Guide · Causes
Constant headaches? The 7 most common causes and how to find yours.
Headaches almost every day and no explanation? Usually one of seven causes is behind it, often several together. Here you can read how to narrow down your own and when an examination is needed.
Dr. med. dent. Bodo S. von GadomskiDentist · Founder of the CMD-Klinik
Contents · 9 questions
People with frequent headaches usually look for the one cause. In practice, there are often several that reinforce each other: little sleep, lots of screen time, stress, a tense neck and, in the end, the tablet that helps briefly. This article helps you sort out the factors.
When are headaches considered chronic?
In shortWhen they occur on 15 or more days a month for longer than three months. But it is worth taking a closer look even when they are much less frequent.
This threshold comes from the International Classification of Headache Disorders (ICHD-3). It helps doctors classify headaches. For you, the more important question is whether the headaches dominate your everyday life: whether you cancel appointments, take tablets regularly or expect a headache as soon as you wake up.
The most common forms are tension-type headache (pressing, on both sides, like a band around the head) and migraine (often throbbing and one-sided, with nausea and sensitivity to light and noise). Both can occur at the same time.
Which 7 causes are most often behind it?
In shortSleep, fluids, screen and posture, stress, too many painkillers, eyes or blood pressure – and the jaw system, which is checked least often.
- Too little or irregular sleepA disrupted sleep-wake rhythm is one of the strongest triggers. Sleeping in too long at the weekend can also cause headaches.
- Not drinking enoughEven mild dehydration can trigger a dull, constant headache, especially in hot weather, with exercise or lots of coffee.
- Screen and postureA head tilted forward for hours overloads the neck and the back of the head. The pain then often spreads from the neck to the front.
- Stress and muscle tensionUnder pressure, many people unconsciously tense their shoulders, neck and jaw. This is the classic route to tension-type headache.
- Too many painkillersIf painkillers are taken very often, they can themselves sustain headaches. More on this in the next question.
- Eyes and blood pressureUncorrected eyesight or outdated glasses can trigger headaches, as can high blood pressure. Both are easy to check.
- The jaw systemClenching, grinding or an unfavourable bite position can permanently overload the chewing and temple muscles. This is rarely checked in the usual work-up.
Other, rarer triggers are hormonal fluctuations, certain foods, alcohol, caffeine withdrawal and sinus infections. A headache diary helps you recognise your own patterns.
Can painkillers themselves cause headaches?
In shortYes. Taking headache medication very often can lead to what is known as medication-overuse headache. The headache then partly sustains itself.
As a guide: triptans or combination products on 10 or more days a month, simple painkillers such as ibuprofen or paracetamol on 15 or more days a month, for more than three months. What matters is the number of days on which you take them, not the number of tablets.
Please do not stop taking painkillers on your own if you have been taking them regularly for a long time. Withdrawal should be supervised by a doctor.
What role do screens, posture and eyes play?
In shortA big one. A head pushed forward loads the neck with many times its weight, and straining to see increases tension in the face.
- Screen at eye level, about an arm’s length away
- Stand up briefly every 30 to 45 minutes and look into the distance
- Have your glasses or contact lenses checked if your last check was more than two years ago
- Keep your teeth slightly apart while working, tongue resting on the roof of your mouth
If the headaches come mainly in the afternoon or after long days at the screen, that points to these causes. More on this in the article Neck pain and headaches together.
How is the jaw linked to headaches?
In shortThe large temple muscle is a chewing muscle. Clenching or grinding overloads it, and the pain is felt where many people have their headache: at the temple.
Then there is the trigeminal nerve. It is the main nerve for head and facial pain and also supplies the jaw joint and chewing muscles. In the brainstem, its signals converge with those from the upper neck. That is why jaw, neck and head can “pass” pain to one another.
For the head and face, this connection is well established. But it does not mean that every headache comes from the jaw. Typical of jaw involvement is the combination: headache in the morning, clicking or grinding, tender temples and a tense neck. The signs are described in detail in the article Recognising headaches from the jaw.
That neurology and imaging often find “nothing abnormal” is not an oversight. Their job is to rule out anything dangerous. Nobody in this work-up measures the bite, because it is not part of their specialty. Why this is →
How do I find my cause?
In shortWith a headache diary over four weeks. It shows patterns you cannot recognise from memory and is the best preparation for any appointment.
Each day, briefly note:
- Whether and when headaches occurred, and how severe on a scale of 0 to 10
- Where the pain is and what it feels like: pressing, throbbing, stabbing
- Which medication you took, and when
- Hours of sleep, fluid intake, coffee and alcohol
- Special strains: stress, long screen time, exercise, dental treatment
- Whether you woke up with a tense jaw or pressure at the temples
After four weeks, you can usually see whether the pain is tied to days of the week, times of day, sleep or medication. If you have eliminated the first six causes and still have headaches mainly in the morning, you should have your jaw system checked as well.
What helps quickly without masking the cause?
In shortDrinking, fresh air, warmth on neck and temples, consciously relaxing jaw and shoulders, and a break from the screen. This relieves but explains nothing.
- Drink a large glass of water
- Go outside for ten minutes
- Warmth on the neck or jaw muscles; for migraine, cold on the forehead or neck is usually better
- Keep your teeth apart, lips loosely closed, tongue on the roof of your mouth
- Consciously raise your shoulders three times and let them drop
You will find gentle exercises for jaw and neck in the article CMD exercises at home.
When do headaches need a doctor immediately?
In shortWith sudden, very severe headache, fever with a stiff neck, visual or speech disturbances or paralysis, and after a fall. Then every hour counts.
With these signs, call a doctor or emergency number 144 immediately: a headache like never before that peaks within seconds to minutes · fever with a stiff neck · paralysis, speech or visual disturbances, confusion · headache after a fall or blow to the head · a new headache from around the age of 50.
Also, if the pattern of your headaches changes significantly, if they increase despite treatment or wake you at night, have this checked by a doctor. This is not a formality but the point at which the order of steps matters.
Who is responsible for chronic headaches?
In shortFirst your GP, and neurology if needed. If the headaches persist despite treatment and there are jaw signs, the jaw system can be assessed in addition.
Your GP practice knows your whole history and rules out common causes such as blood pressure or medication overuse. Neurology classifies the headache and sets the therapy. A CMD assessment does not replace any of these steps; it complements them.
With us, this is done with the CMD Systems Check: among other things, it measures how hard your chewing muscles work and with what force your teeth meet. If nothing abnormal shows up, we tell you just as clearly. You take the first step in two minutes with the CMD self-test.
More questions, already answered
Sources
- International Classification of Headache Disorders, 3rd edition (ICHD-3): chronic headache, medication-overuse headache
- Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)
- Reviews on TMD and headache, as cited on our page for neurology
This article is for general information and does not replace a medical assessment. Only change your medication after consulting your doctor.
Does your headache come from the jaw system?
The self-test gives you an initial assessment. Or call us: +41 44 888 99 44