Headaches are one of the most common medical complaints, with almost everyone experiencing one at some point. Most are temporary and resolve with rest or over-the-counter medication. However, when headaches become frequent, severe, or change in character, they may indicate an underlying neurological issue. Understanding the differences between common headache types and knowing when to seek specialist advice is essential for effective pain management.
Identifying common headache types
Not all headaches are the same. Correctly identifying the type of pain you are experiencing is the first step toward finding the right treatment.
Tension-type headaches
This is the most frequent type of headache. It typically feels like a constant ache or a tight band around both sides of the head. These are often triggered by stress, poor posture, or lack of sleep. While uncomfortable, they are rarely a sign of a serious underlying condition.
Migraines
A migraine is more than just a bad headache. It is a neurological condition that causes intense, throbbing pain, usually on one side of the head. Migraines often come with additional symptoms such as:
- Sensitivity to light and sound
- Nausea or vomiting
- Visual disturbances, known as “aura” (flashing lights or blind spots)
Cluster headaches
These are rare but extremely painful. They occur in cyclical patterns or “clusters,” often waking you in the middle of the night. The pain is typically centred around one eye and can cause redness, watering, or a drooping eyelid on the affected side.
When does a headache become a concern?
While most headaches are primary (not caused by another disease), some are secondary, meaning they are a symptom of an underlying health problem. You should consider a specialist consultation if you experience any of the following “red flag” symptoms:
- Sudden onset: A “thunderclap” headache that reaches maximum intensity within seconds or minutes.
- Changed patterns: A significant change in the frequency or severity of your usual headaches.
- Neurological symptoms: Weakness, numbness, double vision, or difficulty speaking accompanying the pain.
- Systemic symptoms: A headache accompanied by fever, a stiff neck, or a rash.
- Aged over 50: Developing new, persistent headaches later in life.
- Post-injury: Headaches that begin following a blow to the head.
The role of a Consultant Neurologist
Diagnosing the cause of persistent head pain requires clinical expertise. Dr Dominic Paviour is a Consultant Neurologist in London who specialises in the assessment of complex headaches and facial pain.
During a consultation, Dr Paviour focuses on a detailed clinical history and a physical examination. In some cases, he may recommend further investigations, such as an MRI or CT scan, to rule out structural issues. His goal is to provide a clear diagnosis and move beyond simple pain relief to address the root cause of the discomfort.
Modern approaches to headache management
The treatment for neurological pain has advanced considerably. For migraine sufferers, options now include specific preventative medications, Botox injections for chronic cases, and newer CGRP monoclonal antibody therapies. For tension headaches, the focus may shift to lifestyle adjustments and stress management techniques.
By working with a specialist, you can move away from the cycle of over-using painkillers and toward a sustainable, long-term management plan.
Consult Dr Dominic Paviour in London
Living with chronic or worrying headaches can be debilitating. If you are concerned about your symptoms or find that current treatments are ineffective, a specialist review can provide the clarity you need. Dr Paviour sees patients at several London locations, including the Harley Street Clinic and Parkside Hospital. Contact us today to book your appointment.
