Headaches: advice for patients seen in the Emergency Department

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Overview

Headaches are common and in the vast majority of cases are not life threatening although they can cause discomfort and interfere with our lives.

You have been seen in the Emergency department and we do not believe that you have a life-threatening cause of headache. It may be that if the headache is interfering with your life or causing you discomfort that you need to be seen by a specialist. Please talk to your GP if you think this is the case.

To help you, we would advise using over-the-counter painkillers and considering lifestyle changes, such as getting more rest and drinking enough fluids.

For general medical advice please use the NHS website, the NHS 111 service, walk in centres, or your GP.

Types of headache

• Headaches are pains that occur in any region of the head. They can occur on both sides of the head or be isolated to a certain location.
• More than 10 million people in the UK get headaches regularly, making them one of the most common health complaints. But most aren’t serious and are easily treated.

Some of the main types of headaches are described below.

Tension headaches

Tension headaches are the most common type of headache and are what we think of as normal, everyday headaches. They feel like a constant ache that affects both sides of the head, as though a tight band is stretched around it. A tension headache normally won’t be severe enough to prevent you doing everyday activities. They usually last for 30 minutes to several hours, but can last for several days. The exact cause is unclear, but tension headaches have been linked to things such as stress, poor posture, skipping meals and dehydration

Tension headaches can usually be treated with ordinary painkillers such as paracetamol and ibuprofen. Lifestyle changes, such as getting regular sleep, reducing stress and staying well hydrated, may also help

Migraines

Migraines are less common than tension headaches. They’re usually felt as a severe, throbbing pain at the front or side of the head. Some people also have other symptoms, such as nausea or vomiting (feeling or being sick) and increased sensitivity to light or sound.

Migraines tend to be more severe than tension headaches and can stop you carrying out your normal daily activities. They usually last at least a couple of hours, and some people find they need to stay in bed for days at a time.

Cluster headaches

Cluster headaches are a rare type of headache that occur in clusters for a month or two at around the same time of year. They’re very painful, causing intense pain around one eye, and often occur with other symptoms, such as a watering or red eye and a blocked or runny nose.

Painkillers

• Generally over-the-counter painkillers, such as paracetamol, aspirin and ibuprofen, can help to reduce your headache symptoms. For migraines, these are most effective if taken at the first signs of a migraine, to allow time to absorb into your bloodstream and ease your symptoms. It is not advisable to wait until the headache worsens before taking painkillers because by this point it is often too late for the medication to work.
• Soluble painkillers (tablets that dissolve in a glass of water) are a good alternative because they are absorbed quickly by your body.
• If you cannot swallow painkillers because of nausea or vomiting, suppositories may be a better option. These are capsules that are inserted into the anus (back passage).

Self-care

There are a number of steps that can reduce the risk of headaches and ease the pain of headaches that do arise.

• Apply a heat pack or ice pack to your head or neck (avoid extreme temperatures).
• Avoid stress where possible, and develop healthy coping strategies for unavoidable stress.
• Eat regular meals and drink fluids.
• Exercise regularly.
• Get enough rest and regular sleep.
• Minimise screen time.

It is also useful to ensure you have seen an optician recently to rule out eye strain as a cause.

If you have gas appliances at home, ensure they have been safety tested for carbon monoxide if your headaches are worse when you are at home.

The most common methods recommended for treating headaches are rest and over-the-counter pain relief.

When to go to hospital

Further support

• For general medical advice please use the NHS website, the NHS 111 service, walk-in-centres, or your GP.
• NHS website provides online health information and guidance.
• There are walk-in and urgent treatment services at Brighton Station, Crawley Urgent Treatment Centre, Lewes Victoria Hospital, Horsham Minor Injuries Unit and Bognor Regis War Memorial Hospital.