In this article, we will learn everything about headaches such as their causes, symptoms, types, tests, diagnosis, treatment, prevention, etc.
The term “headache” covers a broad spectrum of conditions that affect many aspects of your life. It refers to the pain you experience in your head or upper neck, but it can encompass prolonged fatigue, mood change, feeling sick, or irritability. With each of these different symptoms, there are several different types and causes of headaches that your doctor might help to diagnose.
Suffering from a headache is one of the most common medical complaints, with approximately 50 to 75 percent of all adults experiencing at least one headache in the past year.
Sometimes, headaches can be difficult to describe, but some common symptoms include squeezing, throbbing, unrelenting, constant, or intermittent. Its location may be in one part of the head or may be generalized involving the whole head.
Headache is a major reason for absenteeism from school and work. Continually battling headaches can cause some people to feel anxious and depressed.
Fortunately, there are many ways to treat headaches with or without medications.
What Are The Causes of Headaches?
During a headache, the pain you feel comes from a mix of signals between your brain, nearby nerves, and blood vessels. Particular nerves in your head muscles and blood vessels switch on and send pain signals to your brain. But the exact process of how these signals get turned on in the first place isn’t clear yet.
There are many possible causes of headaches. Some of the common causes are:
Headaches such as migraine headaches tend to run in families. Most children and teens, with migraines, have other family members who get migraines.
When both the parents have a history of migraine headaches, then the child has a 70 percent chance of having it. Whereas, when one parent has a migraine headache, the risk of the child reduces by 25 to 50 percent.
Surroundings and Environment
Weather changes, lighting, noise, pollution, certain foods, allergens, strong smells of perfumes or certain household chemicals, and second-hand tobacco smoke are probable triggers of headaches.
Taking too many medicines, changes in sleep patterns, skipping meals, alcohol consumption, neck strain due to poor posture, depression, and emotional stress can cause headaches.
Headaches are also common with certain conditions like ear infections, throat infections, sinusitis, fevers, colds, etc. It may also result from a blow to the head. In rare cases, headache may be a sign of a serious health problem.
What Are The Types of Headaches?
It is not surprising that there are more than 150 types of headaches. And they fall into 2 major categories: primary headache and secondary headache.
Primary headaches are the most common headaches that lead people to get medical treatment.
A primary headache isn’t due to another medical condition, i.e. it is a disease on its own and isn‘t a symptom of any other disease. Thus it is called a primary headache because it is the main concern.
Stress and disruptions in sleep patterns can also cause primary headaches.
Some Common Types of Primary Headaches:
1) Tension-type headache (TTH) or Tension Headache
Tension headaches are the most common type of headache, which affects about three-fourths of the general population (1). The pain can be mild and short-lasting, or severe and long-lasting. They are usually not serious.
Over the years, tension headache has also been called by various other names, including stress headache, muscle contraction headache, essential headache, psychomyogenic headache, idiopathic headache, ordinary headache, and psychogenic headache (1).
Previously, a tension-type headache was called muscle contraction headache, as it is linked to the muscles of the face, jaw, and neck.
If you have a tension headache, you may feel like your head is being squeezed or your temples are being pressed together. You might also feel tenderness in the scalp, neck, and shoulder muscles.
Tension headaches usually begin gradually and then worsen as the day goes on. They usually last from several hours to several days but can last for weeks at a time. When Tension Headaches happen 15 or more days per month for more than three months in a row, they are considered chronic.
Causes of Tension-type headache (TTH) or Tension Headache
There’s no single cause of tension headaches and also they don’t run in families. Some people get tension headaches because of tight muscles in the scalp and back of the neck.
Triggers of Tension-type headache (TTH) or Tension Headache
Mostly these are triggered by stress from school, work, friends, family, or other relationships, but can also be triggered by muscle strain or postural problems such as poor posture at work or sitting for long periods.
Triggers of tension-type headache may include:
- Not enough rest
- Poor posture
- Mental stress, including depression
- A jaw or dental problem
- Straining your eyes
- Skipping meals
Migraine headaches are the second most common type of primary headaches. This is a common type of neurological condition that can result in significant pain and discomfort.
The pain is usually intense and throbbing on one side of the head. Other symptoms of a migraine headache include:
- Sensitivity to light, odors, or sound,
A migraine episode may last from 4 hours to 72 hours when unsuccessfully treated or untreated.
Some people also have sensory disturbances, such as changes in vision, known as an aura before the headache begins. The frequency of migraine episodes can vary greatly, but most people may have 2 to 4 episodes in a month.
Women are more likely to get migraine headaches than men. The exact cause of migraine headaches is still unknown, but researchers believe it may be due to changes in the activity of the brain’s nerve pathways and chemicals.
3) Cluster Headache
Cluster headache is a rare and extremely painful type of primary headache that occurs in groups or “clusters” at the same time or over a short period. The pain starts abruptly and lasts for 15 minutes to 3 hours. The episode of a cluster headache strikes quickly and usually without warning, although firstly you may have migraine-like nausea and sensitivity to light and sound (aura).
The severity of cluster headaches varies from person to person; some people experience mild pain while others experience excruciating agony.
Causes of Cluster headache
Cluster headache usually affects men between the ages of 20 and 50, but they can affect women as well. It is not clear exactly what causes cluster headaches, but researchers believe that abnormalities in the hypothalamus (which regulates body temperature, blood pressure, sleep, and the release of hormones), may be responsible for cluster headaches.
Signs And Symptoms of Cluster Headache
Cluster headaches typically occur at night and wake patients from sleep; however, they may also occur during the day. The pain is often described as excruciating and excruciatingly painful and can last up to three hours.
Common signs and symptoms of a cluster headache include:
- Excessive tearing
- The excruciating pain that is generally situated in, around, or behind one eye, but can radiate to other areas of your head, face, and neck
- Redness of your eye on the affected side
- One-sided pain
- The blocked or runny nose on the affected side
- Sweating on the forehead
- Pale skin (pallor) or flushing on your face
- Drooping or swollen eyelids on the affected side
- Swelling around your eye on the affected side
Treatment of Cluster headache
While there is no cure for cluster headaches, there are medications that can help manage the pain associated with them.
4) New Daily Persistent Headaches (NDPH)
New daily persistent headaches (NDPH) are a form of headache that begins suddenly. After onset, NDPH becomes persistent within 24 hours (2) and then continues daily for an extended period of time. Often, it occurs in people who have no previous history of headaches.
NDPH is not as common as some other headache types, but it may be extremely debilitating and affect your quality of life.
Each day the pain may get stronger or weaker, but it’s always there.
Causes of New daily persistent headaches (NDPH)
Doctors aren’t exactly sure about the cause of NDPH. Some small studies have suggested that there might be a link between viral and other infections and NDPH, but it requires more research.
Symptoms of New daily persistent headaches (NDPH)
The symptoms of NDPH are similar to those of migraines, tension-type headaches, or a mixture of both. These are:
- Moderate to severe pain
- Pain is either throbbing like a migraine or tightening like a tension headache
- Pain may get better or worse over the day
- The pain is usually on both sides of the head but can be only on only one side
- Pain that worsens after physical activity
- Sensitivity to sound, light, or smells
- Nausea or vomiting
Treatment of New daily persistent headaches (NDPH)
NDPH is not very well understood, and thus there is no single way to treat it. Currently, doctors often recommend treatments on the basis of the type of headache the pain most resembles, i.e. out of migraine or tension-type, for reducing the pain.
Medications for Treatment of New daily persistent headaches (NDPH)
Medications for Treatment of NDPH may include:
- Triptans typically used for migraine, like almotriptan or sumatriptan
- Antiseizure medication, like gabapentin or topiramate
- Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen
- Selective serotonin reuptake inhibitors (SSRIs), like fluoxetine or sertraline
- Tricyclic antidepressants, such as amitriptyline or nortriptyline
A secondary headache is a symptom of another disease that can activate the pain-sensitive nerves of the head. Secondary headaches manifest as a symptom of another health disorder.
Various types of illnesses and disorders may cause secondary headaches, including:
- Sinus congestion
- Systemic conditions, such as an infection
- Brain tumor
- Medication overuse
- Nerve disorders
- Trigeminal neuralgia (and other neuralgias, all involving irritation of certain nerves connecting the brain and face)
- Head injury or trauma
- Mental health conditions
1) Sinus Headache
Sinus headache is a type of secondary headache. This can be very painful and can last for several days.
Sinuses are open passageways behind the forehead and cheeks. And sinus headaches occur as a result of a sinus infection, which causes congestion and inflammation in the sinuses. Usually, it results from an allergy or an infection.
Symptoms of Sinus Headache
Its symptoms consist of a dull, throbbing ache around your cheeks, eyes, and forehead.
Other symptoms of a sinus headache include (3):
- A general feeling of being unwell
- Bad taste
- A blocked nose or nasal discharge
- Pain that gets worse with sudden head movement or straining
- Bad breath
- Facial pressure or pain
- Ear pain or feeling of fullness in the ears.
- Mucus discharge (snot)
- Sometimes pain can spread to the jaw and teeth
- Reduced sense of smell
Treatment of Sinus Headache
Generally, sinusitis goes away within two to three weeks.
Treatment of Sinus Headache includes:
- OTC pain relievers
- Drinking fluids
- Nasal decongestants
- Saline nasal sprays or solutions
- Steroid nasal sprays, (available on prescription)
- Antibiotics, (if there is a bacterial infection)
2) Medication Overuse Headache
Medication overuse headache (MOH) (also called rebound headache or medication withdrawal headache) is a type of secondary headache that occurs due to the long-term and excessive use of medication to treat a headache.
It is estimated that medication overuse headache (MOH) affects up to 5% of people.
MOH or rebound headaches are more likely to occur if a person has a headache disorder and has also taken pain relief medicines for more than 15 days out of a month.
Signs and Symptoms of Medication Overuse Headaches (MOH)
Signs and symptoms of MOH may depend on the medication used and the type of original headache being treated.
Its signs and symptoms may include:
- Pain occurs every day or nearly every day, (often wakes you up in the early morning)
- The pain improves with pain relievers, but again returns as the effect of your medication wears off
- Memory problems
- Difficulty concentrating
Medicines that can cause Medication Overuse Headaches (MOH)
Medicines that can cause medication Overuse Headaches include:
- NSAIDs, such as ibuprofen and aspirin
Treatment of Medication Overuse Headache
If you are experiencing medication overuse headaches, then the only treatment is to stop taking the medication causing the headaches.
But, anyone who is stopping medication should only do so under the supervision of a doctor. Your doctor can devise a plan and may prescribe alternative medicines to help in the withdrawal process.
3) Headaches Due To Infection
Headache is one of the most common symptoms of an infection, affecting more than half of the population at some point in their lives. It is common in the first few days of infection.
They may be caused by several factors, including dehydration, fever, sinusitis, and low blood pressure. If you are getting headaches along with other symptoms of a cold or the flu, such as runny nose, sneezing, etc., then these may be signs that you are having an infection. In most cases, headaches are harmless and will go away on their own within a few days.
If you are feeling dehydrated, your doctor may recommend drinking plenty of fluids (like water) and eating foods high in electrolytes (like bananas). If the headache is really bad, your doctor may prescribe medication for the pain.
4) Post-Traumatic Headache
Post-traumatic headache is a type of headache that can develop after any type of head injury. The headaches can range from moderate to severe, and they usually last up to 6 to 12 months after your injury occurs.
Post-traumatic headaches can also develop months after the original head injury, hence making them difficult to diagnose.
Post-traumatic headaches are diagnosed with a CT scan or MRI scan.
Symptoms of Post-Traumatic Headache
The symptoms of post-traumatic headache include:
- Moderate to severe pain,
- Pain that pulses
- Nausea and vomiting,
- Sensitivity to light and sound,
- Memory problems
- Trouble concentrating
- Mood and personality changes such as depression and nervousness
Treatment of Post-Traumatic Headache
Treatment of Post-traumatic headache depends on the severity of the injury and symptoms. They are typically treated with over-the-counter (OTC) pain relievers
Your doctor may also suggest you:
- Non-steroidal anti-inflammatory drugs such as ibuprofen, or naproxen
- Drugs made specifically for migraines, like triptans
To manage your headache symptoms you also have options that don’t involve medication. The options that your doctor may recommend you are:
- Relaxation therapy
- Physical therapy
- Cognitive behavioral therapy
- Occupational therapy
- Nerve stimulation
It’s important to consult your doctor early if you get a head injury, they can help you to watch for signs and symptoms of post-traumatic headache and start treatment early.
5) Spinal Headache
Spinal headaches are very intense headaches and are a fairly common complication in people who undergo spinal anesthesia or a spinal tap (lumbar puncture). In both of these procedures, the membrane that surrounds the spinal cord and, in the lower spine, the lumbar and sacral nerve roots, is punctured
If cerebrospinal fluid leaks through the tiny puncture site, you may develop a spinal headache (also known as post-dural puncture headache). The leakage can cause the tissues and nerves that support the brain to stretch painfully.
Spinal headaches typically last from a few hours to a few days and usually resolve on their own with no treatment. People with this headache feel better when they lay down and get worse when they sit up or stand.
Severe spinal headaches may need treatment.
What are the Symptoms of a Spinal Headache?
Symptoms of a spinal headache include:
- Dull, throbbing pain that varies in intensity from mild to severe
- Pain starts in the front or back of the head
- Pain that typically gets worse when you sit up or stand and decreases when you lie down
- Nausea and vomiting
- Headaches get worse while sneezing, coughing, or straining
- Neck pain or stiffness
- Ringing in the ears (tinnitus)
- Stiff neck
- Sensitivity to light (photophobia)
- Blurred or double vision
What is the Treatment of a Spinal Headache?
In most cases, to treat spinal headaches, doctors recommend you:
- Bed rest
- Taking oral pain relievers such as ibuprofen
- Drinking lots of fluids,
- Consuming drinks containing caffeine (like tea, coffee, and some soft drinks)
Epidural Blood Patch
If your headache doesn’t get improved by these measures within 24 hours, then your doctor may suggest a procedure called an epidural blood patch.
During this procedure, the doctor injects a small amount of your own blood into the space over the puncture hole. When the blood clots, it seals the hole, restoring normal pressure in the spinal fluid and relieving your headache
This procedure helps in the treatment of persistent spinal headaches that don’t resolve on their own.
6) Brain Aneurysm Headache
An aneurysm headache is a type of secondary headache that occurs when walls of a blood vessel in the brain bulge out and form a small blood-filled balloon. This condition is called a brain aneurysm.
What are the Causes of Brain Aneurysm Headaches?
The cause of a brain aneurysm isn’t clear yet, which is responsible for brain aneurysm headache.
But researchers believe that the following factors irritate and weaken blood vessels:
- Atherosclerosis (which is the fatty buildup on blood-vessel walls)
- High blood pressure (or hypertension)
- Blood infection.
- Traumatic brain injury (often caused by car crashes)
- Amphetamine and cocaine use
Symptoms of Brain Aneurysm Headache
The pain of an aneurysm headache can range from mild to severe, and it often feels like a pulsing or throbbing sensation.
It can cause problems with blood flow and oxygen delivery to the brain, which can lead to stroke or death. They also produce changes in blood pressure within the brain. The pain from aneurysm headaches can be sudden and intense and typically affects one side of your head.
Other symptoms of brain aneurysm headache include
- Nausea and vomiting
- Blurred vision
- Sensitivity to light or sound
7) Cervicogenic Headache
Cervicogenic headache (CGH) is a type of headache that develops in the neck and a person feels up into their head.
Cervicogenic headache is a common chronic and recurrent type of secondary headache that generally starts after neck movement. People often confused it with migraine or tension headache, both of which can cause neck pain.
What Are The Causes of Cervicogenic Headache?
Cervicogenic headaches (CGH) are caused by structural problems in the neck and are often due to problems with cervical vertebrae. Mostly, the C1-C3 vertebrae are a common site of problems causing these headaches (4).
Some people develop Cervicogenic headaches due to:
- Straining their necks.
- An injury to the neck
Some medical conditions responsible for Cervicogenic headache include:
- Arthritis of the upper spine
What are the Symptoms of a Cervicogenic Headache?
Typically, people who have cervicogenic headaches experience a throbbing headache accompanied by neck pain and stiffness (4).
In addition to these, other symptoms of cervicogenic headache (CGH) are:
- Pain in the neck, shoulder, or arm on one side
- Pain around the eyes
- Certain neck movements can provoke headache
- Pain on one side of your head or face
- Pain while coughing or sneezing
Cervicogenic headaches can also cause symptoms that are similar to migraine headaches, like
- Sensitivity to light and noise
- Blurred vision
Treatment For Cervicogenic Headache
Treatments for Cervicogenic headaches mainly focus on eradicating the cause of the pain. Its treatment depends on the person and the severity of their symptoms.
Some treatments for Cervicogenic headaches include:
Physical therapy is the first line of treatment for cervicogenic headaches. It may help manage symptoms and improve mobility in your neck area.
A doctor may prescribe the following medications to relieve painful or uncomfortable symptoms:
- NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or aspirin
- Muscle relaxants,
- Corticosteroids such as prednisone
- Anticonvulsants (like valproate)
Your doctor can inject pain-numbing medicine into joints and nerves in the head and neck. This may temporarily provide pain relief and can help you better work with physical therapy.
In rare cases, if your pain due to a cervicogenic headache (CGH) is severe, then your doctor may suggest a surgical procedure to keep your nerves from being squeezed.
Tests and Diagnosis Of Headache
As you all have seen, there are several types of headaches and therefore their diagnosis becomes much more crucial. So, whenever a headache triggers or whenever it is getting severe, you should immediately contact your family doctor or healthcare provider.
Your doctor will evaluate and diagnose the headache by
- Discussing your medical history, family history, and headache symptoms,
- Performing your physical and neurological examinations,
- Asking about your history of headache treatment
So, let’s understand all the questions that you need to prepare to answer in front of the doctor to help them evaluate and diagnose your headache
Description of Your Headache
Here, you will need to give a detailed description of your headache which includes:
- Your sleep habits
- How your headache makes you feel
- How often does it occur
- The intensity of pain during the headache
- The level of your stress
- Whether you have any personal or professional problems
- How long does it last each time
- The amount of caffeine you take daily
- The events, drinks, or foods which trigger the headache
Family History and Clinical Descriptions of Headaches
The healthcare provider will ask you about the symptoms of your headache along with other questions such as:
- Who else in the family has a headache
- What symptoms do you feel before, between, or after the headache
- If physical activity aggravates the headache pain
- The location of the pain
- Whether the headache occurs suddenly without warning or occurs with accompanying symptoms
- Is there any particular time of the day during which the headache occurs
- If you experience an aura (like changes in vision, flashing lights, blind spots, etc.) before the headache.
History of Headache Treatments
Here, the physician will ask you about:
- Any previous headache treatments
- Whether you have taken any medications in the past or are taking at present for either headache or any other health issue.
Physical and Neurological Examinations For Headache
Now the physician will perform your physical examinations. He/she will look for signs and symptoms of an illness that may be causing the headache, like:
- Speech difficulties
- Inappropriate behavior
- Changes in personality or mental confusion
- Balance problems
- Loss of consciousness
- Excessive fatigue
- Muscle tingling, numbness, or weakness
- High Blood Pressure
- Vision problems like blurry vision, or double vision.
Neurological tests aim to rule out any other health condition that might be causing your headache. These diseases might include:
- Infections such as Lyme disease
- Sinus blockage or disease
- Head trauma
- Blood clots
- Encephalitis (inflammation of the brain)
- Infection of the brain
- Pseudotumor cerebri (increased intracranial pressure)
- Viral or bacterial meningitis
- Brain hemorrhage
After evaluating the results of your headache description, family history, physical examination, and neurological examination, your doctor shall be able to determine:
- The type of headache you are having
- Whether a serious health problem is present or not
- Whether some additional tests are needed or not
The information that you give to your doctor about your headaches is the most important part of the diagnosis process.
Thus, you are more likely to get an accurate diagnosis and a treatment plan, by giving your doctor as much information as possible about your headaches.
Tests for Headache
Certain tests which your doctor or physician will recommend to rule out more serious causes of headache are:
|Blood Tests||To rule out potential causes of headaches such as infection.|
|Sinus X-Ray||It is an imaging test that uses X-rays to look at your sinuses and is used to rule out any congestion or inflammation of the sinuses|
|Computerized Tomography (CT) Scan||It uses a series of X-rays to create detailed cross-sectional images of the brain and helps doctors to diagnose brain damage, tumors, bleeding in the brain, infections, and other possible medical problems that may cause headaches.|
|Magnetic Resonance Imaging (MRI)||It uses a powerful magnetic field and radio waves to produce detailed images of the brain and blood vessels. It helps doctors in diagnosing strokes, tumors, infections, bleeding in the brain, and other brain and nervous system conditions. To produce horizontal or axial images of any part of the body including organs, fats, muscles, and bones.|
|Spinal Tap (also known as Lumbar Puncture)||A spinal tap is a medical procedure in which a long needle is inserted into the spinal canal to collect cerebrospinal fluid for diagnosing certain brain conditions such as inflammation, bleeding, etc.|
|Eye exam||A routine eye exam may help to find any other vision or eye concerns that may cause your headache.|
Certain environmental factors, activities, and diet can trigger headaches. These common triggers of headache are:
- Activities like exercise, jet lag, lifting overhead, and physical inactivity
- Alcohol (like wine) consumption
- Auditory factors like loud music
- Foods with caffeine such as coffee, soft drinks, tea, etc.
- Skipping meals
- Emotions such as anger, depression, anxiety, sadness
- Certain medications
- Sun exposure
- Bright or flashing light
- Changes in sleep habits
- Motion from a vehicle
- Allergy (such as seasonal or pollen allergy)
Treatment For Headaches
The type of headache treatment you require will depend on various things, like the type of headache you get, how often it occurs, and its underlying cause.
Thus, before starting your treatment doctor will look to cure the underlying cause of your headache.
If there is not any underlying cause, numerous medications are available to manage your symptoms. These are:
In acute treatments, a headache and its symptoms are treated after it starts. These can include:
- Nasal sprays
- NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen, naproxen
Preventive treatments are taken regularly to help limit the episodes of headaches and the severity of their symptoms. These can include:
- Calcium channel blockers
- Antiseizure medications
- Antipsychotic medications
- Injectable medications, such as Galcanezumab,
Alternative treatments For Headaches
Apart from medication, various alternative forms of headache treatment are also available. But, it is important to consult your doctor before starting new treatments.
Alternative treatments For Headaches include:
- Diet changes
- Heat therapy
- Cognitive behavioral therapy (CBT)
- Oxygen therapy
Home Remedies For Headaches
There are some strategies (or home remedies) to prevent headaches or ease the pain. These are:
1) Drink plenty of water, as dehydration is a common cause of headaches.
2) Get enough sleep, because not getting enough sleep can lead to fatigue and headaches.
3) Eat healthily – eating nutritious foods helps your body function at its best and can help prevent headaches.
4) Exercise regularly, as exercise releases endorphins, which can help relieve pain and tension headaches.
5) Manage stress – stress can be a major contributor to headaches. You can practice yoga and meditation to reduce stress.
6) Limit alcohol consumption
7) Take breaks while working to stretch and prevent eye strain
8) Use a heat or ice pack against the head or neck.
Prevention Of Headaches
The main key to preventing headaches is figuring out what triggers them. Headache triggers are very specific to each person, which means what triggers your headache may not be a problem for another person. Thus, once you are confirmed about your triggers, you can minimize or avoid them.
For example, you notice your headaches get a bit worse with strong scents. Avoiding scents and scented products can make a big difference in how many headache episodes you have.
The same goes for other common triggers like lack of sleep, bright lights, poor posture, etc.
If your headaches are becoming worse or badly impacting your everyday life, then it’s time to consult with a doctor. They can identify the type of headache you have or what is the cause of your headache, and treat it appropriately.
Headaches are one of the most common medical complaints, and they can be caused by a variety of factors. While most headaches are not serious, they can be quite painful and disruptive. In some cases, headaches can be a sign of a more serious health problem.
There are many different types of headaches, and the treatment depends on the cause. Some people find relief from over-the-counter medications, while others need prescription medication or even surgery. There are also several natural remedies that can help to relieve headaches.
In the end, if a headache is something you suffer from on a regular basis, I would suggest talking to your doctor first. He or she will be able to identify the type of headache you have or the cause of your headache and treat it appropriately.
2) New daily persistent headache: a systematic review on an enigmatic disorder
4) Cervicogenic Headache
This article is intended for informational purposes only. Any information associated with this article should not be considered as a substitute for prescriptions suggested by local health care professionals.