Headaches: your questions answered

A few weeks ago you learnt about the triggers of headaches with expert advice courtesy of Nurofen. Now we look at some broader questions on headaches answered by Dr Andrew Dowson as well as questions on Nurofen, answered by Reckitt Benckiser Sales Development Controller Trevor Gore.

Nurofen answers from Reckitt Benckiser

Is it safe to take Nurofen* 200mg tablets long term if you have a persistent problem?
Like the majority of over-the-counter medicines, Nurofen 200mg tablets are licensed for short-term use only. We would always recommend that during short-term use, if symptoms persist or worsen the patient should be advised to consult a doctor.

How do Nurofen* 200mg tablets target the pain? Does it work on the receptors in the brain or does it actually affect the nerve endings where the pain is located ie a joint/lower back?
Nurofen* 200mg tablets contain the NSAID (Non Steroidal Anti-Inflammatory Drug) Ibuprofen, which inhibits the production of chemicals (Prostaglandins) which are responsible for the brain 'sensing' pain.

- Ibuprofen inhibits the formation of prostaglandins at the site of injury (peripherally joint/lower back) and also reduces prostaglandins in the brain.

How do Nurofen* 200mg tablets work in order for it to get rid of headache pain?
See above.

If I am suffering from a headache as a result of over-consumption of wine the previous evening, is it more effective to take a Nurofen* 200mg tablet or to simply drink several glasses of water?
Nurofen 200mg tablets are licensed for the relief of migraine-headaches, backache, dental pain, neuralgia and period pains as well as rheumatic and muscular pains, and pain of non-serious arthritic conditions. Headache can be triggered by many factors. Nurofen 200mg tablets are useful for headaches, however triggers should be avoided.

Headaches

At what stage should one start to get worried about a headache and consult a doctor?
Most headaches that have a serious underlying cause present as an emergency. If headache has a defined pattern over time, it is reassuring. Patients should consult a doctor if their headache is disruptive despite their best efforts to control them, or symptoms are persisting.

Having gone through the headache quiz, I think mine are mostly related to stress, but they seem to occur with more intensity when I am less stressed, ie at weekends, and on holiday. Is this common? And wondering how I can avoid this?
The weekend/relief of stress headaches are usually migraine based. Attention to daily routines might minimise them eg if you sleep in at the weekend/holiday, having a more usual sleep pattern could reduce the chance of an attack. If you need further help, please visit your doctor.

Why is my eyesight sometime affected before a headache and why do I sometimes become very sensitive to smells before a headache comes on?
This is likely to be a migraine. About a third of migraneurs at some point get a sensory disturbance or aura, usually before the headache, although they can occur during headache or even alone ie no subsequent headache. Patients often describe visual disturbance, numbness or tingling in the hand or face and word-finding difficulties.

Why does the change in the weather help contribute to the onset of a headache?
This can be a trigger - the change in the barometric pressure. Changes in the internal (periods, stress, dehydration) and external environment can trigger attacks in a susceptible individual.

What is the difference between ibuprofen and paracetamol and which is better to take for a headache?
They work in slightly different ways and either or both can be effective. Standard ibuprofen tablets have been found to provide faster and longer relief from headaches than standard paracetamol tablets.

I've heard that taking painkillers can actually make headaches worse. How can I stop this happening?
Regular use of painkillers can cause an analgesic-dependant headache. As few as 2 doses a week can be a problem and the codeine based drugs seem to be the most implicated. Caffeine may have a similar effect. If you do take any pain relievers containing codeine, they should not be used for more than three days.

Often I develop a headache after looking at a computer screen for long periods of time. Why is this? Should I take breaks from looking at the screen to avoid this? If so, how long should I spend away from the screen?
It may be that you are sensitive to the screen colours or if it flickers. This could be the work-station position, such as the angle of your neck etc. Try and make sure that the work position is optimised and it's often the red and blue ends of the spectrum that are most irritant. Flicker can be sometimes countered by a polarising screen or angle poise light across the screen.

I wear contact lenses and my glasses during the week at work. Even when I wear my glasses, I seem to get headaches towards the end of the day. It doesn't seem to help if I take my glasses off. Is this because I am looking at a computer screen for most of the day? Are there any techniques I could use to help prevent them?
Eyestrain headache can occur after a long day when the muscles for the lens of the eye has been working hard. Have the prescription checked. Otherwise see answer above.

Since I started working at a computer all day I've been getting headaches more often. Are the two things connected?
They could be - check above.

What is the difference between migraines and headaches? I have only had 2 migraines. Both of the times I started seeing spots/stars in my vision (like just after staring at the sun) and then was sick about 2 hours later.
Migraine tends to be disruptive whereas tension type headache more of a nuisance. Aura - the visual symptoms - indicates migraine whatever the intensity of the subsequent headache.

Do migraine triggers alter greatly from headache causes, or is a migraine simply a bad headache?
Migraine usually is more than a bad headache. Patients feel nausea, sensitivity to light and sound and can have a galaxy of other symptoms. Triggers are associated with migraine although tension-type headache can occur under stress.

I sometimes get headaches that seem to target just one part of my head, for example just on one side. Why is this and is there anything that can be done?
In fact the activity causing the pain in migraine is in the brainstem (stalk of the brain). The pain is usually felt in the forehead - either side or both sides and is referred (like someone having a heart attack can feel pain in the left hand) One-sided headaches lasting hours are usually migraine and taking pain killers early have a better chance of success than delaying treatment. If your symptoms persist, seek advice from your GP.

* Nurofen 200mg tablets contain ibuprofen. Always read the label