Headaches are common forms of pain that most people will experience at some point during their lives. Although they are usually not dangerous, some headaches may be a sign of a serious underlying condition. Here’s what you need to know about different types of headaches and available treatments.
Types of Common Headaches
A headache is a discomfort or pain in the head, face, or neck that can be described as a throbbing pressure, sharp, or dull ache. While some headaches develop gradually, others occur suddenly. They can last anywhere from a few minutes to several days.
There are over 150 types of headaches that differ significantly when it comes to the location, frequency, and intensity of the pain. The most common forms include:
- Tension headache
- Cluster headache
- Migraine headache
- Hemicrania continua
- Ice pick headache
- Thunderclap headache
- Allergy or sinus headache
- Hormone headache
- Caffeine headache
- Exertion headache
- Hypertension headache
- Rebound headache
- Post-traumatic headache
- Spinal headache.
The Most Common Primary Headaches
Primary headaches are caused by overactivity or dysfunction of pain-sensitive structures in the head, such as the skin, muscles, blood vessels in the head and neck, and cranial nerves. They can occur occasionally (episodic) or be more consistent (chronic), in which case they require the development of a pain management plan.
Although primary headaches are in most cases not dangerous and don’t signal an underlying condition, they can still be very painful and disruptive to your day-to-day life.
Tension headaches are the most common type of primary headaches, usually triggered by stress and muscle tension. If you have a tension headache, you may feel a dull, aching sensation, similar to feeling a tight band around your head. Other symptoms may include tenderness or sensitivity around your forehead, scalp, neck and shoulder muscles.
To relieve a tension-type headache, you can try resting in a quiet room, applying ice packs, and doing relaxation exercises. If your tension headache is chronic, your healthcare provider may prescribe medications to reduce the frequency and severity of attacks.
Cluster headaches are marked by severe burning and piercing pain around or behind one eye or on one side of the face. Pain is experienced in clusters and occurs several times a day. It may be accompanied by swelling, redness, nasal congestion, and eye tearing on the side that is affected by the headache.
Cluster headaches are extremely rare and usually affect men in their 30s and 40s. They may be triggered by alcohol, smoking, exertion, as well as certain foods.
To help you relieve the intense pain of a cluster headache, your doctor may prescribe high-dose oxygen therapy or a nasal spray called sumatriptan. Medicines such as verapamil, prednisone, and lithium carbonate can help prevent recurrent attacks associated with this type of headache.
A migraine is an intense headache, typically accompanied by symptoms such as sensitivity to light and sound, fatigue, nausea, and vomiting. A migraine can last anywhere from a few hours to several days and can significantly limit your ability to carry out your daily tasks.
Common migraine triggers include physical, dietary, and environmental factors, such as sleep disruption, dehydration, certain foods, hormone fluctuations, and exposure to chemicals.
You can keep migraine symptoms at bay by staying hydrated, taking over-the-counter painkillers or supplements (riboflavin, coenzyme Q10, melatonin, butterbur, and feverfew), doing relaxation exercises, and undergoing cognitive behavioral therapy. Prescription drugs such as sumatriptan and rizatriptan are also successfully used to treat migraines.
Hemicrania continua (derived from Latin words for “one side of the head” and “continuous”) is a form of headache characterized by persistent pain on one side of the face and head. You may also experience symptoms such as nasal congestion, eye pain, eyelid drooping, restlessness, nausea, and sensitivity to light.
Hemicrania continua may occur at any age, but is most common in adult women. This type of headache is not triggered by environmental or lifestyle factors, and there’s no effective way to prevent them. The standard treatment consists of taking a nonsteroidal anti-inflammatory drug (NSAID) called indomethacin, which helps reduce pain by blocking an enzyme in your body that leads to inflammation.
Ice pick headache
Ice pick or primary stabbing headaches are some of the most severe headaches that cause a sudden, sharp, stabbing pain on the top, front, or sides of the head. They occur unexpectedly and last only for a few seconds.
Ice pick headaches are usually not a reason for concern. However, if they are frequent and always affect the same spot, they may be a symptom of an underlying condition, such as shingles, meningioma, or multiple sclerosis.
Ice pick headaches are so brief that there is no time to take medication. If you’re prone to frequent attacks, your doctor may prescribe indomethacin, melatonin, or gabapentin, a drug used to treat nerve pain.
Thunderclap headaches are extremely severe and happen very quickly, reaching peak intensity within 60 seconds. Other than splitting pain in the head and neck, symptoms may include weakness, numbness, slurred speech, nausea, seizures, and confusion.
Because thunderclap headaches could indicate a potentially life-threatening condition, such as stroke or brain injury, they require immediate medical attention. Treatments may include medications that control blood pressure and surgery. If no urgent underlying cause is found, your healthcare provider will prescribe a non-steroidal anti-inflammatory medication to manage the pain.
The best way to prevent thunderclap headaches is to avoid known triggers, maintain a healthy diet and active lifestyle, quit smoking, and control cholesterol levels to reduce the risk of blood vessel problems.
The Most Common Secondary Headaches
Secondary headaches are rare, occurring in about 18% of patients with head pain. Unlike primary headaches, they are often a symptom of an underlying medical condition.
Allergy or sinus headache
Allergies and sinus infections can cause headaches. You may feel a constant dull ache behind the eyes or in your cheekbones, forehead, or bridge of the nose. This form of headache is often accompanied by other symptoms, such as fever, stuffy nose, and swollen face.
To ease the pain, you may apply a warm compress to painful areas of the face or use a saline nasal spray to thin mucus. Over-the-counter pain medication such as Tylenol or Advil can also provide short-term relief.
If you suffer from allergies, your doctor may recommend prescription or nonprescription medications such as antihistamines, decongestants, and corticosteroids to treat your symptoms.
Hormone headaches, also known as menstrual migraines, are caused by changes in the hormone levels in the body. They typically occur right before, during, or right after the period, as well as during ovulation. Hormonal headaches may be accompanied by nausea and vomiting, appetite loss, sensitivity to light, stomach pain, dizziness, and blurry vision.
The treatment of hormone headaches depends on the severity of the pain. It may include over-the-counter nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen or switching to birth control that contains low amounts of estrogen. Healthy lifestyle changes, including a regular sleep schedule, exercising, and stress management, may help prevent this type of headache.
When you suddenly stop consuming caffeine, you may get a caffeine headache, typically described as a throbbing pain on the sides of your head. It sometimes occurs along with other symptoms, such as nausea, anxiety, irritability, and general malaise. Caffeine headaches may also be caused by excessive or prolonged intake of coffee.
If you experience headaches after drinking coffee, you may want to consider cutting back on your caffeine intake or eliminating it completely. Over-the-counter pain relievers including ibuprofen, acetaminophen, and aspirin can also help relieve your symptoms.
An exertion or exercise headache is a throbbing pain on both sides of your head that you may experience during or after intense physical activity, such as running or weightlifting. Exertion headaches appear suddenly and go away in a few hours, although in some cases they can last for several days.
Exercise-induced headaches are treated with over-the-counter or prescription NSAIDs. The best way to prevent them is to avoid triggering activities, drink plenty of fluids, and warm up and cool down properly. Supplements such as coenzyme Q10, feverfew, magnesium, and vitamin B2 can help prevent exertion headaches.
Hypertension headaches are caused by high blood pressure. People who suffer from hypertension headaches feel constant throbbing pain on both sides of their head and may experience temporary loss of vision, in addition to feeling sick, sleepy, and irritable. The pain feels worse in the mornings, when coughing or sneezing, and during physical activity.
A hypertension headache may be an indication of a sudden, severe increase in blood pressure known as a hypertensive crisis, and is considered a medical emergency. You should seek immediate medical attention if you experience a severe headache combined with high blood pressure (over 180/120 mm Hg).
Medical professionals may administer intravenous medications to gradually lower your blood pressure and monitor you to ensure there is no organ damage. Regularly taking your blood pressure is key to preventing these potentially life-threatening headaches, in particular if you suffer from hypertension.
A rebound headache, also called medication overuse headache, may feel like a dull, tension headache, but it can also be very painful, similar to a migraine. Rebound headaches are caused by the excessive use of pain-relieving or antimigraine drugs, especially the ones that contain caffeine.
If you are suffering from migraines, talk to your doctor about the best way to use a combination of medications in order to avoid the rebound headache. Usually, the pain will subside as soon as you start taking lower doses or stop taking the medicine altogether. It is also important to exercise caution when combining caffeinated drinks with medications that contain caffeine.
Post-traumatic headaches develop in the first few weeks after a head injury. They can feel like a migraine or tension headache. Head pain is sometimes accompanied by nausea and vomiting, dizziness, insomnia, trouble concentrating, memory problems, light and sound sensitivities, or mood changes.
Post-traumatic headaches can last for months and even years following the injury. If your headache continues for more than three months, it is considered chronic.
The common way to treat post-traumatic headaches is by taking anti-inflammatory drugs, such as aspirin, ibuprofen, or naproxen, as well as pain or migraine medication. Headache symptoms can also be relieved through physical therapy, nerve stimulation, and cognitive behavioral therapy.
Spinal headaches are caused by low cerebrospinal fluid pressure that results from a lumbar puncture. This procedure is used to diagnose illness and deliver anesthesia, for example, an epidural during childbirth. If you have a spinal headache, you may feel pain in your forehead, temples, upper neck, or the back of your head, coupled with nausea, neck pain, dizziness, tinnitus, and radiating pain in the arms.
To manage a spinal headache, you should lie down, drink plenty of fluids (including caffeinated drinks), and take over-the-counter painkillers like ibuprofen. If these measures are not effective and if your headache lasts more than a few days, your doctor may recommend an epidural blood patch, a procedure where a small amount of your blood is injected over the puncture site, where it will form a clot to seal the hole.
When to Visit and Urgent Care
Most episodic headaches go away on their own within a couple of days. However, if you experience a headache that lasts longer or increases in intensity, you should get some medical help. Some headaches may be a symptom of serious health conditions and require treatment beyond over-the-counter painkillers.
When to seek immediate medical attention
You should seek immediate medical help if you experience a sudden, new, or severe headache, if the pain occurs right after a head injury, or if you have any of the following accompanying symptoms:
- Shortness of breath
- Stiff neck
- Weakness or dizziness
- Numbness or tingling
- Slurred speech
- Fever of 100.4 °F or higher
- Paralysis in any part of your body
- Blurry vision or visual loss
- Mental confusion
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