Chronic headaches often get dismissed as mere stress or tired eyes, but they can sometimes indicate more serious issues—including side effects from medications. Dr Kaywaan Khan, a Harley Street GP and founder of Hannah London, highlights seven common but overlooked causes of persistent headaches and advises when to seek medical help.
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Migraine
Migraines are a neurological condition distinct from typical tension headaches, though often misunderstood. Unlike the classic one-sided throbbing pain, migraines can also feel like a persistent pressure or sinus-like heaviness. Some experience warning symptoms called auras, while others do not. Triggers can include hormonal changes, sleep problems, blood pressure fluctuations, and smoking. Affecting about one in seven people in the UK, migraines can worsen if untreated but respond well to lifestyle changes, medications, and treatments like Botox. Discuss with your GP if migraines are frequent or worsening.
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Medication Overuse
Taking painkillers too frequently may lead to medication overuse headaches. Over time, the nervous system becomes sensitized, causing headaches to return with greater intensity as drug effects wear off, prompting more medication use and a vicious cycle. Common offenders include over-the-counter pain relief, triptans, and codeine. Keep a headache diary and talk with your GP to safely reduce medication dependency and explore alternative therapies.
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Dehydration
Often underestimated, dehydration is a straightforward cause of headaches. Losing fluids through everyday activities without adequate replacement disrupts bodily functions and triggers headaches, sometimes accompanied by weakness or dizziness. Increasing water intake—aiming for at least eight glasses daily—usually resolves these headaches. Adding electrolytes can help with faster rehydration, and in severe cases, intravenous fluids may be necessary alongside medical treatment.
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Allergies
Allergic reactions release histamine, which can trigger headaches or migraines by disturbing neurochemical balance. People with allergies often suffer more frequent headaches, especially when compounded by dehydration or missed meals during allergy season. Managing allergies with proper testing and treatment from your GP can reduce headache frequency and intensity.
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Poor Sleep Quality
Disrupted sleep makes the brain more sensitive to headaches, and headaches themselves can further worsen sleep, creating a damaging cycle. Morning headaches paired with loud snoring, dry mouth, or daytime sleepiness may indicate sleep apnea and should be discussed with a GP. Adults need 7–9 hours of uninterrupted sleep for optimal neurological health. Consistent bedtimes, avoiding late caffeine, and limiting evening alcohol support better sleep and fewer headaches.
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Eye Strain
Prolonged screen time causes eye strain and can lead to ‘digital headaches’ characterized by temple and forehead tightness, dry eyes, and blurred vision. To prevent this, follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds. Using warm compresses on closed eyes and adjusting screen brightness also helps. Persistent symptoms warrant an optometrist check, as updated prescriptions may ease discomfort.
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Sinus Disease and Nasal Obstruction
Inflamed sinuses from infection, allergies, or anatomical issues can cause frontal headaches that worsen when bending forward. Conditions like deviated septum or nasal polyps can obstruct airflow, trigger tension headaches, and disrupt sleep. Symptoms include nasal blockage, recurrent infections, reduced smell, and postnasal drip. Treat with saline nasal rinses, adequate hydration, and allergy management. For persistent or severe symptoms, consult your GP or an ENT specialist.
If you experience any of these symptoms or frequent headaches, discussing them with your GP is crucial to identify underlying causes and find effective treatments, improving your quality of life.