Headache — what to take?

Types of headache and how to recognise them

Tension headache is the most common form — it appears as bilateral pressure, like a tight band around the head, of mild or moderate intensity. It usually appears in the evening, after a long day at the office, and is not aggravated by ordinary physical activity.

Migraine is different: a throbbing pain, usually one-sided, accompanied by nausea, sensitivity to light and noise, lasting 4-72 hours. Cluster headache is a rare but extremely intense form, localised around one eye.

Secondary headache arises from another cause — sinusitis, hypertension, dehydration, alcohol consumption, sleep apnoea, chronic use of painkillers. If the pain is new, unusual or worsens rapidly, the cause must be investigated.

What you can take for an occasional headache

For a mild-to-moderate tension headache, paracetamol 500-1000 mg is the first choice — a good safety profile, it does not irritate the stomach. The maximum dose in adults is 4 g/24h, and less in people with liver impairment.

Ibuprofen 200-400 mg is an effective alternative, especially when there is also an inflammatory component (sinus, muscular). It is taken with food to protect the stomach and is contraindicated in people with ulcers, kidney disease or in the last trimester of pregnancy.

Acetylsalicylic acid (aspirin) 500 mg remains effective, but it is not given to children under 16 (risk of Reye's syndrome). Combinations with caffeine (paracetamol + aspirin + caffeine) act more quickly.

Golden rules for OTC painkillers

• Do not exceed the recommended doses and do not combine two NSAIDs at the same time.
• Do not take painkillers for more than 10-15 days a month — risk of medication-overuse headache (MOH).
• Stay hydrated: many headaches disappear after 500 ml of water.
• If the pain returns within 4h, increasing the dose in an adult is safer than a second dose within a short interval — but respect the MDD.

Non-pharmacological measures that work

Rest in a dark room, apply a cold compress to the forehead or a warm one to the nape, try deep-breathing techniques. A mint or chamomile tea can help, as can a handful of almonds (magnesium helps with migraine).

For chronic headache, keep a diary — you identify the triggers (stress, sleep, food, hormonal cycle) and can prevent the episodes.

When to see a doctor

Some headaches are warning signs and must not be ignored. See the dedicated section below for the full list of symptoms that require immediate evaluation.

For recurrent headache or one that affects your quality of life, talk to your family doctor — there are effective preventive treatments (beta-blockers, topiramate, triptans for migraine) that are not OTC but can make the difference.

Medical disclaimer: the information in this guide is for informational purposes and does not replace the advice of a doctor or pharmacist. For diagnosis and treatment, consult a health professional.