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Types of Headaches and Their Causes

Reviewed by Jennifer Robinson, MD on August 18, 2019

They’re annoying, even painful, but most headaches aren't dangerous and are easy to treat with a basic pain reliever.

If your headaches are severe, happen a lot, or come with other symptoms, talk to your doctor about what kind of headache you might have. Together, you can choose the right treatment and maybe prevent them.

Primary Headache

This means the headache itself is the main medical condition. This includes:

  • Migraines
  • Tension-type headaches
  • Cluster headaches
  • New daily persistent headaches

It’s probably a primary headache if:

  • You’ve had it for many months or years.
  • Your family has a history of similar headaches.
  • You don’t have any other health problems.
  • It’s triggered by
    • Hormones
    • Weather
    • Foods
    • Lights, sounds, or smells

Migraine Headaches

Migraine headaches are some of the hardest types of headaches to live with. They usually begin with an intense, throbbing pain on one side of the head, which may spread. They also often cause nausea and vomiting. A migraine can last a few hours to many days and can make people sensitive to lights, smells, and sounds.

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For some people, a warning sign called an aura comes just before a migraine attack. It can be a set of visual symptoms, like seeing flickering lights, blind spots, or zigzag lines, or other signs like numbness in a limb or a strange smell.

Doctors aren’t sure what causes migraine headaches. Most experts believe that they begin in the nervous system. Because migraines often run in families, it seems likely that genes play a role, too.

For people who have migraines, many things can bring on an attack. Common triggers include:

  • Alcohol
  • Caffeine
  • Certain foods or smells
  • Dry winds
  • Changes in altitude or seasons
  • Changes in hormones such as with menstruation
  • Birth control pills
  • Missing a meal
  • Changes in sleep patterns
  • Neck pain
  • Stuffy rooms
  • Stress or tension

Migraines may follow intense emotions such as excitement or anger. Exercise, sex, other types of headaches, or very cold foods can also start a migraine.

Tension-Type Headaches

Almost everyone gets these from time to time. They bring a dull, constant, non-throbbing pain that can make you feel as if your head is wrapped in a tight band. You'll usually feel pain on both sides of your head or neck, not just on one side.

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Triggers can include:

Your neck muscles may seem knotted, and parts of your head and neck may be sensitive to touch.

These headaches aren't typically made worse by physical activity, light, smells, or sounds. And they usually don't come with nausea and vomiting.

Tension-type headaches can be short-lived and happen rarely, or they can last a while and come back often. They’re "episodic" if you get them fewer than 15 days a month. They're "chronic" if you get them more often than that.

Cluster Headaches

 

These got their name because they tend to come in bunches over weeks. An average cluster can go on for 6 to 12 weeks. Typically, they start hours after you fall asleep. Sometimes, a mild ache will warn you that a cluster headache is coming.

The pain is only on one side of your head. It’s often near or around your eye. It is severe and piercing, and it peaks within minutes. Your eye on the affected side becomes red and watery. And you often have nasal congestion with a runny nose on that side.

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This headache lasts 15 minutes to 3 hours and then fades or disappears, only to come back a day or so later. Some people can have eight or more attacks in a day.

Cluster headaches can strike every day for weeks or months and then stay away for a long time. They’re more common in men and tend to start between ages 25 and 50. Heavy smokers get them more often than nonsmokers. Stress, drinking alcohol, and eating certain foods play a role in triggering the headaches for some people, but doctors don’t know the root cause of them.

New Daily Persistent Headache

These may start suddenly and can go on for 3 months or longer. Many people clearly remember the day their pain began.

Doctors aren't sure why this type of headache happens . Some people find that it strikes after an infection, flu-like illness, surgery, or stressful event.

The pain tends to be moderate, but for some people, it's severe. And it's often hard to treat.

Symptoms can vary widely. Some are like tension headaches. Others share symptoms of migraine, such as nausea or sensitivity to light.

Hemicrania Continua

This ongoing headache almost always affects the same side of your face. It usually responds to the pain medication indomethacin.

Your doctor may diagnose hemicrania continua if you have head pain continuously for at least 3 months, and it doesn’t shift sides or go away. It's usually moderate but can get better or worse, at times turning into brief, piercing pain.

There are two types:

  • Chronic. You have daily headaches.
  • Remitting. You have headaches for 6 months. They go away for weeks or months and come back.

You may notice:

  • Worse pain with alcohol or physical activity
  • Red or teary eyes
  • Runny or stuffy nose
  • Droopy eyelid
  • Narrow iris

Some people also have migraine symptoms like:

  • Nausea and vomiting
  • Sensitivity to light and sound

Secondary Headache

This type of headache is caused by another medical condition. In other words, the headache is a symptom of something else. Conditions that can cause it include:

  • High blood pressure
  • Infections
  • Injury
  • Blood vessel problems

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It may be a secondary headache if:

  • It’s the worst headache you’ve ever had.
  • It’s the first headache you’ve ever had.
  • It came on quickly, with no warning.
  • The pattern changes.
  • It started before you were 5 years old or after you were 50.
  • You have cancer or HIV.
  • You’re pregnant.
  • You have an underlying health condition.
  • The headache causes fainting or seizures.
  • You get the headache after you exercise, have sex, or squeeze your body.

They're not all alike. See which of these common types of secondary headache sounds like yours.

Rebound or Medication Overuse Headache

If you take headache medicine too often, it can backfire. Your pain can come on stronger and more often. Doctors call this a "rebound" or "medication overuse" headache.

You'll need to work with your doctor to find the right treatment. Often, you just have to cut back on the medicine you take.

Sinus Headaches

Sinus headaches come with pain in the forehead, nose, cheeks, eyes, and sometimes the top of the head. In some cases, they also make you feel pressure behind your face. Nasal congestion and blockage from seasonal allergies or an infection that leads to sinus congestion is the main cause.

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If you bend down or lean over, the pain can get worse. Cold and damp weather can make it hurt more, too.

Sinus headaches aren't common. After you treat one, it doesn't usually come back. Many people who think they're having sinus headaches actually have migraines.

Posttraumatic Headache

This usually starts 2 or 3 days after a head injury. You’ll feel:

  • A dull ache that gets worse from time to time
  • Vertigo
  • Lightheadedness
  • Trouble concentrating
  • Memory problems
  • Tiring quickly
  • Irritability

Headaches may last a few months. But if it doesn’t get better within a couple of weeks, call your doctor.

Thunderclap Headache

People often call this the worst headache of their life. It comes suddenly, lasts about 5 minutes, and goes away. Causes of this type of headache include:

  • Blood vessel tear, rupture, or blockage
  • Head injury
  • Hemorrhagic stroke from a ruptured blood vessel in your brain
  • Ischemic stroke from a blocked blood vessel in your brain due to a blood clot or plaque
  • Narrowed blood vessels surrounding the brain
  • Inflamed blood vessels
  • Blood pressure changes in late pregnancy

Take a sudden new headache seriously. It’s often the only warning sign of a serious problem.

WebMD Medical Reference

Sources

SOURCES:

Buchholz, D. Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain, Workman Publishing Company, 2002.

Livingstone, I. Breaking the Headache Cycle: A Proven Program for Treating and Preventing Recurring Headaches, Novak Owl Books, 2004.

Smith T. Drugs, 2004.

Young, W. Migraine and Other Headaches, Demos Medical Publishing, 2004.

Cady R. Mayo Clinic Proceedings, July 2005.

Cleveland Clinic: "Migraine Headaches," "Tension Headaches,” "Rebound Headaches," "What Are Tension-Type Headaches?"

Johns Hopkins Medicine: "Rebound Headaches,” "Chronic Daily Headache."

Merck Manual: "Tension-Type Headache."

Seminars in Neurology: "Diagnosis and Management of Chronic Daily Headache."

University of Maryland Medical System: "Sinus Headache."

American Migraine Foundation: "Tension-type Headache,” “Cluster Headache,” “Secondary Headaches,” “Thunderclap Headaches.”

National Center for Complementary and Integrative Health: “Headaches: In Depth.”

UpToDate: “Patient education: Headache causes and diagnosis in adults (Beyond the Basics).”

Mayo Clinic: “Chronic daily headaches.”

National Institutes of Health: Patient Education Institute's "Migraine Headaches."

National Institute of Neurological Disorders and Stroke: "NINDS Hemicrania Continua Information Page."

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