The main types of headaches are tension-type headache, migraine, cluster headache and medication-overuse headache. A tension-type headache feels like pressure or a tight band around the head, a migraine is often a throbbing pain on one side with nausea and sensitivity to light, a cluster headache is brief but extremely severe pain around one eye, and medication-overuse headache comes from taking headache medicines too often. Most headaches are not serious, but a headache that starts suddenly and is extremely painful needs emergency help.
Headaches are common, and usually not serious
Almost everyone gets a headache now and then. The World Health Organization (WHO) says headache disorders affect around 40% of the world's population, about 3.1 billion people in 2021, and are more common in women than in men. The WHO also notes that only a minority of people with headache disorders are properly diagnosed and treated, and about half treat themselves.
The reassuring part comes from the NHS: most headaches go away on their own and are not a sign of anything more serious. A headache can last 30 minutes, several hours or sometimes several days.
Doctors divide headaches into two broad groups. Primary headaches, such as migraine, tension-type headache and cluster headache, are conditions in their own right. Secondary headaches are caused by something else, and the WHO says the most common of these is medication-overuse headache.
Types of headaches compared
This table sums up the four types the WHO describes as most important for public health, using details from the WHO and the NHS.
| Type | What it feels like | How long it lasts | Other features | Who gets it more |
|---|---|---|---|---|
| Tension-type headache | Pressure or tightness, often like a band around the head, sometimes spreading into or from the neck | Episodic attacks usually last a few hours but can go on for several days | May be linked to stress or neck muscle problems | Women (about 50% more than men); often starts in the teenage years |
| Migraine | Throbbing, moderate to severe, often on one side or behind the eye, worse when you move around | Usually 4 hours to 3 days | Nausea or vomiting, sensitivity to light and sound; some people get an aura first | Women; often begins at puberty |
| Cluster headache | Brief but extremely severe pain in or around one eye | Short attacks that can come several times a day | Watery, red eye, runny or blocked nose on the same side, drooping eyelid | Men (about six men for every woman); usually starts in the 20s or later |
| Medication-overuse headache | Oppressive and persistent, often worst on waking | Happens on more days than not | Caused by long-term, excessive use of headache medicines | Women more than men |
The four main types of headaches
Tension-type headache
This is the everyday headache many people know. The WHO describes it as pressure or tightness, often like a band around the head, which may spread into or from the neck. It may be related to stress or to muscle problems in the neck. Episodic tension-type headaches happen on fewer than 15 days a month. Chronic tension-type headache can be constant and is more disabling.
Migraine
The NHS migraine page lists the main symptoms of a migraine attack as:
- a throbbing headache, which can be severe, is often on one side of the head and can get worse when you move around
- feeling sick or being sick
- being very sensitive to light and sounds
Some people notice early signs before the pain starts, such as feeling very tired and yawning a lot, craving certain foods, feeling thirsty, mood changes, a stiff neck or peeing more. Others get an aura, a warning sign such as zigzag lines or flashing lights in your vision, numbness or pins and needles, dizziness or difficulty speaking. The NHS says aura symptoms should not last longer than 1 hour.
Migraine attacks that happen just before or during a period are called menstrual migraines and are often longer and more severe. The NHS notes that most people find their attacks slowly get better as they get older. According to the WHO, children tend to have shorter attacks, and tummy symptoms are often more noticeable in them. The exact cause is unknown, but migraine is more likely if a close family member has it.
Cluster headache
Cluster headaches are much less common, affecting fewer than 1 in 1,000 adults according to the WHO. The pain is extremely severe, usually in or around one eye, and attacks are short but can come back up to several times a day. The eye may water and turn red, the nose on that side may run or feel blocked, and the eyelid may droop.
Medication-overuse headache
This is the headache many people do not expect: one caused by the very medicines taken to treat headaches. The WHO says it is caused by chronic and excessive use of headache medication and occurs on more days than not. The NHS lists taking too many painkillers as a common cause of headaches, and advises people with migraine to try not to take painkillers for more than 2 days a week, because this can cause more headaches and make migraine harder to treat. In Pakistan, where painkillers are easy to buy from any medical store, this is worth keeping in mind.
Common headache triggers
The NHS lists these common causes of headaches:
- having a cold or flu
- stress
- drinking too much alcohol
- bad posture
- eyesight problems
- not eating regular meals
- not drinking enough fluids (dehydration)
- taking too many painkillers
- having your period or going through the menopause (hormone headache)
For migraine, the NHS adds anxiety and depression, tiredness, skipping meals, too much caffeine and not getting enough regular exercise. The WHO mentions alcohol, sleep disruption and certain foods. The WHO also notes that anxiety and depression are more common in people with migraine; our guide on anxiety symptoms explains when worry becomes something to discuss with a doctor.
In a Pakistani summer, dehydration is an easy trigger to miss, especially if you are out in the heat or go long hours without food or water. Both the NHS and the WHO suggest keeping a headache diary or calendar to work out what sets off your headaches.
Self-care and treatment
Easing a headache at home
The NHS suggests these steps for an ordinary headache:
- drink plenty of water
- get plenty of rest if you also have a cold or the flu
- try to relax, as stress can make headaches worse
- do not skip meals, even if you do not feel like eating
- do not sleep more than you usually would, as it can make the headache worse
- do not strain your eyes for a long time, for example by looking at a screen
- do not drink alcohol
The NHS also lists ordinary painkillers such as paracetamol or ibuprofen. A pharmacist or doctor can tell you which one is safe for you, and remember the warning above about using painkillers too often.
For migraine, the NHS suggests sleeping or lying down in a darkened room during an attack, avoiding your known triggers, staying well hydrated, limiting caffeine and alcohol, keeping a healthy weight, eating at regular times, getting regular exercise and plenty of sleep, and managing stress. The WHO agrees that simple steps like regular sleep and exercise, a healthy diet and staying hydrated are often all that is needed.
Treatment a doctor may offer
If headaches keep coming back, a doctor can help. The NHS says migraine cannot be cured, but treatment can ease attacks and help prevent them. Depending on how severe and frequent your migraines are, a doctor may consider:
- painkillers, or migraine medicines called triptans and gepants
- medicines to stop you feeling or being sick
- preventive medicines, such as beta blockers, some antidepressants or some epilepsy medicines
- other options the NHS mentions, such as acupuncture, relaxation techniques, cognitive behavioural therapy (CBT) or vitamin B2
Your doctor will decide what is right for you, and may refer you to a specialist if treatment is not helping.
When to see a doctor, and emergency warning signs
See a doctor if
Based on the NHS pages, book a visit with a doctor if:
- you have tried treating a headache yourself and it is not getting better, or is getting worse
- you get headaches regularly
- your migraine attacks are severe, getting worse, lasting longer than usual, or happening more than once a week
- you find it hard to control your migraine, or regularly get migraine around your period
See a doctor the same day if
- you or a child has a headache with vision or eye problems
- the headache is triggered or made worse by coughing, sneezing, bending down or exercising
- you or a child has a headache and is being sick (vomiting)
- a child has a headache that is getting worse or wakes them at night
- you have a headache with jaw pain when eating, or a sore or tender scalp
- a migraine attack has lasted longer than 72 hours, or aura lasts longer than 1 hour
- you have a migraine attack and are pregnant or have just had a baby
Go to emergency or call 1122 if
Get emergency help straight away if you or a child has a headache and:
- it started suddenly and is extremely painful
- has had a seizure (fit)
- has numbness or weakness in the body or face, or cannot move an arm or leg on one side
- has had a head injury within the last 3 months
- finds it difficult to speak, balance, walk or remember things
- is drowsy or confused
- has loss of vision, or blurred or double vision
- has a rash that does not fade when a glass is rolled over it
- has a very high temperature, a stiff neck, or bright lights are bothering them
The NHS advises not to drive yourself. Ask someone to take you or call for an ambulance, and bring any medicines you take with you.
You can find PMDC-verified doctors by city and specialty and book a visit on SehatDoc Booking.
Sources
Medical note: This guide is for general information and is not a substitute for advice from a doctor who can examine you.
Frequently asked questions
- What are the 4 main types of headaches?
- The four types the WHO highlights are tension-type headache, migraine, cluster headache and medication-overuse headache. Tension-type headache feels like a tight band around the head, migraine is often throbbing and one-sided with nausea, and cluster headache causes extremely severe pain around one eye. Medication-overuse headache is caused by taking headache medicines too often.
- How do I know if my headache is a migraine?
- A migraine is usually a throbbing headache, often on one side, that gets worse when you move. It often comes with feeling sick or vomiting and strong sensitivity to light and sound. Some people see zigzag lines or flashing lights before it starts. A doctor can confirm the diagnosis and suggest treatment.
- Can taking painkillers too often cause headaches?
- Yes. Long-term, excessive use of headache medicines can cause medication-overuse headache, which happens on more days than not and is often worst on waking. The NHS advises people with migraine to try not to take painkillers for more than 2 days a week. If you need painkillers often, see a doctor.
- When is a headache an emergency?
- Get emergency help if a headache starts suddenly and is extremely painful, or comes with a seizure, weakness or numbness, confusion, loss of vision, or trouble speaking or walking. A headache after a recent head injury, or with a very high temperature, stiff neck or a rash that does not fade under a glass, is also an emergency. In Pakistan, call 1122 or go to the nearest emergency department.
- Can dehydration cause headaches?
- Yes. The NHS lists not drinking enough fluids as a common cause of headaches, and drinking plenty of water is one of its first self-care steps. This is easy to overlook in hot weather or when you go long hours without water.
- How long does a migraine last?
- The NHS says migraine attacks usually last between 4 hours and 3 days. Early signs such as tiredness can start hours or up to 2 days before the pain. If an attack lasts longer than 72 hours, see a doctor urgently.
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