CONDITIONS
Understanding headaches and finding the right treatment
Headaches are one of the most common neurological conditions, affecting millions of people every year. While most headaches are not caused by anything serious, frequent or severe headaches can have a profound impact on work, family life, sleep and emotional wellbeing. At Wye Sanctuary, we understand that persistent headaches are rarely just headaches. They are often complex conditions influenced by the nervous system, lifestyle, stress, sleep, hormones and other medical conditions. Our aim is to understand what is driving your headaches and help you find the most appropriate treatment to improve your quality of life.
Many people use the terms interchangeably, but they are not the same. A headache simply means pain in the head or face. A migraine is a neurological condition that causes episodes of headache together with other symptoms caused by changes in the way the brain processes sensory information. Migraine attacks often involve moderate to severe throbbing headache, pain on one or both sides of the head, sensitivity to light or sound, nausea or vomiting, difficulty concentrating, fatigue and worsening pain with movement. Some people experience an aura before a migraine, causing temporary visual changes, tingling sensations or speech disturbance.
Like other chronic pain conditions, repeated headache attacks can make the nervous system increasingly sensitive. Over time, the brain becomes better at producing headache pain, pain occurs more easily, attacks become more frequent and recovery takes longer. This does not mean there is ongoing damage to the brain. Instead, the nervous system has become overprotective. Understanding this process often helps people make sense of why headaches continue even when scans are normal.
Migraine
Migraine is one of the commonest causes of recurrent headache. Attacks can last from a few hours to several days and vary greatly between individuals. Triggers may include stress, poor sleep, hormonal changes, certain foods or alcohol, dehydration, bright lights or strong smells, although many people never identify one single trigger.
Tension-type headache
Tension headaches usually produce a dull, tight or pressing sensation across the forehead or back of the head, often with tightness in the neck and shoulders. Despite the name, they are not simply caused by muscle tension and may reflect increased nervous system sensitivity.
Cervicogenic headache
Pain can sometimes arise from the joints, muscles or nerves of the upper neck. These headaches often start in the neck, spread to the back or side of the head, and are aggravated by neck movement. Careful assessment is important because not all headaches with neck pain originate from the neck.
Occipital neuralgia
Occipital neuralgia occurs when the occipital nerves become irritated. Symptoms may include sharp, stabbing or burning pain over the back of the head, pain radiating towards the scalp or behind the eyes, and tenderness when touching the scalp. Some patients improve with specialist nerve blocks.
Medication overuse headache
Taking painkillers too frequently can make headaches worse. This can occur with paracetamol, ibuprofen, codeine, triptans or combination painkillers. Reducing medication often improves headaches, although symptoms may initially worsen before they improve.
Head pain
Throbbing, pressure, one-sided pain, whole-head pain or pain that starts in the neck or scalp.
Sensitivity
Light, sound, smell, movement or screen sensitivity can all occur during migraine attacks.
Neurological symptoms
Aura, visual disturbance, dizziness, brain fog, fatigue, nausea or difficulty concentrating may accompany headache.
Seek urgent medical assessment for a sudden severe headache unlike anything you have experienced before, headache with weakness, confusion, collapse, fever, neck stiffness, new neurological symptoms, headache after head injury, or a rapidly worsening pattern that feels different from your usual symptoms.
Assessment usually begins with a careful history: headache frequency, duration, associated symptoms, triggers, medication use and the impact on your life. Sometimes scans or blood tests are needed, but many headache and migraine diagnoses are made by understanding the pattern of symptoms.
Treatment depends entirely on the type of headache. Your management plan may include education to reduce anxiety and identify patterns, lifestyle approaches such as sleep, hydration, exercise, nutrition and stress management, medication including acute migraine treatments and preventive medicines, reducing medication overuse where appropriate, and injection treatments such as greater occipital nerve blocks or trigger point injections for selected patients. Pain psychology may also help calm an overactive nervous system and reduce the impact headaches have on daily life.
Every headache has a story. Rather than simply treating pain, we aim to understand what type of headache you have, why it has become persistent, what factors may be maintaining it, and which treatments are most likely to help. Successful headache management usually involves combining medical treatment with education, lifestyle approaches and, where appropriate, targeted interventions.
“Living with frequent headaches or migraine can be exhausting, frustrating and isolating. Many of my patients have spent years searching for answers or worrying that something serious has been missed. My role is to listen carefully, make sense of your symptoms and work with you to develop a treatment plan that is tailored to your individual needs. Whether that involves medication, lifestyle changes, education or specialist injections, our goal is to help you regain control and improve your quality of life.”