Types of Headaches

Having a headache means there’s pain in part of your head. But there are many types of headaches. Learning which type you have is key to effective treatment.

Headaches are the most common form of pain people experience, and they affect people of all races and ages in every country. What your headache feels like, however, can be quite different from another person’s version of a headache. In fact, there are more than a hundred different types of headaches with varying causes and symptoms.

A headache may appear as a sharp pain, a throbbing sensation, or a dull ache. Depending on the type of headache you have, the pain can range from mild to disabling and may be accompanied by symptoms like nausea, dizziness, and increased sensitivity to noise or light.

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Headaches can come on slowly or seem to strike out of the blue, too. They can be so rare you can almost forget what they feel like. On the other hand, headaches can be life-disrupting and last more than 15 days a month, according to the National Institute of Neurological Disorders and Stroke (NINDS). Headaches are a major reason cited for missing days at work or school and are a top cause of doctor visits.

NINDS explains there are more than 150 types of headaches, classified into two different categories, primary or secondary headache disorders.

Primary headaches occur independently; they aren’t the result of another medical condition or injury. Secondary headaches, however, are symptoms of a disease or infection or caused by an injury that impacts pain-sensitive nerve endings.

To effectively find the right treatment for your headaches and ways to prevent or reduce episodes of head pain, you first need to find out what type of headache you have. Learning about types of headaches and keeping a record of your symptoms, when your headaches tend to occur, and how long they last can help your doctor diagnose the cause and find the best way to treat your headaches.

The most common types of primary headaches

Tension-type headache (TTH), migraine, and cluster headache are the main types of primary headaches.

Tension-type headaches. Odds are, you’ve experienced at least one TTH. They occur in about 75 percent of the general population and can range from the occasional mild headache to daily and annoying head pain. Tension headaches are often related to stress, lack of sleep, missing meals, or over-working and straining muscles in your neck, scalp, and jaw.

Over-the-counter pain relievers like aspirin, ibuprofen, or naproxen can usually relieve TTH pain. Most people can feel better and reduce the occurrence of tension-type headaches with healthy lifestyle changes, including regular exercise, adequate sleep, and relaxation techniques, the American Chronic Pain Association points out.

Migraines. About 12 percent of Americans experience migraine headaches, marked by throbbing and pulsating pain, usually on one side of the head. The cause of migraine isn’t fully understood, but excitable brain cells, which trigger chemicals like serotonin to temporarily narrow blood vessels, are likely responsible, according to Johns Hopkins researchers.

Migraine “triggers” vary, but lack of sleep, strong odors or fumes, emotional stress, skipped meals, too much alcohol, and bright or flashing lights are frequently associated with occurrence. In addition, about 50 percent of migraine sufferers report certain foods — including aged cheeses, chocolate, and foods containing the sweetener aspartame — are linked to their headaches. Women are more likely than men to have migraines, probably due to hormonal factors.

There are several types of migraine headaches, but most are migraines without aura (common migraines) and migraine with aura. Most people with migraine have the common type, which occurs without warning and causes a one-sided headache, often accompanied by nausea (and, sometimes, vomiting), confusion, blurred vision, light sensitivity, fatigue, and mood changes. Migraine with aura describes visual and sometimes physical sensations that develop just before or during the migraine. Auras typically are experienced as flashing or bright lights that can appear as geometric patterns; muscle weakness or odd physical sensations can also be part of an aura.

Self-help treatment for migraines includes napping or resting in a quiet, dark room. A cool cloth or ice pack on your forehead and drinking plenty of fluids, especially if your migraine causes vomiting, can help. Prescription medications may be warranted, depending on your specific health history and the severity and frequency of migraines. Some medications are prescribed to take as soon as symptoms occur. There are also preventive treatments that require daily medications, NINDS explains.

Cluster headaches. Cluster headaches get their name because they have a pattern of “clusters.” They usually occur at the same time of day for several weeks.

The good news about cluster headaches is they are fairly rare, affecting fewer than one in 1,000 adults, according to the World Health Organization. The bad news is they can be excruciating painful.

A cluster headache begins with severe discomfort on one side of the head, often behind or around one eye. Other symptoms (always on the same side as the head pain) include an extremely bloodshot eye, swelling under or around the eye, excessive tearing, drooping of the eyelid, a runny nose, and perspiration on the face. Some people who suffer cluster headaches experience nausea, light, and sound sensitivity, as well as changes in blood pressure and heart rate.

Usually the stabbing type pain peaks over several minutes, then continues for three hours before finally diminishing. A cluster of pain can strike up to eight times a day, and a cluster period with recurring headaches can lasts six to 12 weeks.

What causes cluster headaches isn’t yet known, the National Center for Advancing Translational Sciences explains. Research, however, suggests there’s a connection with some irregularity in the body’s circadian rhythm (the internal “clock” that controls the sleep and wake cycle) because the headaches tend to occur during the same time period from day to day, and more often at night. You can use numerous prescription drugs to relieve cluster headache symptoms. But working with a specialist to find the right treatment is vital, the NIH explains.

Why secondary types of headaches can be minor or serious

Secondary headaches are caused by something else going on in your body:

• A cold with a fever
• A stopped-up nose from a hay fever allergy
• A life-threatening stroke
• Damage to nerve endings from an accident

Other causes include over-using medication or going off a medication too quickly, high blood pressure, a head injury, a brain tumor, or trigeminal neuralgia (a chronic condition affecting a nerve on the side of your cheek or jaw).

Not all secondary headaches need medical attention. Afterall, it’s not hard to figure out that a headache accompanying the flu is related to fever and maybe dehydration and will pass. Or, if your headache goes away when hypertension is under control, you have a likely explanation for your previous headache woes.

But if you experience any unusual or sudden headache, call your doctor or seek emergency help ASAP. Examples of secondary headaches that signal potentially serious disorders needing urgent medical care include:

• A severe headache or sudden headache associated with a stiff neck
• Headaches associated with high fever, convulsions, loss of consciousness, or confusion
• Headaches following a blow to the head
• Persistent headaches in a person who was previously headache-free
• Recurring headaches in children

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