Headache is one of the most common medical complaints in the world. Knowing which type you have is the first step to treating it effectively — because a tension headache, a migraine and a cluster headache require quite different approaches.

Tension-Type Headache

The most common headache type, affecting the majority of people at some point. Bilateral (both sides), pressing or tightening quality, mild to moderate intensity, not aggravated by routine activity. No nausea, vomiting or light sensitivity (distinguishing it from migraine). Associated with stress, poor posture, dehydration, eye strain, prolonged screen use and poor sleep. Treatment: paracetamol 1000mg or ibuprofen 400mg taken early. Caffeine combinations (Anadin Extra) provide around 40% better relief than analgesic alone. Non-pharmacological approaches (addressing triggers, relaxation, regular sleep pattern) are particularly important for frequent tension headache.

Migraine

Affects around 1 in 7 UK adults. Characteristically unilateral (one side, though may switch sides), pulsating or throbbing, moderate to severe, significantly aggravated by routine activity. Accompanied by nausea (often), vomiting (sometimes), photophobia (sensitivity to light) and phonophobia (sensitivity to sound). Around 30% of migraine sufferers experience aura — neurological symptoms (typically visual disturbances: zigzag lines, blind spots, scintillating scotoma) lasting 20–60 minutes before or during the headache. OTC treatment: ibuprofen 400mg at headache onset (before aura ends, if possible). Sumatriptan 50mg — a triptan, the most effective OTC migraine-specific treatment. Take at onset of headache (not aura). Not suitable for those with cardiovascular disease, uncontrolled hypertension, or concurrent use of SSRIs/SNRIs/MAOIs.

Cluster Headache

Rare but extremely severe. Unilateral, always around one eye, described as “hot poker” or “drilling” pain. Attacks last 15–180 minutes but come in clusters of 1–4 per day over weeks to months, with pain-free intervals between clusters. Associated features: tearing, red eye, nasal congestion, ptosis (drooping eyelid) on the affected side. Nocturnal attacks are common, waking the sufferer. OTC treatment is generally inadequate — 100% oxygen via face mask is the most effective acute treatment; sumatriptan subcutaneous injection is the standard pharmacological treatment. If you suspect cluster headache, see a GP or neurologist.

Medication-Overuse Headache

Using OTC analgesics more than 10–15 days per month causes medication-overuse headache (MOH) — a chronic daily headache perpetuated by the analgesics meant to treat it. The solution is to stop the overused medication (under medical guidance if needed) and allow a withdrawal period. Prevention: treat headaches with adequate doses early and infrequently; seek prophylactic treatment from a GP if headaches are very frequent.

Browse Pain Relief at Huncoat Pharmacy. Related: OTC Pain Guide.

At Huncoat Pharmacy: Pharmacy First, Private prescription for migraine, Browse headache & migraine relief.