Brief overview
- Causes: Triggers such as stress, lack of fluids, screen work, smoking, high blood pressure, viral infections, inflammation, stroke, head injuries, medication, withdrawal from medication
- When to see a doctor? Always for children and pregnant women with headaches, after head injuries, with recurring or sudden severe headaches, with accompanying symptoms such as vomiting
- Diagnostics: Medical history, physical and neurological examination, possibly blood tests, imaging examinations, examination of the cerebrospinal fluid, examinations by an ophthalmologist, dentist or ENT specialist
- Prevention: Enough sleep, healthy diet, sufficient fluid intake, avoid alcohol and nicotine, consistent caffeine consumption, regular exercise, office gymnastics, relaxation exercises
What types of headaches are there?
Overall, women are slightly more frequently affected by headaches than men. But there are differences: While women suffer more frequently from migraines, men are more likely to experience so-called cluster headaches. Tension headaches are the most common form of headache.
Children also sometimes develop headaches and migraines. However, the number of cases decreases with increasing age: Those over the age of 45 statistically suffer fewer headache attacks.
220 different types of headache
90 percent of all people with headaches suffer from tension headaches. The second most common type of headache is migraine. Both forms are primary headaches.
Secondary headaches occur much less frequently. The causes of these are, for example, side effects of medication, excessive drug consumption, illnesses or injuries.
Tension headache
These mild to moderate headaches occur occasionally and gradually worsen. The reason for this is presumably impaired pain inhibition, which occurs after irritation, for example. Although they occur on both sides of the head, they often only affect regions such as the forehead, temples or crown of the head.
Tension headaches are dull and press like a band around the forehead and back of the head. Some people also feel the pain in the upper part of the skull.
More information on this can be found in the article on tension headaches.
Migraine
Migraines affect sufferers on average one to six times a month. A single migraine attack usually lasts between four and 72 hours. It begins gradually, usually with a one-sided headache. Sometimes the pain changes sides or later becomes bilateral.
Between ten and 15 percent of all migraine patients experience a so-called aura before a pain attack, which is accompanied, for example, by visual disturbances such as flickering in front of the eyes, tingling in the arms and legs and difficulty finding words.
It is possible for migraines and tension headaches to occur in combination.
Drug-induced headache
The pain always occurs when the sufferer has taken medication. A vicious circle often develops: out of fear of pain, painkillers are swallowed, which then cause the headache in the first place.
Those affected then often increase the dose. Other medications, such as some antihypertensives, can also cause headaches (nitrate headaches).
Cluster headache
Cluster headaches often occur several times a day and then disappear again for months. The pain increases to its maximum within a few minutes and usually lasts between 15 minutes and three hours.
Although the cause of these headaches is unclear, alcohol, cigarette smoke or flickering light seem to trigger the attacks in some sufferers. Overall, cluster headaches are rare compared to tension headaches and migraines.
Nausea, nausea, vomiting, sensitivity to noise and light accompany headaches in some cases, as do visual disturbances or depression. These accompanying symptoms as well as the location, type and duration of the headache give the doctor an initial indication of the cause or trigger of the symptoms.
Find out more about sexual headaches here.
What helps against headaches?
Depending on the cause, other treatment methods may be useful for secondary headaches, for example surgery for a brain aneurysm.
Medication for headaches
There are several medications that can be used to treat the various forms of headache.
Medication for tension headaches
The following medications often relieve tension headaches:
- Acetylsalicylic acid (ASS)
- ibuprofen
- naproxen
- Paracetamol
- Combination preparations of acetylsalicylic acid, paracetamol and caffeine
Ask your doctor or pharmacist for advice on the selection and dosage of a suitable painkiller. Also ask about possible side effects and interactions with any other medication you may be taking.
Do not take painkillers for more than three consecutive days and no more than ten days a month. If you take painkillers too often, you run the risk of becoming habituated and developing drug-induced headaches.
Medication for migraines
The following remedies help some people with mild migraines:
- Acetylsalicylic acid (ASS)
- ibuprofen
- Paracetamol
- Diclofenac
- Combination preparations of acetylsalicylic acid, ibuprofen or paracetamol and caffeine
- Anti-emetics for nausea
Severe migraine attacks are often treated with so-called triptans in tablet form, as a nasal spray or injection. Alternatively, the doctor administers lysine acetylsalicylate (ASA lysinate) as an injection.
The active ingredients valproic acid, topiramate and amitriptyline are also used to prevent migraines. They belong to the group of anticonvulsants: these are drugs that are used to treat epilepsy, for example.
Medication for cluster headaches
Injections with botulinum toxin (botulinum neurotoxin, Botox)
Botox injections can sometimes help severely affected migraine patients. The agent is injected at various points in the head, neck and shoulder area. The neurotoxin paralyzes the nerves and counteracts tension. This reduces the severity and number of migraine attacks.
As the body gradually breaks down Botox, repeated applications are necessary.
Special case of medication headaches
Under no circumstances is it advisable to attempt withdrawal on your own – medical help is essential here and makes weaning easier.
Non-medication treatment
There are various ways to counteract headaches without medication. These measures are primarily preventative: they can reduce the number and frequency of headache attacks.
Relaxation against headaches
- Autogenic training
- Progressive muscle relaxation
- meditation
- Tai-Chi
- Chi-Gong
Biofeedback for migraines
Biofeedback can also have a positive effect on migraines. With the help of a computer program that maps the brain waves, the patient learns to influence them voluntarily. Children in particular respond very well to this non-drug method.
Even if certain medications are taboo during pregnancy, biofeedback is an option against migraines.
Acupuncture is sometimes worth a try for frequent tension headaches. The acupuncturist inserts needles into certain points. A large study by the Cochrane Institute shows that acupuncture treatment with at least six treatment sessions offers a good chance of providing lasting relief.
Manual therapy and chirotherapy
This is also the aim of chiropractic therapy, which is a form of alternative medical treatment. It primarily removes blockages in the spine.
Some therapists also use acupressure, applying gentle pressure to certain points on the head.
Whether chiropractic therapy actually helps against headaches has not yet been clearly proven. Larger overview studies have produced contradictory results.
Sport
Homeopathy for headaches
Some patients also swear by homeopathy to relieve their headaches. The type of globules should depend on the exact type and cause of the pain, for example whether it is on the left or right side, after drinking alcohol or too much sun.
However, there is no scientific proof that homeopathy works against headaches.
The concept of homeopathy and its specific effectiveness are controversial and have not been clearly proven by studies.
Transcutaneous electrical nerve stimulation (TENS) is used to treat headaches. Electrodes conduct a weak current into the body via certain areas of the skin. The procedure is gentle, inexpensive and has few side effects. However, scientific evidence of its effectiveness is still lacking.
Psychotherapy for headaches
Headache diary / headache calendar
If you suffer from frequent headaches or migraines, it makes sense to keep a pain diary. In it, you can note down when the pain started and how long it lasted. You can also record possible triggers such as food, stress, weather and, if applicable, the stage of your menstrual cycle.
Make a note of any accompanying symptoms and medication you are taking.
Home remedies for headaches
Headaches don’t always require painkillers – home remedies can also help. But what really helps against headaches?
It is not uncommon for headaches to occur because you have not drunk enough – an effective measure against headaches is therefore often to balance the water balance. If this is not enough, treatments with essential oils, cold and teas are also effective.
Cold for headaches
Cool compresses on the forehead and neck soothe the overstimulated brain and are therefore a suitable home remedy for headaches. However, other compresses are also sometimes helpful against headaches. These are suitable:
Cool forehead compress
Calf compresses
Calf compresses are sometimes also effective against headaches – especially if they are an accompanying symptom of a feverish infection. Dip two cotton cloths in cool (not ice-cold!) water, wring out and place around the calves. Cover with a dry cloth and leave to work for about ten minutes.
You can read more about the correct application in the article Calf compresses.
Pulse wrap
Wring out the soaked strips, wrap them around the pulse points on the wrists and ankles and cover each with a dry towel. Leave on for ten minutes, then repeat twice (i.e. apply the pulse wraps three times in total).
You can find more information about wraps and their application in the article Wraps (compresses) and compresses.
Cold grain pillow
Cold showers
Cold showers on the arms, legs or face can also be used as a home remedy for headaches.
Arm and leg casts
Cold showers on the arms and legs stimulate circulation and blood flow and sometimes relieve headaches. Cold water at around 18 degrees is best. Perform cold showers about once a day.
Facial pouring
With the upper body bent forward, let cold water flow over the right temple, forehead, left temple and then back again. Then run the water jet up and down the right and left sides of the face three times. Finally, circle the face three times. Wipe or lightly dab off the water, do not dry off.
You can find out more about the treatments in the article Hydrotherapy.
Essential oils relieve headaches
For example, invigorating and cooling oils of peppermint, lavender, rosemary or tea tree can help to banish headaches.
Forehead rub
A forehead rub with diluted lavender, tea tree or peppermint oil has a relaxing effect and relieves headaches. To do this, gently rub a few drops of diluted oil into the forehead (and possibly temples and neck). It is best to rest afterwards.
Foot rub
Apply once or twice a day, preferably after waking up or before going to bed.
The essential oil must not get into the eyes or on the mucous membranes. Essential oils are also not suitable for babies and children – there is a risk of dangerous reactions.
Horseradish poultice
Then rub the reddened skin area with vegetable oil (e.g. olive oil) and rest for 30 minutes to an hour. It is advisable to apply a horseradish compress only once a day.
The ingredients irritate the mucous membranes. Therefore, cover the eyes with Vaseline and absorbent cotton pads.
Mustard flour foot bath
Sometimes a mustard flour foot bath is good for headaches.
You can read how to use the foot bath correctly in the article on medicinal plants mustard.
Coffee and tea for headaches
Similar to coffee, tea is said to have a soothing effect on headaches. Black tea also contains caffeine, which dilates the constricted blood vessels in the brain.
Lemon balm tea
Tea made from lemon balm is also sometimes used as a home remedy for headaches. To do this, pour hot water over an infusion of dried loose leaves or tea bags and leave to infuse for ten to 15 minutes. You can drink a cup of lemon balm tea two to three times a day.
Does sex help with headaches?
It may not be a classic home remedy, but sexual activity – whether with a partner or alone – can relieve headaches in some cases. At least this seems to be the case for migraines and cluster headaches. This is the result of a study by the University of Münster.
What are the possible causes of headaches?
Despite intensive research, it is not clear exactly how headaches develop. It is assumed that the processes of pain generation, transmission and inhibition are disturbed.
Primary headaches have no identifiable cause. However, they are usually triggered by various factors, such as
- stress
- Lack of fluids
- Poorly ventilated rooms
- Screen work
- Change of weather
- Lack of sleep and irregular sleep
- Smoking
- Alcohol
- Exertion (e.g. after sport)
Secondary headaches, on the other hand, can always be traced back to an illness or external influences. The most common causes include
- Head and cervical spine injuries, e.g. craniocerebral trauma
- Inflammations: Meningitis (inflammation of the meninges), encephalitis (inflammation of the brain), temporal arteritis (inflammation of the temporal arteries), sinusitis (typical headache when bending over), tooth root inflammation
- Viral infections such as influenza
- High blood pressure
- Herniated disc in the cervical spine
- Tension in the neck muscles
- Hypoglycemia in diabetes mellitus
- Trigeminal neuralgia, craniomandibular dysfunction (formerly also known as Costen’s syndrome)
- Heat stroke
- Acute glaucoma (glaucoma attack)
- Brain aneurysm (abnormal expansion of the wall of a cerebral artery)
- Stroke (ischemic stroke or cerebral hemorrhage)
- Brain tumor
- Intolerance to certain foods, such as glutamate (“Chinese restaurant syndrome”)
- Drug withdrawal
Brain tumors are extremely rarely responsible for headaches. Even the most severe headaches usually have harmless triggers. In addition, brain tumors usually cause additional symptoms. Headaches that occur mainly after lying down (e.g. in the morning) and become more severe over time are sometimes an indication of a tumor. In this case, medical clarification is advisable!
Headaches: when do you need to see a doctor?
- if the headaches occur constantly or repeatedly over weeks and months
- if the pain develops after a head injury or occurs one or more days after a concussion
- if nausea and vomiting are also present
- if fever and/or a stiff neck accompany the pain
Headaches in children
Children and adolescents suffer from headaches just as often as adults. In most cases, they are also harmless tension headaches or migraines. It is advisable to always have headaches in children checked out by a doctor. This is especially true if they occur regularly.
Headaches during pregnancy
You should always discuss whether painkillers are permitted with your doctor so as not to endanger your child. The active ingredient paracetamol is often used for headaches during pregnancy. This is because pregnant women are not allowed to take acetylsalicylic acid (ASA), ibuprofen, diclofenac and other so-called NSAIDs.
More serious complications such as pre-eclampsia (pregnancy poisoning) are less common behind headaches during pregnancy. If in doubt, it is always advisable to seek advice from a doctor.
What does the doctor do to diagnose headaches?
To clarify the type of headache, the doctor will first ask you about your medical history (anamnesis):
- Where exactly is the pain localized?
- How does the pain feel and how intense are the symptoms?
- Are you aware of possible triggers, e.g. accident, stress, intense physical exertion or sensitivity to the weather?
- What illnesses and family history are there?
- What medication (painkillers etc.) are you taking?
If you keep a headache diary (see above), the notes it contains will also provide valuable information about your medical history.
The results of the medical history and physical and neurological examinations are often sufficient to clarify the type and cause of the headache – especially in the case of tension headaches and migraines. Further examinations are rarely necessary, for example if a more serious underlying illness is suspected.
The following are then used, for example
- Blood tests
- Ultrasound examination, especially of the neck organs and neck arteries
- X-ray of the spine and skull (if injuries are suspected)
- Computer tomography (CT)
- Electroencephalography (EEG)
- Positron emission tomography (PET): a nuclear medicine method (examination using a low-level radioactive substance)
- Lumbar puncture (extraction of spinal fluid) for suspected inflammation of the nerves or meninges
- Angiography (vascular imaging with contrast medium in an X-ray image) of the brain vessels for malformations, aneurysms and thromboses
Preventing headaches
In many cases, simple measures can prevent headaches from developing in the first place:
- Sufficient sleep with consistent bedtimes
- Eat a balanced and regular diet
- Drink plenty of fluids, especially water, tea or juice spritzers
- Consistent caffeine consumption
- Little alcohol
- Avoid nicotine
- Regular exercise in the fresh air
- Endurance sports
- Office gymnastics, five minutes several times a day
You should also reduce other risk factors that have been known to trigger headaches, such as staying in stuffy or noisy rooms or eating certain foods.
Frequently asked questions about headaches
What helps against headaches?
What can cause headaches?
There are many triggers for headaches, including stress, too little sleep or a lack of fluids. Headaches are also a typical symptom of migraines. However, they can also occur with other illnesses such as a viral infection. Medication, alcohol and a lot of caffeine also cause headaches. Headaches rarely indicate a serious illness such as a brain tumor.
What home remedies help with headaches?
What relieves severe headaches?
Painkillers such as ibuprofen, paracetamol or ASA often successfully relieve severe headaches. A cool compress on the forehead can also help. See a doctor if the headache persists, is very severe or is accompanied by other symptoms such as dizziness, weakness or a high temperature.
Which painkillers help with headaches?
Which tea helps with headaches?
Peppermint, camomile and ginger are suitable teas for headaches. Peppermint tea has a relaxing effect and dilates the blood vessels. This improves blood circulation and relieves the headache. Chamomile tea has a calming effect and is therefore particularly helpful for stress-related headaches.
Which doctor for headaches?
What should you eat if you have a headache?
Magnesium-rich foods such as nuts, seeds and wholegrain products can help against headaches. However, there is no special diet. Alcohol, lots of caffeine and sugary foods tend to make headaches worse. Also make sure you drink enough water.
