Headaches are one of the most common forms of pain. For some people a headache may be a minor irritation once or twice a year, while others can suffer disabling pain on an almost daily basis. Headaches occur when pain-sensitive nerve endings around the scalp, in the blood vessels that surround the skull, in the lining around the brain, and in other areas around the head send impulses to the part of the brain that interprets pain signals from the rest of the body. Some headaches are related to tender spots in head, neck, and shoulder muscles.
Headaches can range in frequency and severity of pain. Some individuals may experience headaches once or twice a year, while others may experience headaches more than 15 days a month. Pain can range from mild to disabling and may be accompanied by symptoms such as nausea or increased sensitivity to noise or light, depending on the type of headache.
Types of Headaches
The International Classification of Headache Disorders, published by the International Headache Society, describes more than 150 types of primary and secondary headache disorders.
Primary Headaches
Primary headaches occur independently and are not caused by another medical condition. Migraine, cluster, and tension-type headache are the more familiar types of primary headache.
Migraine headaches—which affect about 12 percent of Americans—involve moderate to severe throbbing pain, often on one side of the head. During a migraine, people are sensitive to light and sound and may feel nauseated. Some people have visual disturbances before a migraine—like seeing zigzag lines or flashing lights, or temporarily losing their vision. Anxiety, stress, lack of food or sleep, exposure to light, or hormonal changes (in women) can trigger migraines. Genes that control the activity of some brain cells may play a role in causing migraines. Migraine headaches may last a day or more and can strike as often as several times a week or as rarely as once every few years.
Cluster headaches are a form of headache notable for their extreme pain and their pattern of occurring in "clusters," usually at the same time(s) of the day for several weeks. The headaches are accompanied by autonomic symptoms, and some people experience restlessness and agitation. A cluster headache begins with severe pain strictly on one side of the head, often behind or around one eye. In some people, it may be preceded by a migraine-like "aura." The pain usually peaks over the next 5 to 10 minutes, and then continues at that intensity for up to three hours before going away. Typical attacks may strike up to eight times a day and are relatively short-lived. On average, a cluster period lasts 6 to 12 weeks.
Tension headaches—the most common type of headache—are caused by tight muscles in the shoulders, neck, scalp, and jaw. They may be related to stress, depression, or anxiety and may occur more often in people who work too much, sleep too little, miss meals, or drink alcoholic beverages.
Secondary Headaches
Secondary headaches are symptoms of another health disorder that causes pain-sensitive nerve endings to be pressed on or pulled or pushed out of place. They may result from underlying conditions including fever, infection, medication overuse, stress or emotional conflict, high blood pressure, psychiatric disorders, head injury or trauma, stroke, tumors, and nerve disorders (particularly trigeminal neuralgia, a chronic pain condition that typically affects a major nerve on one side of the jaw or cheek).
Treatment for Headaches
Treatments for headaches may include conventional as well as complementary approaches. When headaches occur three or more times a month, preventive treatment is usually recommended as well.
Treatment may include:
- Over-the-counter medication to relieve symptoms.
- Prescription medication to manage pain or prevent attacks.
- Acupuncture.
- Biofeedback.
- Massage.
- Stress reduction/relaxation techniques.
- Spinal manipulation.
- Tai chi.
- Elimination of certain foods from the diet.
- Dietary supplements under the supervision of a physician.
When to See Your Doctor About a Headache
Not all headaches require medical attention. But some types of headache are signals of more serious disorders and call for prompt medical care. These include:
- Sudden, severe headache or sudden headache associated with a stiff neck
- Headaches associated with fever, convulsions, or accompanied by confusion or loss of consciousness
- Headaches following a blow to the head, or associated with pain in the eye or ear
- Persistent headache in a person who was previously headache free
- Recurring headache in children.