and lack of sleep, are risk factors for several types of headaches.

The diagnosis of headache is based primarily on a thorough clinical examination and a detailed medical history. In more complex cases, additional tests such as magnetic resonance imaging (MRI) or computer tomography (CT-scan) may be necessary to rule out more serious secondary causes.

Headache treatments vary according to type and severity. Tension headaches are often treated with analgesics such as paracetamol or ibuprofen. For chronic forms, non-medicinal approaches such as relaxation, physiotherapy or stress management are often recommended. Migraines, on the other hand, may require specific drugs such as triptans, which act directly on serotonin receptors to relieve pain. In chronic cases, prophylactic treatments, including antidepressants, beta-blockers or anticonvulsants, may be considered to reduce the frequency of attacks.

Some headaches, such as migraines, can become chronic if not properly treated. Untreated headaches can also become increasingly frequent and resistant to treatment. Conversely, over-medicated headaches can aggravate the initial symptoms, creating a vicious circle in which patients increase their consumption of painkillers, making the situation worse.

The key to headache prevention lies in managing risk factors. A headache diary can be useful for identifying recurring triggers, such as certain foods, stress or changes in routine. A healthy lifestyle, including adequate sleep, regular hydration and a balanced diet, can help prevent attacks.

Download the headache calendar 

It is important to consult a doctor if headaches become frequent or severe, or if they are accompanied by neurological symptoms such as blurred vision, muscle weakness or other unusual symptoms.

1. What are the main causes of headaches?
The causes vary depending on the type of headache. Migraines are often triggered by hormonal, dietary or environmental factors. Tension headaches are generally caused by stress or fatigue.

2. Can headaches be prevented?
Generally, yes, by identifying and avoiding personal triggers such as certain foods, lack of sleep or stress. A balanced lifestyle can also reduce the frequency of attacks.

3. When should I see a doctor about a headache?
It is advisable to consult a doctor if the headaches are frequent, if they change in intensity or if they are accompanied by symptoms such as blurred vision or difficulty speaking.

4. Can headaches be linked to a more serious health problem?
Yes, some headaches can be a sign of a serious underlying condition, such as cerebral haemorrhage. Abnormal symptoms warrant prompt medical consultation.

5. Can children get migraines?
Yes, migraines can appear as early as childhood, often in children who have a parent with migraines.