Understanding Headache - the Basics

What Are Headaches?

Although painful and troublesome, most headaches are minor and can be easily treated with aspirin or another analgesic. But if they are severe, recur frequently, or are attended by other symptoms, you may need to take additional steps — and the first step is to see a doctor.

Headaches are categorized according to their underlying causes. Tension (muscle-contraction) headaches make up one common group. A second common category includes migraine and cluster headaches. A third group consists of headaches caused by sinus problems.

Tension headaches afflict almost everyone at one time or another. They bring on a dull, constant, non-throbbing pain that can make your head feel as if it's gripped in a tight band. The muscles of your neck may seem knotted, and certain areas on your head and neck may be sensitive to touch. The chief source of pain is tight muscles that irritate nerve endings in the head and neck. Tension headaches can be short-lived and infrequent or they can be enduring and chronic.

Migraines are the most debilitating of headaches. They can be completely incapacitating. For some people a warning sign — called an aura — comes just before a migraine attack. The aura may be visual disturbances such as flickering points of light, blind spots, or zigzag lines. More rarely it may come as numbness in a limb or the smell of a strange odor. Whether or not a warning occurs, a migraine will usually begin with an intense, throbbing pain on one side of the head. This pain may spread and is often accompanied by nausea and vomiting. A migraine can last from a few hours to many days and can cause oversensitivity to light, odors, and sound.

Cluster headaches are so named because they tend to come in bunches over one or several days. Typically they begin several hours after a person falls asleep. Sometimes a mild aching sensation on one side of the head warns that a cluster headache is coming. The pain is severe, non-throbbing, piercing and usually located in and around one red, watery eye. Nasal congestion and a flushed face usually accompany the pain. It lasts from 30 minutes to two hours, then diminishes or disappears altogether only to recur perhaps a day later. A barrage of four or more attacks may occur in the course of one day. Cluster headaches can strike every day for weeks or months before going into long periods of remission.

Sinus headaches come with pain in the forehead, nasal area, eyes, and sometimes the top of the head. In some cases they also produce a feeling of pressure behind the face. Swelling or infection of the membranes lining the sinus cavities is the usually cause. The headache pain may stem from suction on the sinus walls, which occurs when nasal congestion creates a partial vacuum in the sinuses.