Headaches: common types, why they keep coming back, and warning signs
Almost everyone gets headaches, and about 4 in 10 people worldwide have a headache disorder. Most are tension headaches or migraine, which are uncomfortable but not dangerous. Here is how to tell the common types apart, why headaches can keep coming back, what helps, and the rare warning signs that need a doctor straight away.
Key points
- Tension headaches feel like a tight band around the head, on both sides. Migraine is usually a throbbing pain, often one-sided, with nausea and sensitivity to light and sound.
- Taking painkillers on more than 2 or 3 days a week can cause medication-overuse headache, a common reason headaches keep coming back.
- Stress, poor sleep, skipped meals, dehydration, posture, screen time and alcohol are common triggers. A headache diary helps find yours.
- Menthol or peppermint balms have some evidence for tension headaches. Cluster headaches need specific treatment from a doctor.
- Call 999 for a sudden, extremely severe headache, or a headache with weakness, confusion, slurred speech, a stiff neck and fever, or after a head injury.
Common types of headache
| Type | What it feels like | How long |
|---|---|---|
| Tension-type headache | Pressing or tight, like a band around the head, on both sides. Mild to moderate. Often with tight neck and shoulder muscles. | 30 minutes to several days |
| Migraine | Throbbing, often on one side, moderate to severe, worse with activity. Nausea or vomiting, and sensitivity to light and sound. Some people get an aura first, such as flashing lights. | 4 hours to 3 days |
| Cluster headache | Very severe, one-sided pain around or above the eye, with a red, watery eye, runny nose or drooping eyelid on the same side. Restlessness. Comes in “clusters” lasting weeks or months. | 15 minutes to 3 hours, up to several times a day |
| Medication-overuse headache | A daily or near-daily headache in someone taking painkillers frequently | Persistent |
A community study in Malaysia found that about 1 in 4 adults had tension-type headaches and about 1 in 11 had migraine in a year, more often women.
“Sinus headache” is often migraine. In one study, most people who believed they had sinus headaches actually met the criteria for migraine. A true sinus infection usually comes with a blocked nose, thick discharge and fever.
Pain at the back of the head and neck
Headaches at the back of the head, near the neck, are usually caused by:
- Tension-type headache, often with tight neck and shoulder muscles from stress or long hours at a desk or phone.
- Neck problems (cervicogenic headache): pain that starts in the neck, often with stiffness and pain when moving the neck.
- Occipital neuralgia: brief, sharp, shooting or electric pains from the base of the skull, with a tender scalp.
A low, firm pillow, regular breaks from screens, stretching, and a warm or cold pack on the neck can help. See a doctor for back-of-head pain after a fall or injury, or with any of the warning signs below.
Why do I keep getting headaches? (Punca kerap sakit kepala)
Common triggers, according to the NHS:
- Stress, anxiety and poor or irregular sleep
- Skipping meals, and not drinking enough water
- Poor posture, and long hours looking at screens
- Eyesight problems. Get your eyes tested if headaches come with reading or screen use
- Alcohol, and too much (or suddenly cutting down) caffeine
- Hormonal changes, such as periods and menopause
- Colds, flu and sinus infections
In the Malaysian study, more than half of people with migraine or tension headaches said sun exposure brought them on.
Too many painkillers can cause headaches
Taking simple painkillers on 15 or more days a month, or combination painkillers or triptans on 10 or more days a month, can cause medication-overuse headache, the most common cause of daily headaches. Try to keep painkillers to no more than 2 or 3 days a week. If you are already taking them most days, see a doctor. Stopping, with support, usually brings improvement.
Keep a headache diary. Note when headaches happen, how bad they are, what you were doing, what you ate, how you slept, and what medicine you took. Patterns often appear within a few weeks.
How to get rid of a headache
- Simple painkillers: paracetamol, ibuprofen or aspirin work for most tension headaches. Take them early in a migraine attack. Don’t give aspirin to anyone under 16. In pregnancy, paracetamol is the usual first choice.
- Rest, water and food: drink water, eat if you’ve skipped a meal, and rest in a quiet, dark room during a migraine.
- Relax your neck and shoulders: gentle stretches, a warm shower or a warm pack.
- Koyok, menthol and peppermint balms: small studies have found that 10% peppermint oil or menthol applied to the forehead and temples eased tension headaches and migraine better than a placebo. Many patches also contain methyl salicylate, which is similar to aspirin, so avoid them if you are allergic to aspirin, take blood thinners, or on broken skin, and check the label before using them on children.
For migraine, a doctor may prescribe a triptan, a specific migraine medicine, and anti-sickness medicine. If you have frequent migraines, daily preventive medicines can reduce how often they happen. Newer injectable preventive treatments exist, and a neurologist can advise whether they suit you.
Cluster headaches don’t respond to ordinary painkillers. They are treated with high-flow oxygen or a triptan injection or nasal spray, so see a doctor for a diagnosis and a treatment plan.
When a headache is an emergency
Call 999 or go to an emergency department for a headache
- That comes on suddenly and is extremely painful, reaching its worst within a minute (a “thunderclap” headache)
- With weakness or numbness of the face, arm or leg, slurred speech, confusion, or difficulty walking or balancing. These can be signs of a stroke.
- With a high temperature, stiff neck, sensitivity to light, or a rash that doesn’t fade when pressed with a glass
- After a head injury in the last 3 months
- With a seizure, drowsiness, or loss of vision
See a doctor urgently for a headache that:
- is new, especially if you are over 50, or different from your usual headaches
- is getting steadily worse, wakes you from sleep, or comes with vomiting
- gets worse when you cough, sneeze or bend over
- comes with eye pain or vision problems, or jaw pain when chewing and a tender scalp
- happens when you have a weakened immune system or a history of cancer
In pregnancy or after giving birth, a severe headache with vision problems, pain below the ribs or sudden swelling of the face, hands or feet can be a sign of pre-eclampsia. Contact your clinic or go to hospital straight away.
High blood pressure usually causes no symptoms. It is only very high blood pressure, around 180/120 or above, that can cause a headache, and that is an emergency. See our guide to checking your blood pressure.
Headaches in children
Headaches are common in children, often from tiredness, stress, missed meals or a viral illness. Migraine in children may be shorter, and some children with migraine have tummy pain more than headache.
See a doctor promptly if a child’s headache wakes them up or is there when they wake, keeps getting worse, comes with vomiting or a squint, or follows a head injury. Never give aspirin to children under 16.
Where to see a doctor about headaches
A GP can diagnose most headaches, check your blood pressure and eyesight, review your painkiller use, prescribe migraine treatment and refer you to a neurologist if needed. Our directory lists GP clinics across Kuala Lumpur, Selangor and other states, including clinics open late and at weekends.
Browse the clinic directoryFrequently asked questions
Why do I keep getting headaches? (Punca kerap sakit kepala)
Common causes are stress, poor sleep, skipped meals, dehydration, posture, screen time, eyesight problems and alcohol. Taking painkillers too often can also cause frequent headaches. A headache diary helps find your triggers.
What causes headaches at the back of the head near the neck?
Usually tension-type headaches or neck problems, often from stress and posture. Sharp, shooting pains from the base of the skull may be occipital neuralgia. See a doctor after an injury or if there are warning signs.
How do I get rid of a headache quickly? (Cara hilangkan sakit kepala)
Take paracetamol or ibuprofen early, drink water, eat if you’ve missed a meal, and rest. For migraine, a quiet, dark room helps. Menthol or peppermint balms may ease tension headaches.
What are the symptoms of migraine? (Simptom migrain)
A moderate to severe, throbbing headache, often on one side, lasting 4 hours to 3 days, with nausea or vomiting and sensitivity to light and sound. Some people see flashing lights or zigzags (aura) beforehand.
What is a cluster headache?
A very severe, one-sided headache around the eye, lasting 15 minutes to 3 hours, with a red, watery eye or runny nose on the same side. Attacks come in clusters over weeks or months, and are much more common in men. Ordinary painkillers don’t help, so see a doctor.
When is a headache dangerous?
Call 999 for a sudden, extremely severe headache, or a headache with weakness, confusion, slurred speech, a stiff neck and fever, a seizure, or after a head injury. See a doctor urgently for a new or worsening headache.
Sources
- World Health Organization — Headache disorders fact sheet (Oct 2025)
- International Classification of Headache Disorders, 3rd edition (ICHD-3)
- Alders, Hentzen & Tan — Community-based prevalence study of headache in Malaysia (Headache, 1996)
- NHS — Headaches (Apr 2024)
- NHS — Tension headaches (Aug 2025)
- NHS — Migraine (Mar 2026)
- NHS — Cluster headaches
- NHS — Pre-eclampsia (Mar 2026)
- Schreiber et al. — Prevalence of migraine in patients with a history of self-reported sinus headache (Arch Intern Med, 2004)
- Göbel et al. — Peppermint oil in the acute treatment of tension-type headache (Schmerz, 2016)
- Borhani Haghighi et al. — Cutaneous application of menthol 10% for migraine (Int J Clin Pract, 2010)
