Headaches
Headaches are common, and can be caused by a number of different things. The term headache refers to any pain that occurs in the head or upper neck. Headaches are classified into a number of different types, depending on the location of the pain, how severe it is, how long it lasts, how often it occurs, and sometimes what brings on the pain. Knowing what type of headache you have can help you manage and treat your headaches.
Most headaches can be relieved with pain relief from your pharmacy or prescription medicines prescribed by a doctor. Some people can reduce the number of headaches they get by identifying and avoiding triggers or factors which tend to 'bring them on'. Common triggers associated with headaches include lack of fresh air, lack of food, eye strain, stress, posture, too much alcohol, high blood pressure and caffeine withdrawal.
Most headaches are not serious; however, occasionally headaches may be a sign of eye trouble or high blood pressure. Any headache described as 'worst headache of my life' needs urgent medical attention, even if the person habitually suffers from headaches.
Common types of headache
Tension headaches
Tension headaches are the most common type of headache. Described as a mild, aching pain on both sides of the head, or a tight band across the forehead, this headache tends to worsen as the day goes on, or if the person is stressed. Avoiding eye strain, bad posture, and managing stress may reduce the number of tension headaches. Most tension-type headaches can be treated with pain relief from your pharmacy.
Migraines
Migraines are typically centered on one side of the head, with the pain usually starting as a dull throb or tightening which then intensifies into a concentrated and severe pain. Most people feel sick, however only about 30% will vomit. About 25% of people will have an 'aura' before the migraine starts. This may take the form of a funny smell, taste, feeling or visual disturbance. Most migraine sufferers have a relative who also suffers from migraines, and they usually begin in the teenage years. In women, they may be associated with menstruation. If you suffer from regular migraines, specific migraine treatments are available from your pharmacist. See our topic on Migraine or talk to your pharmacist if you are not sure whether your headache is a migraine.
Sinusitis
Blocked nasal passages can lead to sinusitis, where mucus is unable to drain, causing pressure build-up and pain. Sinusitis is usually associated with a cold, and often causes a headache and/or aching teeth. Bending, coughing or sneezing can make the headache worse. Antibiotics may be needed if the cause is due to a bacterial infection.
Medication overuse headache
This can develop from using pain-relieving medicines too frequently (more than a few times per week). Avoiding pain-relief tablets for a period of time while using non-medicine related self-help measures can help treat this type of headache.
See Your Pharmacist or Medical Professional
Seek urgent medical advice if your headache is the worst headache you have ever experienced, even if you regularly suffer from headaches. Other warning signs that must be taken seriously and require further investigation by a doctor include:
A first headache in a person over 50
Headaches that worsen over time (months) or a new or different headache
A headache that is severe right from the start (as compared to one that gradually develops)
A headache that develops soon after a head injury or major trauma
A headache that is brought on by lying down, a cough, a sneeze, bending or with exertion
Headaches that occur with other symptoms such as a fever, high blood pressure, muscle aches, weight loss, visual disturbances, sore or stiff neck, sensitivity to light or scalp tenderness
Seizures (convulsions), confusion, changes in consciousness or difficulty waking.
If your headache is causing you pain, but you wouldn't consider it an emergency, and you have other medical conditions, take regular medication for any reason, are elderly or frail, or you are wanting advice about headaches in children, always talk to a pharmacist. Also talk to the pharmacist if:
You are not sure what type of headache you have
Your temples feel tender or painful, especially if you are older
You have headaches frequently, especially more than one a month
Your headache has lasted more than 24 hours
Medicines do not help your headache
You are pregnant or breastfeeding – some pain-relieving medicines may not be suitable
You have allergies to any medicines.
Treatment Tips
Keep a diary of when each headache occurs as this can help you and your doctor identify what is causing your headaches
Identify your activities and the foods you’ve eaten 6-8 hours before the headache begins
Try to look for any trends or 'triggers' and avoid them if possible
Drink plenty of water and eat a healthy diet
Sinus headaches may require special medicines – check with your pharmacist
If your headache is part of a cold, be careful not to take multiple medicines containing paracetamol
Have your eyes checked if you do a lot of computer work
Check your posture if you have a desk job – especially if you have shoulder aches and pains.
Rest and relaxation techniques
Try rest and relaxation techniques to help manage your headache, such as:
Lying down in a warm, darkened, quiet room
Calming your emotions by imagining a peaceful scene
Massaging tight neck, shoulder, and head muscles
Applying pressure to the base of the skull behind your ears.
Placing a cool cloth on your forehead or an ice pack on the back of your neck
Soaking in a hot bath or having a hot shower.
Treatment Options
Use medication (including paracetamol, aspirin and ibuprofen) to relieve your headache
Some pain relievers are not suitable for everyone – check with your pharmacist.
Oral pain relief medicines (analgesics)
[GENERAL SALE]
e.g., paracetamol – packets of 20 or fewer (Panadol range, Panadol Rapid, Panadol Optizorb, Paracare range), aspirin (Aspro range, Disprin range), ibuprofen – packets of 25 or fewer (Nurofen range, Nurofen Zavance, Nurofen Zavance Liquid Capsules)
[PHARMACY ONLY]
e.g., paracetamol, ibuprofen – larger pack sizes, paracetamol liquid preparations (Panadol, Panadol Optizorb, Pamol, Paracare, Parapaed), ibuprofen liquid preparations (Fenpaed, Nurofen for Children), diclofenac (Voltaren Rapid 12.5), naproxen (Sonaflam)
[PHARMACIST ONLY]
e.g., Voltaren Rapid 25
Paracetamol, aspirin and NSAIDs (non-steroidal anti-inflammatory drugs, which include ibuprofen, diclofenac and naproxen) relieve pain and reduce fever.
Paracetamol is a safe choice for most people but it is important not to take more than recommended. It is an ingredient in many cold and flu remedies so be careful not to double dose.
The maximum daily dose of paracetamol for an adult is 4g (4000mg) – and no more than 1g (1000mg) every four hours.
Aspirin and NSAIDs are not suitable for everyone. Children under 12 years old must not take aspirin because it can cause Reye’s syndrome – a serious condition. It should also be avoided by adolescents under 16 years old who have a viral illness.
Check with your pharmacist before taking aspirin or NSAIDs if you:
have a history of stomach problems, such as ulcers or indigestion
have asthma – some people with asthma find their condition is made worse by these types of medicines
have kidney problems or a heart condition
take other medications
have an allergy to aspirin or NSAIDs
are pregnant or breastfeeding
are elderly – you may be at more risk of side effects
are dehydrated.
Sometimes aspirin and NSAIDs can cause side effects. If you develop indigestion, or unusual or increased bleeding or bruising, stop taking them and talk to your pharmacist.
Combination products
[GENERAL SALE]
e.g., Arrowcare Parafast Extra (contains caffeine), Maxigesic (16s), Panadol Extra (contains caffeine)
[PHARMACY ONLY]
e.g., Arrowcare Parafast Extra (contains caffeine), Maxigesic (100s), Nuromol
[PHARMACIST ONLY]
e.g., Arrowcare Ibucode Plus, Arrowcare Paracode, Mersyndol, Panadeine, Panadeine Extra, Nurofen Plus, Panafen Plus
these products contain two or more ingredients that relieve pain in different ways
try single-ingredient products first – if these do not give adequate pain relief then try a combination product
codeine-containing analgesics must be sold by a pharmacist and are not suitable for everyone. They should not be used for longer than three days as they can cause addiction, and they can also cause drowsiness and constipation in some people
Doxylamine (contained in Mersyndol) is sedating and may be helpful if the pain is particularly severe: it is not suitable for people with certain medical conditions – so talk to your pharmacist first.
Natural/herbal products/supplements
e.g., Magnesium, herbal decongestant products, caffeine, peppermint
magnesium may help if the headache is accompanied by neck/shoulder tension
herbal decongestants will help if the headache is related to sinusitis
Caffeine in combination with analgesics is effective at relieving simple headache
Topical peppermint oil may help relieve tension headaches.
More Information
Availability of medicines
GENERAL SALE available through pharmacies and possibly other retail outlets.
PHARMACY ONLY available for sale through pharmacies only.
PHARMACIST ONLY may only be sold by a pharmacist.
Consumer Medicine Information on some medicines is available at the government website www.medsafe.govt.nz
