There are many different types of headaches, each associated with its own set of causes and symptoms. Being able to recognize the type of headache you are experiencing can inform how to treat it best.
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Headaches are broadly divided into two categories: primary and secondary.
In primary headache, the pain in your head is the condition itself. It isn’t due to another physical condition.
Tension headaches are the most common type of primary headache. It accounts for approximately 75 percent of all headaches.
A tension headache may cause mild-to-moderate pain on both sides of the head. It is a dull, “tightening” sensation, like a clamp squeezing your skull or a tight band around your head. You may also feel tenderness or pressure around your forehead or the back of your head.
Tension headaches can be either episodic or chronic. Episodic tension headaches occur gradually, often in the middle of the day, and last less than 15 days per episode. On the other hand, chronic tension headaches come and go over an extended period of more than 15 days per month for at least three months. Frequent episodic tension headaches may become chronic.
Migraine is the second commonest type of primary headache. It is characteristically unilateral (one-sided).
The migraine symptoms include adebilitatingthrobbing, pounding painthat may be accompanied by auras. Auras are visual and sensory disturbances, including:
- Seeing zig-zag lines, flickering lights, or spots
- Partial loss of vision
- Pins and needles
- Muscle weakness
- Difficulty speaking
A migraine tends to be recurrent and may persist for up to three days without treatment.
Cluster headaches are so named because these headaches tend to occur in groups before entering into remission. After one episode resolves, another will soon follow. Each headache episode may last between 15 minutes to three hours.
These excruciating headaches come on quickly and are characterized by sharp, piercing, burning one-sided pain behind or around one eye. That eye may also be red, teary, swollen, or droopy. The nostril on that side runs or becomes stuffy.
Exertional headaches happen very quickly after periods of intense physical activity. Potential triggers include:
- Weight lifting
- Bouts of coughing or sneezing
- Sexual intercourse
These physical activities could enhance blood flow to your skull, which may cause throbbing pain on both sides of your head.
As a result, you may feel pulsating pain on both sides of the head. The head pain could resolve within 5 minutes to 48 hours.
Occipital neuralgia is a rare condition caused by pinched or damaged occipital nerves that travel from your upper back to the scalp, also called the occipital region. When they’re injured or inflamed, you’ll feel “electric shock” pain in the back of your head or behind your ears. The pain may radiate up toward the eye, usually involving the cheek and forehead. Afterward, it may subside into a dull ache.
Ice pick headaches
Ice pick headaches are transient, stabbing intense pain that usually only lasts a couple of seconds. The pain is usually in front or side of the head but may move from one area to another. There is no warning before striking, and could be debilitating and excruciating.
Thunderclap headaches are sudden, severe headaches that are frequently described as the “worst headache.” It comes abruptly and peaks quickly, reaching maximum intensity within several seconds.
Potential causes of thunderclap headaches:
- Blood vessel tear, rupture, or blockage
- Head injury
- Inflamed blood vessels
- Hemorrhage stroke from a ruptured blood vessel in the brain
- Narrowed blood vessels surrounding the brain
- Ischemic stroke from a blocked blood vessel in the brain
- Blood pressure changes in late pregnancy
Giant cell arteritis (temporal arteritis)
Giant cell arteritis occurs when the temporal arteries on the side of your head or neck become inflamed, which reduces blood flow.
Symptoms of giant cell arteritis may initially mimic that of a migraine because it starts with throbbing in the temple on one side of your head. But unlike a migraine, giant cell arteritis causes your temples to be tender to the touch, and the throbbing may be constant. The symptoms tend to occur very quickly.
Because giant cell arteritis may cause permanent vision loss, it is a medical emergency. As such, you should seek immediate medical attention.
Hemicrania continua is a chronic, persistent headache that almost always affects the same side of your face and head. Other symptoms include:
- Pain that varies in severity
- Red or teary eyes
- Runny or stuffy nose
- Droopy eyelid
- Contracted iris
- Nausea and vomiting
- Sensitivity to light and sound
Hypnic headaches are also known as “alarm clock headaches.” It is a rare form of headache that wakes you up during the night. It is characterized by a mild-to-moderate throbbing pain on both sides of the head. The primary treatment option is caffeine.
Secondary headaches are a consequence of a medical condition that stimulates the pain-sensitive nerves in the head. In other words, these headaches are attributed to another cause.
Medication-overuse headaches (rebound headaches)
A medication-overuse headache – also known as a rebound headache – is the most common type of secondary headache. It stems from excessive use of painkiller medication to treat headache symptoms.
It is marked by frequent headaches with symptoms similar to those of either tension headaches or migraines. The symptoms typically begin early in the morning and persist throughout the day.
Having an excessive amount of caffeine can cause a headache, as can quitting coffee “cold turkey.” Often, the primary determining factor is the quantity of caffeine consumed.
Once you recognize how much caffeine you’re consuming and where it’s coming from, you should track your caffeine intake alongside your headache frequency. If you discover your headaches are being triggered by caffeine withdrawal, don’t attempt to quit cold turkey: that’s a surefire fuel for more headaches.
Consuming too much alcohol can cause a throbbing headache subsequent morning. The migraine-like headaches are typically felt on both sides of the head and are made worse by movement. This is due to alcohol widening and aggravating the blood vessels in your brain and nearby tissue.
Cervicogenic headaches are caused by problems with the nerves, bones, or muscles in your cervical spine or the base of the skull. It could be caused by various conditions, including a whiplash injury, osteoarthritis, poor posture, and bulging discs. The headache pain may worsen with specific neck movements or touch.
Cervicogenic headaches can mimic migraines, so it isn’t easy to differentiate between the two conditions. The main difference is that a migraine headache begins in the brain. In contrast, a cervicogenic headache begins in the cervical spine or the base of the skull.
Headaches may happen as a result of an allergy. The pain is usually focused around the sinus area and the front of the head.
Causes of allergy headaches:
- Allergy rhinitis (hay fever). If you’ve got a headache in conjunction with seasonal and indoor nasal allergies, it is more likely due to a migraine headache instead of allergies. But pain associated with hay fever or other allergies may cause headaches due to sinus disease. A true sinus headache is rare.
- Food allergies. There could be a relationship between food and headaches. For instance, foods like aged cheese, chocolate, and artificial sweeteners can trigger a migraine in some people.
- Histamine. Your body produces histamines in response to an allergy. Among other things, histamines cause vasodilation (a decrease in blood pressure). This could cause a headache.
Symptoms of a sinus headache include:
- Dull, throbbing pain in the cheeks or forehead
- Pain which could be aggravated by head movements
- Facial tenderness or swelling
- A blocked or runny nose
- Green or yellow nasal discharge
Barometric pressure headaches
Barometric pressure headaches occur following a drastic change in barometric pressure. When the external barometric pressure lowers, it creates a difference between the pressure inside and outside of your sinus. The sinus becomes stuffed with air, and any change in that temperature can trigger a headache.
Causes of barometric headaches include:
- Sudden increases or drops in temperature or humidity
- Storm or wind systems
- Changes in altitudes
Women commonly experience migraine headaches associated with the fluctuations in estrogen levels. Menstruation, contraception pills, pregnancy, and menopause can all trigger hormonal headaches. The hormonal change from contraception pills and hormone replacement therapy can also trigger headaches.
Hypertension, otherwise known as high blood pressure, can also trigger a headache. This happens when your blood pressure becomes dangerously high.
A hypertension headache will typically cause a pulsing head pain on both sides of your head. It is usually worse with activity.
This type of headache is an emergency. You should seek immediate medical attention.
Hypotension headache (spontaneous intracranial hypotension)
Hypotension headaches are caused by low blood pressure. This happens when there’s a cerebrospinal fluid leak in your neck or back. You may experience intense pain at the back of your head and neck that worsens as you stand or sit.
Post-traumatic headaches can develop 2-3 days after a head injury. Symptoms include:
- A dull ache that worsens from time to time
- Trouble concentrating
- Memory problems
Eye strain is typically caused by uncorrected vision or astigmatism in the eyes. Triggers include:
- Prolonged visual tasks, like reading or using a computer
- Extended periods of concentration
- Poor posture
Pain location of common headache types
The location of the headache pain can help predict the type of headache that you are having. This information could enable you to get proper treatment promptly.
Here’s a guide to the potential type of headache that you may be having based on the pain location.
|Pain location||Most common cause||Other possible causes|
|Back of your head or neck||Tension headache Migraine||Arthritis in your upper spine Occipital neuralgia|
|Top of your head||Tension headache||Migraine Occipital neuralgia Severe hypertension (rare) Aneurysm or a hemorrhagic stroke (rare)|
|Forehead Cheeks Behind both eyes||Tension headache Migraine||Cluster headache Sinus infection|
|Behind one eye||Cluster headache||Migraine Occipital neuralgia Eye infection Aneurysm (rare)|
|Temples||Tension headache||Migraine Cluster headache Temporal arteritis (more common in the elderly) Temporomandibular joint (TMJ) disorder|
|Behind the ear||Ear infection (more common in children)||Occipital neuralgia Sinus infection Temporomandibular joint (TMJ) disorder Dental problems|
|On one side of your head||Migraine Cluster headache||Hemicrania continua (rare) Aneurysm (rare)|
|Not sure Hurts all over||Tension headache||Migraine Sinus infection|
When to see a doctor
- Sharp, intense headache pain for the first time
- Headaches that are persistent, severe, recurrent, or worsening
- Swelling or injury on your head
- Muscle weakness or paralysis on one side of your body
- Slurred speech
- A stiff neck or fever
Get immediate medical attention if you have the aforementioned serious symptoms.