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Migraines & Headaches

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Migraines & Headaches — Symptoms, Causes & Treatment

Medically reviewed by Dr Sulaiman Shah, GMC No. 7038832 — The GP Clinic, 124 City Road, London.

Last updated: September 12, 2026

Quick answer: A headache is pain anywhere in the head, and has many possible causes, while a migraine is a specific neurological condition causing intense, often one-sided throbbing pain, usually alongside nausea and sensitivity to light or sound. Most headaches and migraines are manageable with the right treatment. See a GP if headaches are frequent, severe, or unlike anything you’ve experienced before.

Headaches are one of the most common reasons people visit a GP or pharmacy, yet many people use “headache” and “migraine” interchangeably — even though they’re treated quite differently. Knowing which type you’re actually dealing with makes a real difference to finding relief faster, rather than working through trial and error.

Understanding exactly what’s causing your headaches — and what genuinely helps — is where our online GPs can help.

Migraines & Headaches — Symptoms, Causes & Treatment

Headache Types Compared

Before diving into migraine specifically, it helps to see how the most common headache types differ side by side:

Type Key Distinguishing Signs
Tension headache Dull, band-like pressure across both sides of the head, mild to moderate, most common type overall
Migraine Throbbing, often one-sided, moderate to severe, with nausea and light/sound sensitivity
Cluster headache Severe, one-sided pain around one eye, occurs in sudden clusters, often with a watering eye
Sinus headache Pressure across the forehead and cheeks, worse leaning forward, usually with other cold/sinus symptoms
Medication-overuse headache Develops from taking painkillers too frequently; headaches become more constant rather than easing

What Are the Symptoms of a Migraine?

Migraine attacks typically progress through up to four distinct phases, though not everyone experiences all of them:

  • Premonitory phase (hours to a day before) — subtle warning signs like fatigue, yawning, mood changes, food cravings, or neck stiffness
  • Aura phase (before or during the headache, in some people) — visual disturbances like flashing lights, blind spots, or zigzag lines; sometimes tingling or difficulty speaking, usually lasting under an hour
  • Headache phase — the main attack: throbbing pain, often one-sided, worsened by movement, alongside nausea, vomiting, and sensitivity to light, sound, or smell, typically lasting 4 to 72 hours
  • Postdrome phase (after the headache eases) — a lingering “migraine hangover” of fatigue, low mood, or difficulty concentrating, which can last a day or more

Recognising which phase you’re in during an attack can genuinely help you respond faster and more effectively, rather than waiting until the pain has already peaked.

What Are the Symptoms of Common Headache Types?

  • Tension headaches — the most common headache type — cause a dull, constant ache or pressure, often described as a tight band around the head, usually mild to moderate and not typically accompanied by nausea.
  • Cluster headaches cause sudden, severe, one-sided pain, usually centred around one eye, often accompanied by a watering eye, drooping eyelid, or a blocked nostril on the same side. Attacks tend to occur in clusters over weeks, sometimes multiple times a day.
  • Sinus headaches cause pressure and pain across the forehead and cheeks, typically worsening when bending forward, and usually accompanied by other sinus symptoms like congestion or facial tenderness.

What Triggers Migraines?

Migraine triggers vary significantly from person to person, but commonly reported categories include:

  • Dietary triggers — alcohol (particularly red wine), caffeine or caffeine withdrawal, aged cheese, and processed or cured meats
  • Sleep disruption — both too little and too much sleep can trigger attacks
  • Hormonal changes — fluctuations around menstruation, pregnancy, or menopause
  • Stress and anxiety — both during periods of high stress, and sometimes as stress starts to ease
  • Dehydration and missed meals — skipping food or fluids can be a genuine trigger
  • Environmental factors — bright or flickering lights, strong smells, loud noise, and weather changes
  • Screen use — prolonged screen time, particularly with glare or poor lighting

Triggers often combine rather than acting alone — for example, poor sleep plus skipped meals plus stress together may cause an attack that none of these factors would trigger individually.

Hormonal and Menstrual Migraine

Migraine affects considerably more women than men, largely due to the role hormonal fluctuations play in triggering attacks. Menstrual migraine typically occurs in the days immediately before or during a period, linked to the drop in oestrogen at this point in the cycle. Some women also notice changes in migraine frequency during pregnancy or perimenopause. If you notice a clear pattern between your migraines and your cycle, this is genuinely useful information to share with a GP, as it can guide more targeted treatment, including hormonal approaches in some cases.

Medication-Overuse Headache — A Commonly Missed Cause

This is one of the most overlooked headache causes. If you find yourself taking painkillers — even simple ones like paracetamol or ibuprofen — more than two to three days a week on a regular basis, this can actually cause headaches to become more frequent rather than less, in a cycle that’s easy to miss because it feels like the headaches are simply “not responding” to treatment. Breaking this cycle usually requires stopping the overused medication under medical guidance, which can temporarily worsen symptoms before genuine improvement begins.

Red Flag Symptoms — When a Headache Needs Urgent Attention

Most headaches are not dangerous, but certain symptoms need immediate medical assessment:

  • A sudden, extremely severe headache that reaches maximum intensity within seconds (“thunderclap headache”)
  • A headache alongside a stiff neck, fever, confusion, or a rash
  • A headache following a head injury
  • New weakness, numbness, slurred speech, or vision loss alongside the headache
  • A headache that’s unlike any you’ve had before, particularly if you’re over 50
  • A headache that wakes you from sleep or is worse first thing in the morning, alongside vomiting

If you or someone else experiences any of these, seek emergency medical attention immediately rather than waiting for a routine appointment.

How Are Migraines and Headaches Diagnosed?

A GP will usually diagnose migraine and common headache types based on your symptoms, their pattern, and your medical history, without needing scans in most routine cases. They’ll ask how often your headaches occur, how long they last, what they feel like, and whether you notice any warning signs, triggers, or accompanying symptoms like nausea or visual disturbances. Keeping a headache diary for a few weeks before your appointment — noting timing, triggers, symptoms, and any medication taken — can make this assessment considerably more accurate.

How Our Online GPs Treat Migraines & Headaches

  • Confirm whether you’re dealing with migraine, tension headache, or another type
  • Recommend acute treatment to use at the start of an attack, including migraine-specific medication where appropriate
  • Discuss preventive treatment options if you’re having frequent or severely disabling attacks
  • Identify and address medication-overuse headache if relevant
  • Investigate hormonal patterns and discuss targeted approaches for menstrual migraine
  • Refer you to a headache specialist or neurologist for complex or treatment-resistant cases

Acute vs preventive treatment — what’s the difference?

Acute (or “rescue”) treatment is taken at the first sign of an attack to stop or reduce it, and includes simple painkillers, anti-sickness medication, or migraine-specific drugs called triptans. Preventive treatment, by contrast, is taken regularly — often daily — to reduce how often attacks happen in the first place, and is usually considered if you’re having four or more headache days a month, or attacks are significantly disabling.

Keeping a Headache or Migraine Diary

Tracking your headaches for a few weeks can reveal patterns you might otherwise miss. Note down:

  • The date and time each headache starts and ends
  • How severe it was, and where the pain was located
  • Any warning signs or aura beforehand
  • What you ate, drank, or did in the hours before
  • Your sleep the night before
  • Any medication taken, and whether it helped

This information genuinely helps identify your personal triggers and gives your GP a much clearer picture to work from.

Self-Help Strategies for Headaches and Migraines

  • Stay hydrated — dehydration is a common, easily-fixed trigger
  • Keep regular sleep and meal times — irregular patterns are a frequent trigger
  • Rest in a quiet, dark room during an attack if possible
  • Try a cold compress on the forehead or neck for tension-type pain
  • Manage stress through regular breaks, relaxation techniques, or exercise
  • Limit painkiller use to avoid medication-overuse headache

Preventing Migraines and Headaches

  • Identify and avoid your personal triggers using a headache diary
  • Maintain consistent sleep, meal, and hydration routines
  • Manage stress proactively rather than reactively
  • Limit alcohol and caffeine, particularly if you notice they trigger attacks
  • Take regular screen breaks, especially during long working sessions
  • Discuss preventive medication with a GP if attacks are frequent

When Should You See a GP for Migraines or Headaches?

Book an online GP appointment if:

  • You’re having migraines or headaches four or more days a month
  • Over-the-counter painkillers aren’t providing relief
  • You suspect you’re taking painkillers too often
  • Your migraines are significantly disrupting work or daily life
  • You notice a clear pattern between your migraines and your menstrual cycle
  • Your headaches have changed in pattern, frequency, or severity recently

Seek emergency care immediately if you experience a sudden, severe “thunderclap” headache, or a headache alongside neurological symptoms like weakness, slurred speech, or vision loss.

Book Your Migraine & Headache Consultation Today

Migraines & Headaches are genuinely manageable once you understand your triggers and have the right treatment in place, but many people go years without a proper diagnosis or effective plan. Our online GPs are available 7 days a week — get the right diagnosis and a treatment plan that actually works for you.

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Frequently Asked Questions

Migraines typically involve throbbing, often one-sided pain alongside nausea and sensitivity to light or sound, and can last hours to days. A typical tension headache is milder, dull, and affects both sides without these accompanying symptoms.

Common triggers include poor sleep, dehydration, skipped meals, stress, hormonal changes, certain foods and alcohol, and environmental factors like bright lights or strong smells — often combining rather than acting alone.

Yes, taking painkillers too frequently — more than two to three days a week regularly — can cause medication-overuse headache, where headaches become more frequent rather than improving.

No, having migraines or headaches on four or more days a month is generally considered frequent enough to warrant a GP assessment and discussion of preventive treatment options.

Acute treatment is taken at the start of an attack to stop or reduce it, while preventive treatment is taken regularly to reduce how often attacks happen in the first place.

Yes, many women experience menstrual migraine linked to hormonal changes around their period, and migraine patterns can also shift during pregnancy or perimenopause.

Aura refers to warning symptoms, often visual disturbances like flashing lights or blind spots, that can occur before or during a migraine attack, usually lasting under an hour.

A sudden, extremely severe headache, one following a head injury, or one accompanied by neurological symptoms like weakness, slurred speech, or vision changes needs urgent medical attention.

Yes, stress is a commonly reported migraine trigger, and interestingly, migraines can also occur as stress starts to ease, sometimes called a “let-down” migraine.

Usually not. Most migraines and common headache types are diagnosed based on your symptoms and pattern, without needing imaging, unless red-flag symptoms are present.

Yes, children can experience migraines, sometimes presenting differently than in adults, such as abdominal migraine, which causes stomach pain rather than head pain.

An untreated or inadequately treated migraine attack typically lasts between 4 and 72 hours, though effective treatment taken early can significantly shorten this.

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