They told you that headache is just a headache. That you should just buy paracetamol, drink it with cold water, lie down for a bit, and it will pass. Emeka and Nkechi, that advice can cost someone their life. Because your head does not have only one type of pain. Your head has many types. And while some of them are nothing serious, some of them are a warning. Today, I will teach you how to tell the difference.

First of all, What Is A Headache?

Now, headaches fall into two big families. Let me break it down.

The first family, we call primary headache. This is where the headache itself is the problem. Nothing serious is hiding behind it, the pain is just giving you wahala on its own.

The second family is secondary headache. Here, the headache is not the real problem. The headache is a messenger. Something else is wrong in your body, and it is sending pain to your head to report the matter.

It’s just like, if your car is making a loud kpong-kpong sound because the bonnet is loose and shaking, that is primary, the loose bonnet itself is the problem. You just tighten it, and you’re good to go. But if that same noise is happening because your engine has completely knocked, that is secondary, the noise is just a messenger announcing a heavy problem in your car. Your head can do the same thing. So the question is not just ‘how do I stop this pain,’ eh ehn, it is ‘what is this pain trying to tell me?’

Now let us talk about the regular headaches, the ones almost everybody has felt.

Number one, the most common of all: the tension-type headache. This is the Lagos-traffic of headaches, common, tiring, and caused by stress. It feels like someone has tied a rubber band or a rope around your head, and they’re squeezing on two sides. What can cause it? Stress, hunger, no water in your body, staring at your phone or laptop for too long, bad posture, no sleep. It is not dangerous, but it can spoil your whole day.

Number two: the migraine. Now this one is not just a ‘big headache,’ it is a different level entirely. A migraine likes to pick one side of your head and pound it, as if someone is using a pestle inside your skull. You know that thing you use to pound yam at home, kpom kpom kpom. It comes with extra trouble: sometimes vomiting, or you’ll just be feeling like you want to vomit but you won’t, you hate light and noise, you will just want to enter a dark room, lock the door, and tell everybody, abeg dey go, dey go. Some people even get a warning sign before it starts, you may see zigzag lights, or one side of your body may feel numb, you can’t feel anything there, and then the headache lands. A migraine can last hours; it can even last days.

Number three: the cluster headache. This one is rare, but it is very bad. The pain lands around one eye, very serious, and it comes in clusters, at the same time every day, for days or weeks, then it disappears. That eye turns red, water starts to come out, and you’ll be having runny nose on that same side. People who have it will tell you it is one of the most painful things a human being can feel.

Now, let us talk about those headaches that are not ordinary at all, at all.

These are the secondary ones, the messengers. If you see any of these signs, forget the chemist, forget agbo, forget ‘it will get better.’ Hospital. Right away.

One: the thunderclap. A headache that lands suddenly, as if someone hit your head with plank. The person will experience full pain in just seconds. People describe it as ‘the worst headache of my life.’ That kind of sudden, brutal headache may mean there is bleeding inside the brain. It is an emergency.

Two: headache plus fever plus a stiff neck. If your head is banging, you have a fever, and you cannot bend your neck to touch your chin to your chest, like this, because it is too stiff, sometimes comes with a rash, that may be meningitis, an infection wrapping around the brain. Rush to the hospital osiso.

Three: headache after a knock. If you hit your head, maybe during an accident, a fall, a fight, and later you start to vomit, feel sleepy, or get confused, blood may be gathering inside. Don’t say ‘I am okay.’ Go to the hospital.

Four: headache with stroke signs. If a headache comes with weakness on one side of the body, the mouth twisting to one side, you can’t talk clearly, or a sudden change in your vision, that can be a stroke. Remember the word FAST: Face drooping, Arm weakness, Speech difficulty, Time to rush for help. Don’t waste time.

Five: the new headache that will not go. A fresh headache that starts after the age of fifty, or one that gets worse every week, is worse in the early morning, wakes you from sleep, and comes with vomiting, that pattern needs a doctor and maybe a brain scan.

And six, Philomena, this one is for you especially: the painkiller you swallow every single day can be the very thing causing the headache. We call it a medication-overuse headache. You take it, the pain stops for a while, then it bounces back worse, so you take it again. It is a trap. If you are looking for painkiller more than two days every week, the drug has become part of the problem.

So, what should you do?

Number 1. Become a record-keeper about your own headache. Note when it comes, which side, how it feels, and what you ate or did not eat before it. That record can show your trigger very fast.

Number 2. The things that actually fix most ordinary headaches: drink water, many headaches are because of dehydration. Eat on time, don’t skip meals. Sleep well. Manage stress, try dey rest. Rest your eyes from screens, Nkechi, reduce TikTok! And if you squeeze your face to read like this, please go and check your eyes, you may need glasses. It’s not by God-forbid, go and check.

Number 3. Use painkillers correctly, to help you once in a while, not as breakfast every morning. If you need them almost every day, that is a sign to see a doctor and find the root cause, not to buy more painkillers.

Number 4. Because high blood pressure is mostly silent, go and check your blood pressure too. Don’t wait for a headache to tell you your blood pressure is high, because most of the time it will not say anything at all.

Let me also say this. If you’re pregnant and you have headache, serious headache that may come with swelling of the face or hands, or you can’t see well, that may be a sign of pre-eclampsia, a dangerous high blood pressure in pregnancy. Don’t manage it. See a doctor immediately.

So, If your head is headaching you and you don’t know which type it is, don’t sit there and be doing guess work. You can talk to a real doctor on AwaDoc…

Emeka, share this with your friend who swallows painkillers like sweets. Nkechi, send it to your friend who is suffering from migraines in silence. You may save a life today.