To mark World Headache Day (5 September): Headaches are usually easy to treat – provided the diagnosis is correct

For many people, headaches are part of everyday life – and are therefore often treated at home. Take a painkiller and carry on. However, in the case of regularly recurring symptoms, this approach may not be enough: only the correct diagnosis enables targeted treatment.

“Headaches are very often easily treatable,” says Prof. Dr Klaus Weckbecker, a practising GP and head of the Institute of General Practice and Primary Care (iamag) at Witten/Herdecke University (UW/H). The first crucial step is to determine exactly what type of headache is present.

Several hundred different types of headache have been described in medicine. Tension-type headaches and migraines are particularly common, whilst cluster headaches, for example, are significantly less common. They differ not only in their symptoms, but also in their triggers and in the treatment required. Treatment varies considerably depending on the type of headache. What may be effective for migraines will not help with cluster headaches. For migraines, for example, modern antibody therapies may be considered for prevention, whilst cluster headaches may be treated with oxygen inhalation, amongst other things.

Diagnosis begins with a consultation

 “The medical history is our most important tool,” says Weckbecker, referring to the detailed consultation with the patient. Key questions include: When do the headaches occur? How often? How long do they last? Where are they localised? What do they feel like? Are there any accompanying symptoms or possible triggers? A headache diary can help to identify such patterns.

There are many triggers – and they vary from person to person. A lack of sleep can contribute to headaches, as can changes to one’s sleep pattern or an unusually high amount of rest. Stress can play a role, as can certain foods or other personal factors. 

When headaches become a medical emergency

A sudden, extremely severe headache that reaches its peak intensity within seconds – known as a ‘destruction headache’ – is a completely different matter; it may indicate a brain haemorrhage and is a medical emergency.