What it means
Most headaches fall into two familiar patterns, and knowing which one you have changes what helps.
Tension-type headache — pressing or tightening, usually both sides, often from the forehead, neck or shoulders. Common, usually mild to moderate, not made much worse by activity.
Migraine — usually one side, throbbing, moderate to severe, made worse by movement, and often with nausea or vomiting, light or sound sensitivity, and sometimes a visual aura beforehand.
Both are real, both are treatable, and neither is a sign of anything dangerous underneath.
What can vary
- Frequency matters more than severity. A headache you can manage twice a month is a different situation from one you need painkillers for daily.
- Triggers are individual. Common ones include skipped meals, dehydration, poor or irregular sleep, screen-heavy days, stress, bright or flickering light, strong smells, alcohol, and — for many people who menstruate — the cycle.
- Teens get more headaches than adults, often because of school schedules, screen time and irregular meals rather than anything serious.
- Overusing painkillers causes headaches. Taking painkillers on more than about two days a week for more than a month can cause medication-overuse headache, which is real and reversible.
Possible explanations
A clinician considers: tension-type headache; migraine; medication-overuse headache; sleep apnoea, particularly with snoring and daytime sleepiness; anaemia; dehydration or skipped meals; hormonal changes; vision problems; and, less commonly, structural causes.
They cannot be distinguished from a description alone, which is why a diary of when, how often and what the headache feels like is genuinely useful.
Warning signs
Emergency:
- Headache reaching full strength within seconds to a minute
- Headache with fever, stiff neck, confusion, or a rash that does not fade when pressed with a glass
- Headache with weakness, numbness, slurred speech, or vision loss
- Headache after a significant head injury
Prompt:
- A new headache that is getting progressively worse over weeks
- Headaches interfering with school, work or sleep
- Painkillers needed more than two days a week
- A change in a long-standing headache pattern
What to do next
Track them: when, how long, severity, where on the head, associated symptoms, and what you took. A month of that gives a clinician something to work with.
If you need painkillers most days, say so — that is the point at which a plan is more useful than another box of tablets.
Self-care
These have reasonable evidence:
- Regular meals and fluids. Skipped meals and dehydration are common triggers, especially in teenagers.
- Regular sleep. Not just duration — regularity matters.
- Movement. Regular exercise reduces migraine frequency for many people.
- Take painkillers early in a migraine, rather than waiting.
- Reduce screens during an attack, and consider breaks during the day generally.
- Relaxation and CBT have good evidence for migraine and tension headache.
- Quiet, dim space to recover in.
What does not work reliably: “detox” products, supplements claiming to cure migraine, and taking more pain relief than the packet says.
When to seek help
Routine: occasional headaches with no warning signs.
Prompt: frequent headaches, painkillers several days a week, or a changing pattern.
Emergency: any of the emergency features listed above.
How to talk about it
“I’ve been having headaches most days for a few weeks.”
“It builds up over about an hour, I feel sick, and light hurts my eyes.”
“It came on instantly and reached full pain within seconds.”
That last sentence triggers a very different response, and it is worth saying precisely if it describes what happened.
Related articles
Sources
Public sources are linked so you can read the detail rather than take this site’s word for it. None of this has yet been reviewed by a qualified clinician — see how we handle medical review.
References
Where this comes from
Linked so you can check it against a recognised public health source rather than take this site's word for it.
- Headaches and migraine — NHS NHS (opens in a new tab)
- Migraine — WHO World Health Organization (opens in a new tab)
These are public sources from recognised health organisations, linked so you can read the detail rather than take this site's word for it. Reading them does not tell you whether any of it applies to you, and none of these articles has yet been reviewed by a qualified clinician. How we handle sourcing and review.