What is a left headache

Headache strategies

Accurate diagnosis for a suitable treatment

08/30/18 (ams). Almost everyone has had a headache at some point, perhaps because they slept too little or drank too much alcohol. This is often harmless and quickly disappears on its own. With the European Headache and Migraine Day on September 12th, the European Headache Alliance would like to draw attention to the various forms and treatment options of headaches.

If headaches keep recurring without a specific cause, they are referred to as primary headaches and are diseases in their own right. They are the number one cause of headaches. These include tension and cluster headaches, as well as migraines. However, headaches can also be a side effect of various illnesses, such as a cold or high blood pressure or an injury to the head or the cervical spine. In such cases it is then a secondary headache.

Ready-to-broadcast radio o-tones with Anja Debrodt, doctor in the AOK Federal Association

Headache doesn't always feel the same. A dull ache all over the skull, a throbbing pain on the left side of the head, or a sharp pain around one eye that is watering and reddening. The International Headache Society classifies more than 240 types of headache. "The various forms differ in exactly where the pain occurs, how often and how long it lasts and which accompanying symptoms, such as nausea or visual disturbances, are added," reports Anja Debrodt, a doctor at the AOK Federal Association. An accurate diagnosis is important so that the appropriate treatment can be given. "Migraines, tension headaches and cluster headaches - all three forms are regarded as independent diseases, provided the pain occurs again and again and restricts the lives of those affected," says doctor Debrodt.

Tension headache

Tension headaches are very common. According to the Institute for Quality and Efficiency in Health Care (IQWiG), more than 40 out of 100 people repeatedly have tension headaches. The pain occurs on both sides of the head, the intensity is usually light to moderate and is not increased by physical activity as with migraines. Over-the-counter pain relievers, which should always be taken according to the instructions on the packaging, are sufficient to get the occasional tension headache under control. "It is also helpful to dab cooling peppermint oil on the temples, forehead and neck," says doctor Debrodt. Relaxation exercises, endurance sports, enough breaks and enough sleep - these changes in everyday life can also help prevent tension headaches from occurring as often.


Migraines are severe headache attacks that can become unbearable. About 14 percent of women and seven percent of men suffer from recurrent migraines. According to IQWiG, four to five out of 100 children, girls and boys, are affected equally.

The following features are characteristic:

  • The pain only occurs on one side of the head.
  • The pain, which is usually severe, feels throbbing or throbbing.
  • The pain increases with movement.

Often it does not stop at the severe, one-sided pain. In addition, there is nausea and vomiting, sensitivity to light and / or noise. Some patients are also very sensitive to odors. What is particularly puzzling about the disease is the so-called aura, which is noticeable in some migraine patients before an attack: These are neurological symptoms, mainly visual disturbances such as flickering vision or visual field defects, but also sensory disturbances on one side of the body or speech disorders. The exact causes of the migraines are not known. It is believed that excitation of fibers in the nervous system leads to dilation of blood vessels. The permeability of the vessel walls leads to the release of substances that cause inflammation of the trigeminal nerve. This nerve sends impulses to the cerebral cortex, which the patient then perceives as pain. Just switching between tension and relaxation, going to bed later or eating irregularly can trigger a seizure. These triggers should be avoided. When the migraines are very painful, most people take medication to help them get through the attack. Before treating yourself, however, it should be clarified by a doctor that the headache attacks are actually a migraine. Migraine drugs are not suitable for people with high blood pressure and coronary artery disease, for example. Debrodt: "Pain and migraine medication should therefore not be taken more than ten days a month. In addition to drug treatment, stress management, relaxation exercises and endurance training play a central role in reducing stress in everyday life."

Cluster headache

Cluster headaches occur less often than the other two types of headache, namely only in about 0.1 percent of the population. Men are three times more likely to be affected than women. Cluster headaches are possible at any age, but they usually appear for the first time between the ages of 20 and 40. The triggers are often alcohol or being at higher altitudes. The stabbing, boring pains of cluster headaches are strictly one-sided in the area of ​​the eyes, possibly also forehead or temples. The attacks are relatively short (15 minutes to less than three hours), but increase at certain times. As with migraines, other symptoms can occur: reddened and watery eyes, the pupils constrict, one eyelid droops or swells, the nose may be blocked or runny. After medical clarification, the seizures can be treated with a drug from the group of triptans, which is actually a migraine drug. The patients do not take the drug as a tablet, but instead inject it under the skin or use it as a nasal spray. Inhaling oxygen through an oxygen mask helps many people.

Patients should keep a pain diary

The primary goal of therapies, however, is to prevent the attacks. The attending physician can prescribe medication, some of which are also used to prevent migraines. In order to confirm the diagnosis and to track down possible causes of the pain, patients should keep a pain diary. When did you have which headache in which situation? And when did they take which medication? In this way it can also be found out whether a so-called drug-related headache may have developed as a result of excessive use of painkillers. This can be the case if you regularly take medication for headaches for more than ten days a month and for more than three consecutive days, as the nervous system probably gets used to the medication, the pain threshold drops and the brain becomes hypersensitive. Such headaches often feel dull, and patients feel as if they have never cleared their heads. A medically accompanied medication break - outpatient or in the hospital - is advisable in these cases, possibly supplemented by psychological help, through which patients with chronic headaches learn to recognize individual stress limits and develop specific coping strategies with the help of the therapist.

© 2016 AOK Federal Association