Tension-type and medication-overuse headaches Q&As
Published by Bupa's health information team, April 2009.
Answers to questions about tension-type and medication-overuse headaches
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- How can I treat the symptoms of my headache without taking medication?
- Can I start taking painkillers again when my medication-overuse headache has disappeared?
- Could my headache be a sign of a serious medical condition?
How can I treat the symptoms of my headache without taking medication?
There are a lot of things you can do to help ease the symptoms of your headaches without having to take medication. Taking regular physical exercise, having a massage or learning effective relaxation techniques are just some of the ways you can treat the symptoms of headaches and prevent them occurring as often.
Explanation
Tension-type headaches are often, but not always, linked to stress and anxiety. If your life is very busy and you're having regular headaches, it may be useful to try some relaxation and stress management techniques.
It's often difficult to find time to relax properly, but learning relaxation techniques may help to reduce the tension that could be contributing to your headaches. You can buy books and CDs that can help you to learn to relax or you could try yoga or meditation classes. Alternatively, you could ask your GP about cognitive behavioural therapy (CBT). This is a type of talking treatment that can teach you techniques to manage stress in a more effective way.
Regular exercise may help to stop you getting headaches so often. You should aim for 30 minutes of exercise on at least five days per week. Cycling, swimming or walking are all good ways to get regular exercise. If you spend a lot of time sitting down, it's important to maintain a good posture and sit straight as this will help ease the pressure on your muscles and reduce tension.
A massage may help relieve the symptoms of a tension-type headache by reducing the tension in your muscles.
It may also be useful to keep a diary of when your headaches occur and how intense they are. This could help you to recognise things that may trigger them, such as certain situations, hunger or particular food types. If you do notice a certain pattern to your headaches, you may be able to make small lifestyle changes to help prevent them.
If your symptoms change at any time or if your headaches get worse, you should seek advice from your GP.
Further information
- International Headache Society
www.i-h-s.org
Sources
- Headache - background information. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 21 July 2008
- Warrell DA, Cox TM, Firth JD. Oxford Textbook of Medicine. 4th ed. Vol 3. Oxford: Oxford University Press, 2005:996
- Fumal A, Schoenen J. Tension-type headache: current research and clinical management. Lancet Neurol 2008; 7:70-83. www.thelancet.com
- Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension-type, cluster and medication-overuse headache. British Association for the Study of Headaches. 2007. www.bash.org.uk
Can I start taking painkillers again when my medication-overuse headache has disappeared?
Yes, once your medication-overuse headache has disappeared you can take painkillers again, but you shouldn't take them on more than 15 days each month or for more than two consecutive days.
Explanation
You may get medication-overuse headaches if you have frequent headaches and take medication regularly to treat or prevent them. Using painkillers in this way can reduce their effectiveness and cause medication-overuse headaches, although it's not known why this happens.
There are several different types of painkiller that can cause medication-overuse headaches, including paracetamol, aspirin and ibuprofen. If you're taking any of these medicines on 15 or more days each month for over three months, this could be causing your medication-overuse headache. Headaches caused by these painkillers may give a tightening pain on both sides of your head.
Migraine treatments, including the medicines called triptans, such as zolmitriptan (Zomig), opioids (codeine) and ergotamine combinations (eg Migril) can also cause medication-overuse headaches if they are taken on 10 or more days each month for more than three months. If a triptan, such as zolmitriptan, is causing your medication-overuse headache, you will probably have a pulsating pain on one side of your head, which is made worse by physical activity, light and sound. You may also feel sick. If your medication-overuse headache is caused by an ergotamine, you will probably have a pressing or tightening pain on both sides of your head.
Medication-overuse headaches can also develop when you're taking more than one type of painkiller to treat your headache.
If you have medication-overuse headaches, your GP will recommend that you stop taking any painkillers that could be causing them until your headaches stop. When you stop taking the painkillers your headache may get worse at first and you may have problems sleeping. You may also feel sick and vomit.
Your headaches should start to improve within two months of you stopping your medication. When this happens you can start taking painkillers again for any occasional headaches you get, but you should carefully monitor how often you take them. You shouldn't take painkillers on more than 15 days each month or for more than two consecutive days.
By sticking to these guidelines you should be able to prevent your medication-overuse headaches returning again.
Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Further information
- International Headache Society
www.i-h-s.org
Sources
- Headache - background information. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 21 July 2008
- Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 2nd ed. Cephalalgia 2004; 24(Supplement 1):9-160. www.blackwellpublishing.com
- Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007:598
- Joint Formulary Committee, British National Formulary. 53rd ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2007:235
- Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension-type, cluster and medication-overuse headache. British Association for the Study of Headaches. 2007. www.bash.org.uk
Could my headache be a sign of a serious medical condition?
It's very unlikely that your headache is a sign of a serious medical condition, but if you suddenly develop a stiff neck, fever (high temperature), rash, slurred speech or visual disturbances, you should visit your GP immediately.
Explanation
Tension-type and medication-overuse headaches are very common. Around three to eight out of 10 people will have tension-type headaches at some point in their life and two in 100 people get medication-overuse headaches.
If you have regular headaches, it's very unlikely that you have a serious underlying medical condition, but it can be worrying all the same. It's important to remember that most serious conditions linked to headaches, such as brain tumours or haemorrhages, have very specific symptoms.
Only three out of 100 people who have a brain tumour have a headache as their only symptom. If you just have a headache, it's very unlikely that you have a brain tumour, but if you develop visual problems or have a fit (seizure), you should contact your GP immediately.
If you suddenly get a severe headaches, especially at the back of the head, which are accompanied by a stiff neck, you should contact your GP immediately as these could be symptoms of a brain haemorrhage.
Encephalitis is an inflammation of the brain caused by a virus. One of the symptoms is a headache, but it's usually accompanied by a fever, confusion and loss of consciousness. Similarly, meningitis can cause headaches, but generally there is also a stiff neck, fever and rash and an increased sensitivity to light. If you develop any of these symptoms, you should contact your GP immediately.
You should seek advice from your GP if your headaches suddenly get worse, or if you develop any other symptoms as well as your headache.
Further information
- International Headache Society
www.i-h-s.org
Sources
- Headache - background information. Clinical Knowledge Summaries, 2008. http://cks.library.nhs.uk, accessed 21 July 20088
- Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension-type, cluster and medication-overuse headache. British Association for the Study of Headaches. 2007. www.bash.org.uk
- Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007:596-597; 604-605
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: April 2009
Tension-type and medication-overuse headaches factsheet
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