Complaints & connections · borters.ch
The kind of pain usually says more than its intensity — and points the way to the right treatment.
Also known as: headache · which type of headache
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Headaches are very common and almost always harmless. The most frequent is tension headache — a dull, both-sided pressure “like a band around the head”. Migraine is usually one-sided, throbbing, often with nausea and light/noise sensitivity, sometimes preceded by an aura. The rare cluster headache is strictly one-sided around the eye and extremely severe. Tension, too little sleep or fluid, the eyes, sinuses or overuse of painkillers can also cause headaches. The three main types have their own dossiers. Get checked quickly for warning signs: a sudden “worst headache of my life”, headache with fever and neck stiffness, after a fall, with weakness/speech or vision problems, or a new, persistent headache from middle age on.
A headache appearing for the first time at this age and unlike earlier ones belongs looked at in its own right — especially with a tender temple, pain on chewing, fever or weight loss.
Most headaches improve on lying down. If it worsens instead, increases on coughing and comes with brief visual blackouts, double vision or a pulse-synchronous rushing, it belongs looked at urgently.
A short headache diary (when, where, how, triggers) helps find the type and the right help.
Enough sleep, water, breaks and movement prevent many headaches.
Too-frequent painkillers can themselves cause headaches (rule: no more than ~10 days/month).
With the warning signs above, seek help immediately.
Screen away, a large glass of water, 20 minutes in a quiet, darkened room; a cool cloth on the forehead or neck.
Apply diluted peppermint oil thinly to temples and neck, repeat after an hour if needed. Keep away from the eyes.
New, persistent headaches in someone who lived for a long time in Latin America, Africa or South Asia can come from a tapeworm larva in the brain. Imaging shows it.
More than ninety out of a hundred headaches are primary — tension-type and migraine — and not a sign of another illness. Tension headache lasts thirty minutes to seven days, migraine four to seventy-two hours, cluster headache fifteen minutes to three hours. A headache that reaches its peak within seconds to a minute needs immediate assessment — that time course is the sign that matters.
The most important sentence concerns amount: painkillers on more than ten days a month — fifteen for simple ones — create, over weeks to months, a lasting headache of their own. It goes only after stopping, over two to ten weeks in which it first gets worse. Counting the days rather than the tablets gives the overview. Preventive drugs do not work during an attack, and attack drugs do not prevent — that mix-up is common.
Dull, both-sided pressure, often from stress/tension. Own dossier.
One-sided, throbbing, nausea and light/noise sensitivity. Own dossier.
Strictly one-sided around the eye, extremely severe, in attacks. Own dossier.
Sudden worst-ever, with fever/neck stiffness, after a fall, with weakness/vision or speech trouble → seek help now.
The decisive value with new headaches after the age of fifty: together with pain on chewing and a tender temple it is about an inflammation of the arteries — and about eyesight.
No value explains the pain itself. This one looks for the rare but important exception: an inflammation or infection behind the complaints.
Belongs alongside when fever, night sweats or weight loss come too. With an ordinary headache it contributes nothing.
Having drunk too little is the most common avoidable trigger of all — and the only one that can be put right within an hour.
Long used for preventing migraine; the studies are inconsistent, but the tolerance is good. The belly shows the upper limit.
In a higher dose over several months it is used for preventing migraine. It colours the urine bright yellow — that is expected and no sign of anything else.
Caffeine helps in an attack and, taken daily, is at the same time one of the most common reasons for headache in the morning and on a day off. Steady amounts are better than back and forth.
An empty store lowers the threshold for headache and migraine, especially in women with heavy periods. That is an often overlooked connection.
Studied for migraine prevention: 400–600 mg a day over at least 3 months. Before that no statement is possible, and loose stools are the most common side effect.
400 mg a day over 3 months is the studied amount for migraine prevention — a hundred times the daily need. Urine turns bright yellow from it, which is harmless.
Both at once: combined with painkillers it strengthens the effect, and on stopping it causes headaches itself within 24 hours. Anyone drinking more than three cups a day has withdrawal headache in the picture.
Clearly effective with proven deficiency, useless without. Take only with a documented deficiency — excess is harmful.
With menstrual migraine the trigger is not the high value but the drop in the two days before the bleed. That is why it comes reliably at the same point in the cycle — and why keeping a calendar helps.
Cluster headache follows the body clock: same hour, same season, often out of sleep. Lower night-time values have been measured in those affected.
The weekend headache belongs here: the fall in tension after a tense week is a trigger in its own right — not the tension itself.
The two most common avoidable triggers. A fluid loss of 1–2 % is enough for many; regular meals and 1.5–2 litres a day remove a large share of the attacks.
Drinking coffee on weekdays and getting up later at the weekend brings withdrawal headache. The same amount at the same time — on Sunday too — solves the most common weekend headache.
Red wine, chocolate and cheese are on every list. In controlled studies they triggered far less often than assumed — the craving for chocolate is often already part of the warning phase, not the cause.
Studied for migraine prevention: 400–600 mg a day over 3 months. It works slowly and not during an attack; the most common side effect is loose stool.
Too little and too much sleep both trigger headache — hence the weekend headache. The same times on days off remove a common trigger.
The bark is the plant forerunner of aspirin. In a tea the amount is small — anyone reaching for the tablet regularly should know that both act in the same direction and add up.
Diluted peppermint oil on forehead and temples is better studied than most plant remedies for tension headache — the coolness sets in within minutes. Not for small children and not near the eyes.
At ten per cent in alcohol on forehead and temples, one of the few plant remedies with usable studies for tension headache — comparable to paracetamol. Not in the eyes, not under six.
Inhaled as a scent over 15 minutes, it was studied in migraine in a small trial. The result was favourable and has not been convincingly repeated since.
The classic point for head and tooth pain, between thumb and index finger. Avoided in pregnancy.
At the back of the head where the neck muscles attach — the most used point in tension headache.
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