Question 1

What is headaches or migraines?

Accepted Answer

Headaches and migraines together account for the vast majority of primary headache presentations. Tension-type headache is characterised by bilateral, non-pulsating pressure or tightness, mild-to-moderate intensity, and absence of significant nausea or photophobia/phonophobia — it does not worsen with physical activity. Migraine is characterised by unilateral (typically), pulsating pain of moderate-to-severe intensity, lasting 4–72 hours, with nausea and/or photophobia and phonophobia, and worsening with activity.

Question 2

What do people commonly experience with headaches or migraines?

Accepted Answer

People with frequent headaches often describe feeling like they're walking on eggshells, never knowing when the next episode might strike. Many report a sense of frustration when others don't understand the severity of their pain, particularly with migraines that can't be seen from the outside.

The anticipation of pain can be almost as challenging as the headaches themselves. Many individuals develop heightened awareness of potential triggers, sometimes limiting their activities or social engagements out of fear. The unpredictable nature means people often feel they need to plan their lives around their headaches, carrying medications everywhere and having backup plans for important events.

Question 3

What lifestyle changes can help with headaches or migraines?

Accepted Answer

Consistent sleep-wake times, regular meals, and adequate hydration reduce headache and migraine frequency. Identifying and managing personal triggers (through headache diary) is the foundation of self-management. Regular aerobic exercise reduces migraine frequency. Stress management, mindfulness, and biofeedback are effective adjuncts. Limiting analgesic use to prevent medication overuse headache.

Question 4

What integrative approaches support headaches or migraines?

Accepted Answer

Tension-type headache: paracetamol, NSAIDs, physiotherapy, amitriptyline for prevention. Migraine acute: triptans (first-line specific treatment), NSAIDs, antiemetics; CGRP antagonists (gepants) for those who cannot tolerate triptans. Migraine prevention: topiramate, amitriptyline, propranolol, candesartan; anti-CGRP monoclonal antibodies (erenumab, fremanezumab) for frequent or chronic migraine. Magnesium supplementation, riboflavin (vitamin B2), and CoQ10 have evidence for migraine prevention. Acupuncture has NICE recommendation for both tension and migraine prevention.

Question 5

When should I seek professional support for headaches or migraines?

Accepted Answer

Seek urgent assessment for thunderclap headache (sudden severe onset), headache with fever and neck stiffness, headache with neurological deficit, or new headache over age 50. Seek routine assessment for headaches occurring more than 4 days per month, significantly impairing quality of life, or requiring regular analgesia.

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