The commonest cause of a headache is tension. The man who has had a busy day at work, has been stuck in a traffic jam for two hours and been worrying about a business deal will probably develop one. The woman who has been battling her way through crowded stores, who has missed her bus and been hurrying to get home before the children get in from school may have one. Tension headaches are a common sign that the stress threshold has been reached.
Tension headaches are caused by a sustained, painful contraction of the muscles around the face, scalp and neck. The headache, which usually seems throbbing and may affect any part of the head, will invariably disappear if the patient sits quietly for a while and perhaps takes a couple of mild analgesic tablets.
There are, of course, many other causes of headache. Headaches across the forehead, accompanied by a feeling of stuffiness and a difficulty in breathing are often caused by sinusitis and catarrh . They may be worse in the morning, and are sometimes helped by a warm shower. These may need antibiotic tablets before they clear up. An infected or rotten tooth can cause a headache which seems to spread far beyond the area of tissue around the tooth . Indeed, sometimes the pain seems to be completely unrelated to the tooth itself. The pain is transmitted by nerves which pass nearby the tooth. Toothache may merit a visit to the dentist, but if an infection is causing the problem you will probably have to take antibiotics before the tooth can be dealt with.
Very high blood pressure may cause headaches which are worse on waking and which are concentrated at the back of the head. People who, because of poor lighting conditions or poor eyesight, squint a great deal when reading or studying figures may develop headaches which are worse in the evenings and are concentrated at the front of the head. These headaches are caused by screwing up the muscles around the eyes. Ear infections cause headaches, usually around the ears.
Alcohol, of course, is also a cause of headaches. Mixing drinks is a sure way to develop a headache, although champagne alone is particularly liable to cause pains in the head. To avoid an alcohol-induced headache and the other accompanying feelings of being hungover drink plenty of water after a heavy consumption of alcohol.
Arthritis in the cervical spine, and the neck, is another common cause of headache. Less common causes include an inflammatory disease known as ‘temporal arthritis’ and the various types of brain tumour which are all rare. Meningitis, an uncommon inflammation of the covering over the brain, also causes headache and neck stiffness. Migraine, a common type of headache, is discussed elsewhere . Finally, bumps and bangs on the head cause pain.
As I have said, the commonest cause of a headache is worry. Paradoxically the pains may well be at their worst when the problems which caused the worry have eased. Experts believe that this is because during relaxation the blood flow into the brain changes. In times of tension there is a decreased flow of blood into the brain caused probably by the tensing of muscles. When the muscles relax the blood flow increases. Most ‘worry’ headaches can be treated at home with soluble aspirin or paracetamol tablets and plenty of rest. But if a headache lasts more than a day, is accompanied by vomiting or follows a blow on the head then see a doctor.