pain management clinic singapore

What are the different types of headache?

The main types of headaches are:

  • Tension headaches – Tension headaches are characterised by pressure on the sides of the head.
  • Migraine headaches – Migraine headaches usually begin mild and then become more painful. Most of the time, they act on a single side of the head. They may lead to nausea or vomiting, or make you sensitive to light and sound.

What can I do to relieve my headache?

Here are some tips:

  • Rest in a cool, dark, silent room (this is most effective for migraine headaches)
  • Consume non-prescription pain medicines (but remember to ask your doctor before consuming any new medicines should you have a health condition or already take prescription medicines)

What can I do to stop getting headaches?

Some individuals discover that their headaches are caused by specific foods or habits. To prevent headaches, you can write journal entries about your headaches. In the diary, note down the times you had a headache and the details of every meal taken or any activity done prior to it starting. Through this, you can figure out what you should not eat or do in order to avoid triggering headaches

Some well-known causes of headaches are:

  • Inconsistent diets or insufficient food
  • Overconsumption or inadequate intake of caffeine
  • Excessive or inadequate sleep
  • Certain foods, such as red wine, aged cheese, and hot dogs

A number of women experience migraine headaches prior to getting their period. If this occurs to you, tell it to your doctor or nurse. They can prescribe suitable medicines.

Should I see a doctor?

Visit a doctor immediately if:

  • Your headache develops quickly, becomes serious within a short time, or could be described as “the most terrible headache of your life”
  • Your headache is severe and you also have a fever or stiff neck
  • You also have a seizure, personality changes or confusion, or you pass out
  • Your headache starts immediately after exercise or a minor injury
  • • You have not had headaches before and you also experience weakness, numbness, or difficulties with your vison (migraine headaches can sometimes lead these symptoms occur)

You should also consult a doctor if your headaches are frequent or serious.

Cluster Headaches

Cluster headache is rare (lifetime prevalence of 0.07%). Cluster headaches are characterized by recurrent severe headaches on one side of the head, typically around the eye. There is often accompanying eye watering, nasal congestion, or swelling around the eye on the affected side. These symptoms typically last 15 minutes to 3 hours. Attacks often occur in clusters which typically last for weeks or months and occasionally more than a year.

Smoking appears to increase the risk but there is conflicting evidence about the role of coffee and alcohol.

Diagnosis is entirely based on clinical features. There are no conclusive diagnostic tests or investigations available to confirm the diagnosis.

Cluster Headache Treatment

Treatment for cluster headache is divided into 2 primary categories: abortive and preventive

Preventive Cluster Headache treatments in Singapore are applied to lessen or put an end to cluster headache attacks; they are normally used together with abortive and transitional methods.


Verapamil, a calcium channel blocker, is the preferred first-line preventive therapy


There are few studies to justify the effectiveness of glucocorticoids in the long run, however they can be used until other medications take effect as they seem to work for three days. Normally, people stop using them after 8–10 days of treatment.


Nerve stimulators can be a choice for the minority of people who see no improvements with medications. Occipital nerve stimulation (ONS), may be useful. Prior studies indicate an improvement in nearly 60% of cases. This effect normally needs weeks or months to be seen.

cluster headache treatment

A number of surgical procedures, such as a sphenopalatine radiofrequency or pulsed radiofrequency are available but evidence to support them is limited and there are cases of people whose symptoms worsen after these procedures.

Abortive Treatment

There are two main treatment options for acute cluster headaches: oxygen and triptans. However, they are not used enough because the syndrome is often diagnosed wrongly. During episodes of headaches, people should steer clear of factors that trigger it such as alcohol, nitroglycerine and afternoon naps.


Oxygen therapy can be useful for people with CH, but it does not help stop the headaches from happening in the future. Normally it is provided at a rate of 12–15 liters per minute for 15–20 minutes. A review discovered that roughly 70% show improvements in 15 minutes. However, there is little supporting evidence for the effectiveness of 100% oxygen. Hyperbaric oxygen at twice higher pressures than atmospheric pressure can ease cluster headaches.


The other primarily recommended treatment of acute attacks is subcutaneous or intranasal sumatriptan. Sumatriptan and zolmitriptan have both been shown to improve symptoms during an attack with sumatriptan being superior. Because of the vasoconstrictive side-effect of triptans, they may be contraindicated in people with ischemic heart disease.