SIMPLE HEADACHE

Headache is exceptionally common as a symptom. Very few of us escape them completely. There are, unfortunately serious causes (see Severe Headache) but these are relatively uncommon.

Common causes are:

• Tension headaches. Stress, anxiety etc. cause muscle spasm in the scalp muscles which in turn can cause headache "like a tight band around the head". If simple painkillers alone are insufficient then relaxation techniques can help.
• Musculo-skeletal headaches often come from the spine in the neck. They tend to cause headaches at the back of the head and around the side.
• Eye strain. If you need glasses or if your glasses need updating then this puts a strain on the eye muscles and tends to give you a headache at the front of the head - especially after reading, watching TV or looking at the blackboard for any length of time
• Temperatures and infections. These often cause quite bad headaches. Obviously there is always a worry about meningitis but with a simple headache there is very little sensitivity to the light and the neck can be fully flexed forward - if there is any doubt ring to speak to the duty doctor for advice.
• Sinus infections can cause pain around the face and above the eyes. Inhaling steam and simple painkillers can be very helpful in this situation but antibiotics may be required.
• Migraine.
• Other causes - go to severe headache.

Treatment.

• In the over twelves there is a choice of painkiller between paracetamol, aspirin, combination painkillers (e.g. Solpadeine) and ibuprofen (Nurofen, Brufen). For simple headaches paracetamol is perfectly adequate in most cases and relatively cheap. Soluble aspirin is quite useful if you also have a sore throat because it soothes the throat if used as a gargle. Other painkillers offer little extra but cost a lot more. Ibuprofen may be helpful if the headache is coming from the neck and can be combined with paracetamol if necessary.

• In patients under twelve paracetamol is the mainstay. Aspirin is no longer thought to be entirely safe in this age group and combination painkillers are inappropriate. Ibuprofen is marketed in a suitable form but we don't recommend it routinely unless there is a good reason not to use paracetamol (which is rarely the case). Paracetamol comes in various brands as well as the plain form. It also comes as soluble tablets and elixirs. Dose for dose all are equivalent so it is entirely down to your own and the child's preference (and the cost!).

• Patients with chronic on-going headaches may have prescription drugs to take as well. Do check what painkillers (if any) can be combined with them. Equally, if you are on drugs for other conditions - e.g. arthritis - you will need to ask your pharmacist about combinations with over-the-counter remedies.

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