Headaches and Migraines

Most headaches fall into a few common groups. Not everyone fits neatly into one type.

• Tension-type headache. The most common type. Usually a dull, pressing or tight pain across both sides of the head, often described as a band around the head. Not usually made worse by everyday activity.
• Migraine. A throbbing pain, often on one side of the head, that can last hours to a few days. May come with nausea, vomiting, and sensitivity to light, sound or smell. Some people notice warning signs (see aura below).
• Cluster headache. Severe, sharp pain around one eye, often with a watery or red eye, blocked nostril or drooping eyelid on the same side. Attacks come in clusters over weeks or months.
• Sinus headache. Pain and pressure across the forehead, cheeks and around the eyes, often with a blocked nose during a cold or sinus infection.
• Medication-overuse headache. A headache that develops or worsens because painkillers are being taken too often (see below).

Headaches can also be a symptom of other issues — from tiredness, dehydration and eye strain through to infections and, more rarely, serious conditions. If you are unsure or worried, speak to a pharmacist, GP or NHS 111.

Migraine can involve:

• A moderate to severe throbbing or pounding headache, often on one side.
• Feeling sick, being sick or losing appetite.
• Being sensitive to light, sound, smells or movement.
• Feeling very tired, low in mood or unable to concentrate.
• Wanting to lie down in a dark, quiet room.

Some people have migraine with aura. Aura symptoms usually appear before the headache and can include:

• Flashing lights, zig-zag lines or blind spots in your vision.
• Numbness or a tingling "pins and needles" feeling, often starting in one hand.
• Difficulty finding words or speaking clearly.
• Feeling dizzy or off-balance.

Aura symptoms can look similar to the early signs of a stroke. If they are new, come on very suddenly, or are different from your usual pattern, treat them as an emergency and call 999.

A headache diary can help you and your GP find patterns and possible triggers. Try to note:

• The date, time the headache started and how long it lasted.
• Where the pain was and how severe it felt (for example, on a scale of 1 to 10).
• Any other symptoms, such as nausea or sensitivity to light.
• What you ate and drank in the hours beforehand.
• How much sleep you had, and how you slept.
• Stress levels, exercise, screen time and menstrual cycle if relevant.
• Any medication you took and whether it helped.

Common triggers can include stress, poor sleep, missed meals, dehydration, alcohol, caffeine, certain foods, bright or flickering lights, strong smells, changes in weather, and hormonal changes. Triggers are personal — a diary helps you spot yours.

• Rest in a quiet, dark room during an attack if you can.
• Drink water regularly through the day.
• Eat regular meals — do not skip breakfast.
• Aim for a steady sleep pattern, going to bed and getting up at similar times.
• Take short breaks from screens; look at something in the distance for a minute.
• Gentle regular activity, such as walking, yoga or swimming.
• Reduce alcohol and caffeine, especially in the evening.
• Manage stress with breathing exercises, mindfulness or talking to someone you trust.
• Check your eyesight if you have not been tested for a while.

You may find related guidance helpful on Sleep, Nutrition, Physical Activity, Eye Health and Mental Health.

A pharmacist can help with:

• Choosing suitable over-the-counter painkillers.
• Advice on how often you can safely use them.
• Spotting when you need to see a GP.

Contact your GP if:

• Headaches keep coming back or are getting worse.
• Painkillers do not help, or you are needing them very often.
• Headaches wake you at night or are worse in the morning.
• You have other new symptoms, such as vision changes, weakness or unusual tiredness.
• You are pregnant, have high blood pressure, or take medicines that could be involved.
• Headaches are affecting work, school, family life or your mental health.

You can find your nearest GP or pharmacy through Find Local Services, or read our GP Services page for tips on booking and preparing for an appointment.

Treatment depends on the type of headache, how often it happens and how severe it is. Options your GP might discuss include:

• Simple painkillers such as paracetamol or ibuprofen (used carefully).
• Specific migraine treatments, such as triptans, for suitable people.
• Anti-sickness medicines to take with pain relief during a migraine.
• Preventive medicines for people with frequent migraines or cluster headaches.
• Referral to a specialist headache clinic or neurologist if needed.
• Advice on lifestyle changes, stress and sleep.

Please do not start, stop or change prescribed medicines based on general information. Speak to a pharmacist, GP or another qualified professional about what is right for you.

Taking painkillers too frequently can, over time, cause a new pattern of headache called a medication-overuse headache. It can happen with everyday painkillers as well as prescription migraine treatments.

Warning signs can include:

• Headaches on 15 or more days each month.
• Taking painkillers on most days.
• Waking with a headache that eases after painkillers, then returns.
• Needing higher doses or trying different painkillers to get relief.

If this sounds familiar, please speak to a pharmacist or GP before making changes. Coming off overused painkillers can be uncomfortable at first and is best done with guidance.

Frequent headaches or migraine can be classed as a disability if they have a significant, long-term effect on daily life. That means employers and places of study should consider reasonable adjustments, which might include:

• Reducing exposure to bright, flickering or fluorescent light.
• Anti-glare screens, adjustable brightness and larger font sizes.
• Regular screen breaks and a quieter workspace where possible.
• Flexibility on start times, breaks or working from home during attacks.
• Time off for medical appointments without penalty.
• Coursework extensions or a quiet exam room for students.

Occupational health, HR and student support services can help. Charities such as The Migraine Trust offer information on rights at work and study.

Contact NHS 111 (online at 111.nhs.uk or by phone) if:

• Your headache is unusually severe but does not have the emergency signs above.
• You have other new symptoms and are not sure how urgent they are.
• You cannot see your GP quickly and are worried.
• Painkillers are not helping and the pain is getting worse.
• You are pregnant, elderly, immunocompromised or caring for a child who is unwell.

NHS 111 can direct you to the right service, including out-of-hours GPs, urgent treatment centres or A&E.

• Eye Health — eyesight and screen use can affect headaches.
• Mental Health — stress, anxiety and low mood can make headaches worse.
• Sleep — steady sleep is one of the strongest headache preventers.
• Nutrition — regular meals, hydration and possible food triggers.
• Physical Activity — gentle regular movement often helps.
• GP Services — booking, appointments and what to expect.
• Find Local Services — GP, pharmacy, A&E and more.

Main sources used on this page:

• NHS — Headaches
• NHS — Migraine
• NHS — When to get medical help for a headache
• NICE CG150 — Headaches in over 12s
• The Migraine Trust

This page provides general information and cannot diagnose a condition or replace professional medical advice. Always speak to a pharmacist, GP or other qualified health provider about your own symptoms. In an emergency, call 999.