Neurological conditions /

Headache and facial pain

Headache has been described as the most common medical complaint known to man. There are hundreds of different types of headache and facial pain disorders, including migraine and cluster headache. Due to their prevalence, these disorders are responsible for almost three quarters of neurological-related disability. New treatment approaches are desperately needed, but a lack of research investment has hampered progress. This is why we have made headache and facial pain a priority research area.

About headache

Headaches are extremely common. Nearly everyone has a headache occasionally. When they occur repeatedly, they are a symptom of a headache disorder. More than 20 million people in the UK are affected by a headache or facial pain disorder, two in five adults.

Headache disorders, characterised by recurrent headache, are the most common disorders of the nervous system. Due to their prevalence, they are responsible for almost three quarters of all neurological-related disability.

Primary headache disorders include migraine, tension-type headache and cluster headache. Headache can also be caused by - or occur secondarily to - other conditions, the most common of which is medication-overuse headache.

The different types of headache range in severity and frequency. Although the burden of the severe headache disorders such as cluster headache is huge on an individual level, the societal burden of this is quite small compared to the burden of migraine and tension-type headache.

Headaches are an unglamorous disability - the Cinderella of the medical profession, under-rated and often ignored.

- Stephen O'Brien MP, from 'Headache Disorders - Not Respected, Not Resourced. A Report of the All-Party Parliamentary Group on Primary Headache Disorders', 2010.

Tension-type headache

Tension-type headache is the most common type of headache, affecting around 13 million people in the UK. It is usually described as a pain that feels like a tight band around the head, or a weight on top of it.

People who experience tension-type headache may have chronic tension-type headaches - also known as 'common daily headache' - defined as having headache for more than four hours on more than 15 days per month.

Migraine

Migraine is a complex condition that affects more than 10 million people in the UK. It represents the leading cause of disability in the 15 to 49 age group and the second leading cause across all age groups.

Migraine has a variety of symptoms, of which a painful headache is the main feature for most people. Other symptoms include disturbed vision, sensitivity to light, sound and smells, nausea and vomiting. The symptoms vary from person to person, as do the length and frequency of attacks. There are a number of different types of migraine, which exhibit different symptoms.

Migraine is said to be the third most common disease in the world, behind dental caries and tension-type headache. It is more prevalent that diabetes, epilepsy and asthma combined.

Migraine affects three-times as many women as men, with this higher rate being most likely hormonally-driven.

Research suggests that 3,000 migraine attacks occur every day for each million of the general population. This equates to over 190,000 migraine attacks every day in the UK.

Read more: Migraine

Cluster headache

Cluster headache is a rare headache disorder characterised by recurring bouts of excruciating headaches on one side of the head. The pain is overwhelming, with cluster headache described as one of the most painful conditions known to man.

Most patients have 'episodic' cluster headache - with bouts (or 'clusters') of pain that last between 4 and 12 weeks once a year. They may then be headache-free until the following year. A small number of patients do not have these pain-free intervals and are said to have 'chronic' cluster headache.

Around 65,000 people in the UK suffer from cluster headache. But whilst rare, cluster headache is enormously debilitating. Those affected are rendered incapable of functioning normally or maintaining daily life during these bouts of headache.

Cluster headache is more common in men than women, by a ratio of around 6:1.

Read more: Cluster headache

Trigeminal neuralgia

Trigeminal neuralgia is an extremely severe facial pain that affects around 50,000 people in the UK. It tends to come and go unpredictably in sudden shock-like attacks, with pain described as stabbing, shooting, excruciating or burning. Like cluster headache, it is described as one of the worst pains known to man.

The pain is related to the trigeminal nerve, which runs from the brain to the side of the face. The pain can occur in a single burst that lasts for a matter of seconds, or in repetitive bursts that last for hours or even days. For most sufferers, the condition is progressive and will get worse over time.

Although there is no cure for trigeminal neuralgia, there are a number of treatments that can give relief, including anti-convulsant medications, neuroablation procedures, surgery and chronic pain rehabilitation programmes.

Our research into headache and facial pain

Headache and facial pain is one of Brain Research UK's three priority research areas.

This reflects a large unmet need, coupled with a lack of sufficient research investment from other sources.

We want to improve the outlook for people with headache and facial pain disorders by funding research that addresses the causes and mechanisms of headache and facial pain, and advances diagnosis and treatment of these disorders.

We are currently funding the following projects in this area: