Headache
A headache is pain or discomfort anywhere in your head or face. Headache pain can be sharp, throbbing or a dull ache. A headache can be an isolated event that’s easily treated, or it can be a symptom of underlying medical conditions.
Common causes and symptoms of a headache
In order to determine the cause of a headache, we classify them as primary or secondary:
- A primary headache. The headache itself is the main health problem, but other factors may be triggers, such as muscle tension, exposure to certain foods, medicines, dehydration or hormone changes.
- A secondary headache. Related to an underlying health condition, such as a neck injury, brain tumor, eye problems or an infection in the jaw, teeth or sinus.
Headache symptoms can depend on the type, but typical symptoms include:
- Slow start of the headache.
- Pain on both sides of the head.
- Pain is dull or feels like a band or vice around the head.
- Pain may be in the back part of the head or neck.
- Pain is mild to moderate, but not severe.
When to see your primary care provider for a headache
You can treat most mild to moderate headaches with over-the-counter (OTC) pain relievers and stress management.
However, a headache can be a sign of a serious medical condition such as a brain tumor or a rupture of a weakened blood vessel (aneurysm), so you should call your provider right away if you have a severe headache, plus one or more of the following symptoms:
- Change in level of consciousness.
- Confusion.
- Convulsion.
- Double vision.
- Fever.
- Muscle weakness.
- Nausea.
- Shortness of breath.
- Stiff neck.
- Vomiting.
Common types of headaches
Your primary care provider can help.
Cluster headaches. Usually occur in a series that may last weeks or months. The most common symptoms of a cluster headache are:
- Severe pain on one side of the head, usually behind one eye.
- The eye that is affected may be red and watery, with a droopy lid and small pupil.
- Swelling of the eyelid.
- Runny nose or congestion.
- Swelling of the forehead.
Medication overuse headaches, or rebound headaches. Caused by regular, long-term use of medication to treat headaches such as migraines.
Migraine. In addition to serious pain, other symptoms can occur, including nausea and vomiting, lightheadedness, sensitivity to light (photophobia) and sound (phonophobia), and other visual symptoms. Migraines also have distinct phases, but not all people have each phase:
- Premonition or prodromal phase. A change in mood or behavior may occur hours or days before the headache.
- Aura phase. A group of visual, sensory or motor symptoms can precede the headache. Examples include vision changes, hallucinations, numbness, changes in speech and muscle weakness.
- Headache phase. This is the period during the actual headache with throbbing pain on one or both sides of the head. Sensitivity to light and motion are common, as are depression, fatigue and anxiety.
- Resolution phase. Pain lessens during this phase, but may be replaced with tiredness, irritability and trouble concentrating. Some people feel refreshed after an attack, others don’t.
Sinus headaches. Typically feels like you have an infection in the sinuses (sinusitis), with throbbing pain and pressure around your eyes, cheeks and forehead.
Tension headaches. The most common type of headache, usually due to stress and tight muscles. Tension headaches typically present with common symptoms, and don’t cause nausea, vomiting or sensitivity to light.
Thunderclap headaches. Named so because the severe pain strikes suddenly like a clap of thunder, peaking within 60 seconds. It can be a sign of life-threatening conditions, usually bleeding in and around the brain, so you should seek medical help immediately for a CT scan and other tests. Other signs and symptoms include:
- Altered mental state.
- Fever.
- Nausea or vomiting.
- Seizures.
Treating a tension headache
Tension headaches are the most common type of headache, and are divided into two main categories:
- Episodic tension headache. Can last from 30 minutes to a week, and occurs less than 15 days a month for at least three months. Frequent episodic tension headaches may become chronic.
- Chronic tension headache. Lasts for hours, may be continuous and occurs 15 or more days a month for at least three months.
Your primary care provider can develop a treatment plan to help you manage tension headaches. Your plan may include:
- Avoiding any triggers, such as certain foods and beverages, lack of sleep and fasting.
- Controlling your stress.
- Eating healthy.
- Exercising.
- Ice and/or heat. Apply heat or ice to sore muscles to ease a tension headache, and try taking a hot bath or shower.
- Resting in a quiet, dark environment.
- Taking medicines as recommended, including OTC pain medications.
Preventing and treating other types of headaches
The goal of your treatment plan will be to prevent or stop your headaches from occurring, which depends on the type of headache you have. To treat migraine and cluster headaches, your provider may recommend or prescribe medications such as:
- Abortive medicines. They act on certain receptors in nerves and blood vessels in the head to stop a headache in progress.
- Preventive medicines. Taken daily to stop a headache from starting.
- Rescue medicines. Includes OTC pain relievers.
Your plan will also include preventative steps you can easily incorporate into your lifestyle:
- Avoid triggers. Alcohol and some foods like chocolate and peanuts can cause a migraine. Treating sinus congestion can help prevent a sinus headache.
- Biofeedback training. Teaches you to control certain body responses that help reduce pain.
- Cognitive behavioral therapy. Talk therapy can help you learn to manage stress and may help reduce the frequency and severity of your headaches.
- Other relaxation techniques. Try deep breathing, yoga, meditation and progressive muscle relaxation.
- Manage your stress level.
- Perfect your posture. Good posture can help keep your muscles from tensing.
- Quit smoking.
References
MedlinePlus: National Library of Medicine. Headache (https://medlineplus.gov/headache.html)
National Institute of Neurological Disorders and Stroke (NINDS). Headache (https://www.ninds.nih.gov/health-information/disorders/headache)
National Headache Foundation. Cure headache, and to end its pain and suffering (https://headaches.org/)