Headaches can be more complicated than most people realize. Different kinds can have their own set of symptoms, happen for unique reasons, and need different kinds of treatment.
Once you know the type of headache you have, you and your doctor can find the treatment that’s most likely to help and even try to prevent them.
What Are the Types of Headaches?
There are 150 different types of headaches. The most common ones are:
Tension-type headaches: They are the most common type of headache among adults and teens. They cause mild to moderate pain and come and go over time and usually have no other symptoms.
Migraine: This condition is accompanied by intense headaches. These headaches are often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually happen one to four times per month. Along with the pain, people have other symptoms, such as sensitivity to light, noise, or smells; nausea or vomiting; loss of appetite; and upset stomach or belly pain. When a child has a migraine, she may look pale, feel dizzy, and have blurry vision, fever, and an upset stomach.
A small percentage of children's migraines include digestive symptoms, like vomiting, that happen about once a month.
Cluster headaches: This type is intense and feels like a burning or piercing pain behind or around one eye, either throbbing or constant. It’s the least common but the most severe type of headache. The pain can be so bad that most people with cluster headaches can’t sit still and will often pace during an attack. On the side of the pain, the eyelid droops, the eye reddens, pupil gets smaller or the eye tears. The nostril on that side runs or stuffs
They’re called “cluster headaches” because they tend to happen in groups. You might get them one to three times per day during a cluster period, which may last 2 weeks to 3 months. Each headache attack last 15 mins to 3 hours and often wakens the patient from sleep. The headaches may disappear completely (go into "remission") for months or years, only to come back again. Cluster headaches affect men 3-4 times more often than women.
Sinus headaches: With these, you feel a deep and constant pain in your cheekbones, forehead, or bridge of your nose. They happen when cavities in your head, called sinuses, get inflamed. The pain usually comes along with other sinus symptoms, such as a runny nose, feeling of fullness in the ears, fever, and swelling in your face. A true sinus headache is from a sinus infection so the nasal discharge is yellow or green, unlike the clear discharge in cluster or migraine
Hormone headaches: Women can get headaches from changing hormone levels during their periods, pregnancy, and menopause. The hormone changes from birth control pills also trigger headaches in some women.
What Causes Headaches?
The pain you feel during a headache comes from a mix of signals between your brain, blood vessels, and nearby nerves. Specific nerves of the blood vessels and head muscles switch on and send pain signals to your brain. But it's not clear why these signals turn on in the first place.
People often get headaches because of:
Illness: such as an infection, cold, or fever. They’re also common with conditions like sinusitis (inflammation of the sinuses), a throat infection, or an ear infection. In some cases, the headaches may be the result of a blow to the head or rarely, a sign of a more serious medical problem.
Stress: Emotional stress and depression as well as alcohol use, skipping meals, changes in sleep patterns, and taking too much medication. Other causes include eyestrain and neck or back strain due to poor posture.
Your environment, including secondhand tobacco smoke, strong smells from household chemicals or perfumes, allergens, and certain foods. Stress, pollution, noise, lighting, and weather changes are other possible triggers.
Headaches, especially migraine headaches, tend to run in families. Most children and teens (90%) who have migraines have other family members who get them. When both parents have a history of migraines, there is a 70% chance that their child will also have them. If only one parent has a history of these headaches, the risk drops to 25%-50%.
Doctors don’t know exactly what causes migraines. A popular theory is that triggers cause unusual brain activity, which causes changes in the blood vessels there. Some forms of migraines are linked to genetic problems in certain parts of the brain.
Too much physical activity can also trigger a migraine in adults.
Getting a Diagnosis
Once you get your headaches diagnosed correctly, you can start the right treatment plan for your symptoms.
The first step is to talk to your doctor about your headaches. She’ll give you a physical exam and ask you about the symptoms you have and how often they happen. It’s important to be as complete as possible with these descriptions. Give your doctor a list of things that cause your headaches, make them worse, and what helps you feel better. You can track details in a headache diary to help your doctor diagnose your problem.
Most people don’t need special diagnostic tests. But sometimes, doctors suggest a CT scan or MRI to look for problems inside your brain that might cause your headaches. Skull X-rays are not helpful. An EEG (electroencephalogram) is also unnecessary unless you have passed out when you had a headache.
If your headache symptoms get worse or happen more often despite treatment, ask your doctor to refer you to a headache specialist. If you need more information, contact one of the organizations in the resource list for a list of member doctors in your state.
How Are Headaches Treated?
Your doctor may recommend different types of treatment to try. She also might recommend more testing or refer you to a headache specialist.
The treatment you need will depend on a lot of things, including the type of headache you get, how often, and its cause. Some people don’t need medical help at all. But those who do might get medications, counseling, stress management, and biofeedback. Your doctor will make a treatment plan to meet your specific needs.
What Happens After I Start Treatment?
Once you start a treatment program, keep track of how well it’s working. A headache diary can help you note any patterns or changes in how you feel. Know that it may take some time for you and your doctor to find the best treatment plan, so try to be patient. Be honest with her about what is and isn’t working for you.
Even though you’re getting treatment, you should still steer clear of the things you know can trigger your problem, like foods or smells. And it’s important to stick to healthy habits that will keep you feeling good, like regular exercise, enough sleep, and a healthy diet. Also, make your scheduled follow-up appointments so your doctor can see how you’re doing and make changes in the treatment program if you need them.