Causes of headaches

Is this the reason you have a headache?

Headaches are one of those things in life that the majority of us will suffer with from time to time. These can be brought on through lifestyle aspects, like stress or diet, but sometimes, there may be an underlying cause.

Common causes of headaches

Many headaches will come and go naturally with rest and hydration, and it’s fairly easy to identify the issue.

Common causes of head pain include:

  • Dehydration
  • Not eating enough / change in diet e.g. less sugar or salt, low calorie and carbohydrates
  • Eyestrain
  • A hangover from alcohol
  • Caffeine withdrawal
  • Reaction to new medication
  • Eating cold food such as ice cream and drinking extremely cold or piping hot beverages
  • Under sleeping or oversleeping (yes too much sleep can be bad for you!)

It’s important to listen to your body and understand the symptoms associated with your pain, as most people don’t know there are differences between each type of headache.

There are two main types of headaches:

  1. Primary headaches migraines, tension and cluster
  2. Secondary headaches sinus, hypertension, TMJ, hormonal, cervicogenic, hypnic, exertional, chronic

Primary headaches


Migraines are more serious than most headaches. You may not even be aware that you suffer from migraines, as these can often be mistaken for a tension or sinus headache. A migraine is a neurological condition that can last for up to seven days in some instances and usually flares up a few times a month.

What causes migraines?
There are many triggers for migraine headaches. Hormonal changes, emotional stress, depression and anxiety, physical tiredness, low blood sugar, jet lag, changes in diet and medication can all set off migraines.

What are the symptoms of a migraine?
If your headache is indeed a migraine, you will experience at least one or many of the following:
throbbing pain:

  • sensitivity to light and sound
  • a loss of appetite
  • stomach pain
  • nausea and vomiting

It’s also not uncommon to feel weak and unable to carry out every day tasks such as going to work or driving when you’re suffering with a migraine.

How to treat migraines

People suffering from chronic migraines are usually under a doctor’s care, which includes a remedy along with lifestyle changes. If you think you might be experiencing migraines, book an appointment to see your doctor as soon as possible.

How to treat migraines

Tension headaches

Tension headaches are the most common type of headache that 90% of us will experience at least once in our lifetime. They come and go sporadically and usually disappear quite quickly.

What causes tension headaches?
There are many reasons you may get tension headaches, including tiredness, stress and anxiety, squinting, lack of physical activity and missing meals.

What are the symptoms of a tension headache?
This type of headache is the result of tightness or tension in the muscles of the upper back and neck and is often caused by stress and fatigue. The pain is moderate to mild and feels like a dull pressure in the forehead.

How to treat a tension headache
You can cure tension headaches through natural relaxation methods like yoga, meditation, massage or even a nap. If your headache persists, over-the-counter pain relievers are also an option.

Cluster headaches

Cluster headaches are rare types of headaches that only affect 1% of the population. These headaches cause significant pain on side of the head and you can often feel it around your eye area.
Anyone can get them, but they're more common in men and tend to start when a person is in their 30s or 40s.

What are the symptoms of a cluster headache?
Cluster headaches can begin quickly and out of the blue. The pain is very severe and feels like a sharp burning or piercing sensation on one side of your head. This is usually around the eye, temple and sometimes face and occurs on the same side each time you experience this type of headache.

Symptoms associated with a cluster headache include:

  • a smaller pupil in one eye
  • drooping and swelling of one eye
  • a sweaty face
  • red and watery eye
  • a runny or blocked nostril

You may also feel agitated and struggle to rest because of the intense pain. Cluster headache attacks can last between 15 minutes and three hours, and typically occur between one and eight times a day.

What causes cluster headaches?
This isn’t yet clear but people who smoke appear to be at higher risk to these types of headaches. Genetics and strong scents can also be the cause of these headaches.

How to treat cluster headaches
While cluster headaches aren’t life threatening, they can still cause significant pain and affect your quality of life. Over-the-counter painkillers like paracetamol aren’t effective for cluster headaches because they are too slow to take effect and treat the pain. Instead, you will need to have specialist treatment.

These include:

  • Oxygen therapy – when you breathe oxygen through a face mask
  • A sumatriptan injection – which you can give yourself up to twice a day
  • Sumatriptan or zolmitriptan nasal spray – an alternative to injections

These treatments should relieve the pain of a cluster headache within 30 minutes.

Secondary headaches

Sinus headaches

Sinus headaches are caused by inflammation of the sinuses and can be confused with migraines, as the symptoms often overlap. Sinusitis, however, isn't associated with nausea or vomiting or aggravated by noise or bright light, all of which are common features of migraines.

What are the symptoms of a sinus headache?

If you have sinus headaches, you’re likely to experience:

  • Pain and pressure around the sinuses - in your forehead, brow or cheeks
  • A stuffy nose
  • A sore throat
  • Cough
  • Fatigue
  • Aching feeling in your upper teeth
  • Worsened pain if you bend forward or lie down

How to treat sinus headaches
Over-the-counter treatments such as paracetamol, ibuprofen, or naproxen sodium may help, and you can also buy decongestants without prescription, which should help open your blocked sinuses. Natural cures such as gargling salt water might also help ease your symptoms.
If it lasts longer than 10 days, then make an appointment with your doctor.

Hypertension headaches

Hypertension, more commonly known as high blood pressure, occurs when the force of the blood flow inside the arteries is elevated. When this occurs, you can sometimes experience a headache.
Doctors and medical experts haven’t confirmed whether hypertension and headaches are officially linked but experiencing headaches and high blood pressure together can be a sign of something more serious.

What causes hypertension headaches?
High blood pressure may be the reason you are experiencing headaches, as it affects the blood-brain barrier. This can result in excess pressure on the brain, which can cause blood to leak from the blood vessels in this organ. In worst case scenarios, hypertension can lead to risks of a stroke, heart disease, and more life-threatening diseases.

What are the symptoms of hypertension headaches?
While hypertension headaches are a symptom themselves of something potentially worse, the symptoms of this type of headache include:

  • A constant throbbing headache
  • Feeling and being sick
  • Drowsiness and irritability
  • Blurred or double vision
  • Dizziness

How to treat hypertension headaches
If you suspect you have high blood pressure, it’s important to get checked out by your GP as soon as possible to see if it is related to headaches or something more severe. If you receive treatment to help lower your blood pressure, your headache symptoms should improve within an hour.

TMJ headaches

If you have a headache and you feel like your jaw is the cause, TMJ (or temporomandibular joint) could be the reason you are experiencing pain.

What causes TMJ?
Causes of TMJ disorders include injury to the teeth or jaw, misalignment of the teeth or jaw, teeth grinding or clenching, poor posture, stress, arthritis, and gum chewing.

What are the symptoms of a TMJ?
Key signs and symptoms to look out for with a TMJ include:

  • Pain or tenderness of your jaw
  • Aching pain in and around your ear
  • Headaches
  • Locking of the joint
  • Difficulty or pain chewing

How to treat TMJ
TMJ disorders can often be treated by home remedies, including ice packs to the joint, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) and reducing stress and avoiding chewing gum. If you feel like the problem is getting worse, it’s recommended you see a doctor to help with the pain.

Hormonal headaches

For women, fluctuating hormone levels are a major contributing factor in chronic headaches and menstrual migraines.

What causes hormonal headaches?
Headaches have been linked to the female hormone estrogen, which controls the chemicals in the brain that affect the feeling of pain, and a drop in estrogen levels can trigger a headache. Hormone levels can change during the menstrual cycle, pregnancy, and menopause, and are also affected by oral contraceptives and hormone replacement therapies. Skipping meals, too much or too little sleep, severe weather changes, caffeine, processed meats and stress can also cause hormonal headaches.

What are the symptoms of hormonal headaches?
Menstrual or hormonal migraines are very similar to regular migraines, but other symptoms of hormonal headaches include:

  • Fatigue and tiredness
  • Acne
  • Loss of appetite
  • Cravings for alcohol, salt or chocolate
  • Decreased urination
  • Constipation
  • Joint pain

How to treat hormonal headachesHow to treat hormonal headaches
A variety of medications and other treatments are used to relieve headaches. Women who experience hormonal headaches often find relief during pregnancy or upon reaching menopause.
Natural home remedies include drinking plenty of water and staying hydrated, lying down in a dark and quiet room, placing an ice bag or cold cloth on your head, massaging the area of pain and also performing deep breathing exercises. If you experience frequent attacks or your symptoms worsen, you can speak to your doctor who can recommend medication.

Cervicogenic Headaches

A cervicogenic headache is a pain that develops in the neck, but the pain is felt in your head instead.

What causes cervicogenic headaches?
Cervicogenic headaches are also secondary headaches, meaning they are those caused by an underlying condition, such as neck injuries, infections, or severe high blood pressure.
The pain caused by a cervicogenic headache usually begins in the neck and the back of the head and radiates towards the front of the head.

What are the symptoms of cervicogenic headaches?
In most cases, you will feel pain from the back or the head or in the neck to begin with, but other symptoms may include:

  • A reduced range of motion in the neck
  • Pain around the eyes
  • Sensitivity to noise and light
  • A stiffness and pain in the neck
  • Head pain triggered by neck movements

How to treat cervicogenic headaches
Treatments for cervicogenic headaches focus on removing the cause of your pain and can vary depending on how severe your symptoms are. Medications, physical therapy and radiofrequency ablation are all options and it’s recommended you get a professional opinion to choose the right treatment.

Hypnic headaches

Hypnic headaches begin during sleep at night and quite often can wake you up due to the pain. They can last anywhere between 15 up to 4 hours and usually occur for the first time in your 50s but can start sooner.

What causes hypnic headaches?
It’s not clear as to what causes hypnic headaches, but some examples that have been linked to this include intracranial disorder causing high intracranial pressure, sleep apnoea, nocturnal high blood pressure, nocturnal low blood sugar and medication withdrawal, when pain medication wears-off overnight.

What are the symptoms of hypnic headaches?
The pain you can experience with these types of headaches can range from mild to severe and is usually present on both sides of your head. You may suffer from migraine-like symptoms including nausea with hypnic headaches.

How to treat hypnic headaches
If you’re experiencing hypnic headaches, recommended treatment is usually caffeine, or indomethacin.
Lithium carbonate is an alternative treatment but may be not be recommended for older adult patients. If you’re on lithium you would also require regular blood tests to check if the blood levels of lithium are within safe limits.
If you cannot tolerate lithium, your doctor may suggest alternative treatments including flunarizine, which are taken at bedtime.

Exertional headaches

Exertional headaches are a group of headache syndromes, which are associated with physical activity.

What causes exertional headaches?
If you perform strenuous physical exercise, such as running, jumping, weight lifting and sexual intercourse, you can experience headaches for up to 2 days. If you exercise in hot weather, at a high altitude or have a family history of migraines, you may be at extra risk of exertional headaches.

What are the symptoms of exertional headaches?
The main symptom of these types of headaches is moderate to severe throbbing pains in your head, which you might feel across your head or just on one side. Other symptoms include:

  • double vision
  • vomiting
  • neck stiffness
  • loss of consciousness

How to treat exertional headaches
There are a range of treatments available for this type of headache, including indomethacin, propranolol, naproxen (Naprosyn), ergonovine (ergometrine) and phenelzine (Nardil) medication, but treatment all depends on if your headaches are secondary or primary.

Primary exertional headaches are usually harmless, and you can prevent them by warming up before exercise or taking medication before or after exercising. If it’s secondary, it’s best to see your doctor to rule out any potential underlying issues.

Chronic headaches & brain tumours

If you are suffering from constant headaches, then it’s definitely worth exploring the cause. According to the Brain Tumour Charity, Around 50% of people with a brain tumour had headaches as one of the complaints they went to the doctor with.

Headaches are a common symptom of a potential brain tumour, but head pain is also very common in healthy people. If you’re unsure, do some research and seek peace of mind from your doctor.

Sources used in writing this article are available on request

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Next review: 10 May 2022