The Covid headache

Increasingly, among friends and family who have contracted Covid-19, the Omicron variant, in particular, I’m hearing of people experiencing what is being referred to as the ‘Covid headache’.

“A headache is a potential symptom of Covid-19,” medical writer Dr Jill Seladi-Schulman said in a 2020 article for Healthline, adding that research has found it occurred in 11 to 35 per cent of people hospitalised with Covid-19.

Pointing to data from the World Health Organisation, she added: “A WHO report that looked at over 55,000 confirmed cases of Covid-19 found that a headache was reported in 13.6 per cent of these cases.”

A recent article published by the National Institute of Neurological Disorders and Stroke suggested headaches are often among the many symptoms that can accompany infection from the coronavirus.

“Some people continue to have mild to serious headaches sometimes for weeks after recovery… The headaches may be infrequent or occur chronically,” the article said.

Writing for Medical News Today, South Africa-based freelance writer Caitlin Geng in her 2021 article, ‘Headache for days: What can cause it?’ says common diagnosis questions doctors often ask that help determine the “cause of a persistent headache” include:

  • When did the headache begin?
  • Where does the pain occur and how does it feel?
  • What medications is the person taking?
  • What are the other symptoms that the person may be experiencing?
  • Do the headaches occur at a certain time or after a certain activity?
  • Does the person have a family history of headache or other neurological conditions, such as migraine?

According to community pharmacist and master herbalist Gerald Quigley, while “we know that there are neurological issues associated with the current viral infection”, many of the reported headaches may be caused by “the stress of not getting over something, which we’ve been led to believe we can recover from quickly”.

“So, if you’re still feeling tired and lethargic, and you’re worried about your job and about all sorts of other things, of course, there’s the stress involved,” he said.

However, Mr Quigley adds that managing a Covid headache may be about “hydration, electrolyte replacement, fresh air, rest, minimal exposure to stress, and more exposure to things that make you happy”.

“And that hastens the recovery time,” he said, “along with a course of sensible sleep patterns and suitable nutrition. There’s no simple option. It’s a package of things.”

Regarding over-the-counter pain medication, Mr Quigley points to “paracetamol as the simplest way to start”.

However, he adds that he mostly recommends a “non-steroidal anti-inflammatory” for use over “a couple of days”.

Mr Quigley suggests taking magnesium as the “mineral of choice”, describing it as the “undertone or part of an electrolyte replacement strategy”. He also recommends adequate fluid intake across the day.

In terms of lifestyle factors associated with managing headaches, such as those that may be seen in Covid-19 infection, Mr Quigley says it’s important to keep to a regular routine, especially with sleep, and to consider other symptoms that may contribute to a so-called Covid headache.

“Everybody’s different and a lot of people probably blame ‘long Covid’, whereas it could be a sinus issue,” he said referring to Covid headache symptoms.

“We’ve had a lot of heat, and in some states across Australia, there’s been a lot of people sleeping in air-conditioning, which normally means you wake up with a sinus full of mucus that [may] cause a headache,” he said. “It really depends on the underlying cause.”

My Quigley says it’s important to “look at all the options” in these cases.

“Every individual needs to find what [solution] suits them,” he said, adding that this is a key message that a pharmacist should impart in this space – guiding customers towards a solution most helpful to them while health professionals continue learning more about the nuances of this ever-unfolding virus.

This feature was originally published in the April issue of Retail Pharmacy magazine:

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