Headaches are a common health problem — most people experience them at some time.
Factors that lead to headaches may be:
- emotional, such as stress, depression, or anxiety
- medical, such as migraine or high blood pressure
- physical, such as an injury
- environmental, such as the weather
Frequent or severe headaches can affect a person’s quality of life. Knowing how to recognize the cause of a headache can help a person take appropriate action.
A headache can affect any part of the head, and pain may be present in one or several locations.
Headaches can cause various types of pain, and classifying the pain can help a doctor reach a diagnosis.
Doctors also categorize headaches based on whether an underlying health condition is responsible for the pain. In other words, a headache may be primary or secondary, the International Headache Society note.
A primary headache is not a symptom of an underlying illness. Instead, these headaches result from problems involving the structures of the head and neck.
A primary headache may be due to overactivity of:
- specific areas of the brain
- blood vessels
- brain chemicals
Common types of primary headaches include cluster and tension headaches.
Also, headaches can result from using medication for the pain too often. In this case, a person has a medication overuse headache, and this is another type of primary headache.
These are symptoms of underlying medical conditions. The cause of a secondary headache may be:
- systemic conditions, such as an infection
- giant cell arteritis
- a stroke
- a brain tumor
Secondary headaches can result from serious health issues. It is important to seek medical advice if any headache:
- is severe or disruptive
- is persistent
- occurs regularly
- does not improve with medication
- occurs alongside other symptoms, such as confusion, a fever, sensory changes, or stiffness in the neck
Some of the various kinds of headache include:
This is a common form of primary headache. The pain usually arises gradually, in the middle of the day.
A person may feel:
- as if they have a tight band around their head
- a constant, dull ache on both sides of the head
- pain spreading to or from the neck
Tension-type headaches may be:
Episodic: These attacks usually last for a few hours, though they can last for several days.
Chronic: This involves tension-type headaches occurring on 15 or more days per month for at least 3 months.
A migraine headache may involve pulsating, throbbing pain. It often occurs on one side of the head but may switch sides.
During an episode, a person may also experience:
- sensory disturbances, such as changes in vision, known as an aura
- sensitivity to light or sound
- nausea, possibly with vomiting
Migraine headaches are the second most common form of primary headache. They can significantly impact the quality of life.
A migraine episode may last from a few hours to 2–3 days. The frequency of episodes can vary greatly; they may occur from once a week to once a year.
Medication overuse headache
This was once known as a rebound headache. It occurs if a person uses medication to treat headaches too often.
Medication overuse headaches tend to result from taking opiate-based medications, such as those that contain codeine or morphine.
Beyond the headache, a person may experience:
- neck pain
- a feeling of nasal congestion
- reduced sleep quality
Symptoms can vary, and the pain may change from day to day.
According to The Migraine Trust, a charity organization based in the United Kingdom, people with migraine often develop medication overuse headaches. These can cause migraine episodes to occur more frequently and become more severe.
These headaches usually last between 15 minutes and 3 hours, and they may occur one to eight times per day.
Cluster headaches may arise frequently for 4–12 weeks, then disappear. They tend to happen at around the same time each day.
Between the clusters, the person may have no symptoms. These remission periods may last months or years.
Cluster headaches often involve:
- brief but severe pain
- pain around one eye
- tearing or redness in the eye
- a drooping eyelid
- a blocked or runny nose
- a smaller pupil in one eye
- facial sweating
These are sudden, severe headaches that people often describe as the “worst headache of my life.” They reach maximum intensity in under 1 minute and last longer than 5 minutes.
A thunderclap headache is a secondary headache that can indicate a life-threatening condition, such as:
- an aneurysm
- reversible cerebral vasoconstriction syndrome
- pituitary apoplexy
- bleeding in the brain
- a blood clot in the brain
People who experience these sudden, severe headaches should receive immediate medical care.
Rest and pain relief medication are the main treatments for headaches.
- over-the-counter pain relief medications, such as nonsteroidal anti-inflammatory drugs
- prescription pain relief medications
- preventive medication for specific conditions, such as migraine
- other treatments for underlying conditions
To prevent medication overuse headaches, it is crucial to follow a doctor’s guidance.
Treating medication overuse headaches involves reducing or stopping the medication. A doctor can help develop a plan to ease off the medication safely. In extreme cases, a person may need a short hospital stay to manage withdrawal safely and effectively.
Several alternative — now known as integrative — forms of headache treatment are available, but it is important to consult a doctor before making any major changes or beginning any new treatments.
Some of these approaches include:
- cognitive behavioral therapy
- herbal and nutritional health products
Research has not shown that all of these methods work, however.
Some evidence has suggested that migraine episodes may be more likely to occur when a person has low levels of magnesium and vitamin D. While the evidence is not conclusive, a person may find that taking 400–500 milligrams of magnesium oxide per day helps prevent episodes.
Nutrient deficiencies may result from the quality of a person’s diet, malabsorption issues, or other medical conditions.
Certain care strategies can help prevent headaches or ease the pain. A person could:
- Use a heat or ice pack against the head or neck, but avoid extreme temperatures, and never apply ice directly to the skin.
- Avoid stressors whenever possible, and use healthful coping strategies for unavoidable stress.
- Eat regular meals, taking care to maintain stable blood sugar levels.
- Get enough sleep, by following a regular routine and keeping the bedroom cool, dark, and quiet.
- Exercise regularly to boost overall health and lower stress.
- Limit alcohol intake and drink plenty of water.
- Take breaks when working to stretch and prevent eye strain.
The characteristics of a headache — and the effects on daily life — can vary. A headache may:
- affect one or both sides of the head
- radiate from a central point
- involve sharp, throbbing, or dull pain
- have a vise-like quality
- come on gradually or suddenly
- last from under an hour to several days
The features of the pain depend, to some extent, on the type of headache.
A doctor can usually diagnose a type of headache after asking the person about:
- their symptoms
- the type of pain
- the timing and pattern of attacks
In some cases, the doctor may perform or request tests to rule out more serious causes of head pain. The tests may involve blood samples or imaging, such as a CT or MRI scan.