The term headache disorder encompasses a wide variety of nervous system conditions that cause painful symptoms in the head. Headache disorders include headaches and migraine. Most people experience a headache at one point in their lives.
Some people may have trouble differentiating between a migraine, which is a chronic condition, and a common headache.
Headaches cause pain in the head, face, or upper neck, and can vary in frequency and intensity.
A migraine is an extremely painful primary headache disorder.
Migraines usually produce symptoms that are more intense and debilitating than headaches.
Some types of migraines do not cause head pain, however.
There are many different types of headaches, which experts have classified into two main groups — primary and secondary.
Primary headaches refer to independent conditions that cause pain in the head, face, or neck. Examples of primary headaches include migraines and tension headaches.
Secondary headaches occur as the result of another medical condition, such as an infection, stress, or medication overuse.
Types of primary headaches include:
Tension-type headaches are common primary headache disorder that affect around 42 percent of adults worldwide.
Tension-type headaches feel like a band of intense pressure around the head.
Doctors classify tension-type headaches as episodic or chronic. Episodic tension-type headaches happen between 10 and 15 days per month. Chronic tension-type headaches occur more often and may cause soreness in the scalp.
Several factors can cause tension-type headaches. These can include:
- clenching the jaw
- depression or anxiety
- lack of sleep
- sleep apnea
- bending or straining the neck
- poor posture
Cluster headaches cause severe pain on one side of the head, often behind the eye. These headaches come in clusters, meaning multiple headaches occur around the same time every day for several weeks.
Cluster headaches occur in cycles of recurring headaches followed by periods without headaches.
According to the National Institutes of Health (NIH), cluster headaches usually last 6 to 12 weeks. Cluster headaches tend to affect males more often than females.
Symptoms of cluster headaches include:
- severe pain on one side of the head
- pain behind the eye
- red, watery eyes
- restlessness or agitation
- changes in heart rate
Hemicrania are persistent headaches that fluctuate in severity. These headaches usually affect the same side of the head. People can have daily, or chronic, hemicrania headaches.
Other people might experience periods of recurring headaches followed by headache-free periods.
Other symptoms of hemicrania headaches include:
- nausea and vomiting
- sensitivity to light and sound
- watery eyes
- redness or irritation of the eyes
- swollen eyelids
Secondary headache disorders
Illnesses and chronic medical conditions that affect the nervous system can cause secondary headaches.
Causes of secondary headaches include:
A migraine is a type of primary headache disorder that can cause severe pain and other symptoms. People with migraine may experience recurring symptoms that doctors call episodes or attacks.
Headaches are only one symptom of migraines, and they can range in severity. Migraine can cause intense, throbbing headaches that last anywhere from a few hours to several days.
A migraine headache usually affects one side of the head, but some people experience pain on both sides.
A migraine episode can occur in four distinct phases, though not everyone experiences every phase.
Doctors also call the premonitory phase the preheadache or prodrome phase. It includes nonpainful symptoms that occur hours or days before the headache arrives.
Premonitory phase symptoms can include:
- unexplainable mood changes
- food cravings
- stiffness of the neck
- frequent yawning
- constipation or diarrhea
- sensitivity to light, sound, or smells
Auras refer to sensory disturbances that occur before or during a migraine attack. Auras can affect a person’s vision, touch, or speech.
Visual auras can cause the following symptoms in one or both eyes:
- flashing lights
- zig-zagging lines
- blurred vision
- blind spots that expand over time
Sensory auras cause numbness or tingling that starts in the arm and radiates to the face.
Motor auras affect a person’s ability to communicate and think clearly. Motor auras include:
- slurred or jumbled speech
- difficulty understanding what others say
- difficulty writing words or sentences
- having trouble thinking clearly
Migraine headaches can range from mild to severe. People who have a severe migraine headache may need to seek emergency medical treatment.
Physical activity and exposure to light, sound, and smells worsen the pain. People can have migraine episodes without developing a headache, however.
The postdrome phase occurs after the headache subsides. People may feel exhausted, confused, or generally unwell during the postdrome phase.
This phase can last anywhere from a few hours or several days.
Types of migraines
Migraine falls into several different categories depending on the symptoms. Some examples of migraines include:
Migraine without aura
Common migraines, or migraines without auras, cause intense, throbbing headaches on one side of the head.
These headaches usually last between 4–72 hours. Migraines without auras do not produce symptoms before the onset of the migraine attack, but people with this type of migraine may have the premonitory symptoms described above.
Migraine with aura
According to the National Institute of Neurological Disorders and Stroke, about one in every three individuals with migraine reports experiencing an aura before the headache.
People who have migraine episodes with auras might not experience an aura every time. Headaches may or may not accompany auras.
According to the authors of a 2018 article, abdominal migraines usually affect children between the ages of 3 and 10 years old.
Abdominal migraines cause abdominal pain, nausea, and vomiting. People who have this type of migraine can develop a mild headache or no headache at all.
This rare type of migraine causes temporary paralysis before or during the headache. Other symptoms of hemiplegic migraines include:
- vertigo (dizziness)
- a piercing or stabbing sensation in the head
- vision problems
- difficulty speaking or swallowing
- trouble moving one side of the body
Risk factors for migraine
Researchers and doctors have identified several factors associated with higher risks of migraines. These include:
- being female
- having a family history of migraines
- mood disorders, such as depression, anxiety, or bipolar disorders
- sleep disorders
Effective treatments for headache disorders require timely and accurate diagnoses. Unfortunately, accurately diagnosing headache disorders presents a significant challenge for individuals and their doctors.
A doctor can diagnose headache disorders, including migraine, based on an individual’s symptoms and medical and family history.
They may refer a person to a neurologist, who specializes in nervous system disorders.
People with migraine or another headache disorder might notice that certain things trigger their symptoms.
Triggers vary from person to person, and they can include anything from environmental changes to specific foods.
Other migraine triggers may include:
- depression or anxiety
- hormonal changes
- lack of sleep
- alcohol consumption
While there is no cure for headaches or migraine, people can use medication and lifestyle changes to treat their symptoms and help prevent future episodes.
People can treat tension headaches and mild migraines with over-the-counter (OTC) medications. These include:
- Pain relievers. These can include acetaminophen and nonsteroidal anti-inflammatory medications (NSAIDs), such as aspirin and ibuprofen.
- Melatonin. A 2017 review cited findings from a number of randomized placebo-controlled trials that suggest melatonin may effectively prevent migraine and cluster headaches. The best dose may vary according to the condition, so a person should speak to a doctor about using this treatment.
Moderate to severe migraine symptoms may not respond to OTC treatments. In this case, people may require prescription medications, including:
- antinausea medicines, such as beta-blockers
- triptans, such as almotriptan (Axert) or sumatriptan/naproxen (Treximet)
- ergot alkaloids, such as ergotamine (Ergomar)
People can also use prescription medication to prevent future migraines. Examples of these medications include:
- antiseizure medications, such as topiramate (Topamax) or valproate (Depacon)
- botulinum toxin A (Botox) injections
People who treat their headaches with an OTC or prescription medication should remember to follow the dose a doctor or manufacturer recommends. Overusing medication can cause some people to develop a condition known as a medication-overuse headache.
Medication-overuse headaches occur when a person takes too much medication to treat a primary headache. As a result, they develop either a new type of headache or experience worse symptoms of their preexisting headache.
Some lifestyle factors may also help prevent migraine episodes and some types of headache. These include:
- exercising regularly
- making dietary changes that eliminate trigger foods
- using relaxation techniques, such as mindful breathing and mediation
- learning stress-management techniques
- keeping a migraine or headache journal to track patterns and uncover potential triggers
People should consider speaking with a healthcare provider if they experience frequent headaches that interfere with their ability to function or their quality of life.
People should also seek medical care if their headaches cause any of the following symptoms:
- vision problems
- tingling or numbness in the limbs, face, neck, or head
- difficulty speaking or understanding what other people say
- difficulty thinking
- difficulty moving one side of the body
Most people will experience a headache at one point in their lives. Not all headaches are the same, as they range in severity, frequency, and cause.
Headache disorders can significantly impact a person’s ability to function and reduce their overall quality of life. This is why accurate diagnoses are so important.
Correctly differentiating between headaches and types of migraine headache can lead to faster, more effective treatment.