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Understanding Headache -- the Basics

What Are Headaches?

Although painful and troublesome, most headaches are minor and can be easily treated with aspirin or another pain reliever. (Do not use aspirin in anyone under age 19 because it may increase the risk for Reye's syndrome, a potentially fatal disease.) But if your headaches are severe, recur frequently, or are accompanied by other symptoms, you need to see a health care provider.

Headaches are categorized according to their underlying causes. Common types of headaches include:

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  • 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 thought to be 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. Many tension headaches are actually migraines.
  • Migraines are among 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. Cluster headaches are more common in men.
  • Sinus headaches come with pain in the forehead, nasal area, cheek, 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 usual cause. The headache pain may stem from suction on the sinus walls, which occurs when nasal congestion creates a partial vacuum in the sinuses. Sinus headaches are not common and they do not usually continue to recur after treatment. Most people who think they are having sinus headaches are actually suffering from migraines.

Tension headaches, cluster headaches, and sinus headaches can trigger a migraine headache, so it you have recurring headaches, you may actually be experiencing migraine headaches. See your health care provider to be evaluated.

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