A headache is pain or discomfort in
the head or face. Headaches vary greatly in terms of the location and intensity of
pain, and how often they occur. Almost all people have headaches during their life.
brain tissue doesn’t have pain-sensitive nerve fibers and doesn’t feel pain. But,
parts of the head can be responsible for a headache including:
- A network of nerves that extends over the scalp
- Certain nerves in the face, mouth, and throat
- Muscles of the head, neck, and shoulders
- Blood vessels found along the surface and at the base of the brain
Different types of headaches are
In migraines, symptoms other
than pain occur as part of the headache. These may include nausea and vomiting,
lightheadedness, sensitivity to light (photophobia) and sound (phonophobia), and
other visual symptoms. Migraines also have distinct phases. But, not all people have
each phase. The phases of a migraine headache may include:
- Premonition or prodromal phase. A change in mood or behavior may occur hours or days before the headache.
Aura phase. A group of visual, sensory, or motor symptoms can precede the headache. Examples
include vision changes, hallucinations, numbness, changes in speech, and muscle weakness.
Headache phase. This is the period
during the actual headache with throbbing pain on one or both sides of the head.
Sensitivity to light and motion are common, as are depression, tiredness
(fatigue), and anxiety.
Resolution phase. Pain lessens
during this phase, but may be replaced with tiredness, irritability, and trouble
concentrating. Some people feel refreshed after an attack, others don’t.
Tension headaches are the most
common type of headache. Stress and tight muscles are often factors in tension-type
headaches. These are common symptoms of a tension-type headache:
- Slow onset of the headache
- Head usually hurts on both
- Pain is dull or feels like a band
or vice around the head
- Pain may be in the back part of the
head or neck
- Pain is mild to moderate, but not
Tension type headaches typically don’t cause nausea, vomiting, or sensitivity to
Cluster headaches usually occur in a series that may last weeks or months.
These are the most common symptoms of a cluster headache:
- Severe pain on one side of the head, usually behind one eye
- The eye that is affected may be red and watery with a droopy lid and small pupil
- Swelling of the eyelid
- Runny nose or congestion
- Swelling of the forehead
Headaches are classified as primary or secondary.
A primary headache means the headache
itself is the main health problem. but other factors such as muscle tension or
exposure to certain foods may be triggers. Other things that may help cause the
headache include medicines, dehydration, or hormone changes.
A secondary headache is related to an
underlying health condition. An example of this would be a headache caused by a neck
injury, eye problems, or an infection in the jaw, teeth or sinus .
Headache symptoms depend on the type of headache. The frequency of headaches and the
intensity of the symptoms may vary, too. Typical headache symptoms include:
- Slow start of the headache
- Head usually hurts on both sides
- Pain is dull or feels like a band or vice around the head
- Pain may be in the back part of the
head or neck
- Pain is mild to moderate, but not severe
Tension type headaches typically
don’t cause nausea, vomiting, or sensitivity to light (photophobia).
The symptoms of a headache may look
like other health conditions. Always see your healthcare provider for a diagnosis.
Your doctor will ask about your
health history. He or she will also do a physical exam and certain tests.
Questions commonly asked during the exam may include:
- When do headaches occur?
- What is the location of the
- What do the headaches feel like?
- How long do the headaches last?
- Have there been changes in behavior or
- Do changes in position or sitting up
cause the headache?
- Do you have trouble sleeping?
- Do you have a history of stress?
- Do you have a history of head
- Do you have other symptoms during a headache?
If your doctor suspects migraine or
tension-type headaches and the nervous system exam is normal, you may not need any
further testing. But it is not a primary type headache, or if you have uncommon
symptoms, other tests may be done to find the cause.
Tests used to find the cause of a headache may include:
Blood tests. Various blood and other
tests may be done to check for underlying conditions.
Sinus X-rays. An imaging procedure
done to look for congestion or other problems that may be corrected.
MRI. A test that uses a combination
of large magnets, radio waves, and a computer to produce detailed images of organs
and structures within the body.
CT scan. An imaging test that uses
X-rays and computer technology to make detailed images of the body. A CT scan shows
detailed images of bones, muscles, fat, and organs. CT scans are more detailed than
Spinal tap (lumbar puncture). This may be done to rule
out inflammation, infection, or high pressure in the spinal fluid
The goal of treatment is to stop
headaches from occurring. Good headache management depends on finding what type of
headache you have. Management may include:
- Staying away from your known triggers,
such as certain foods and beverages, lack of sleep, and fasting
- Changing eating habits
- Resting in a quiet, dark
- Taking medicines as recommended by
your healthcare provider
- Controlling stress
Migraine and cluster headaches may
need specific medicines. These include:
Abortive medicines. These are
medicines prescribed by your healthcare provider. They act on certain receptors in
nerves and blood vessels in the head to stop a headache in progress.
Rescue medicines. These medicines
include pain relievers bought over the counter, to stop the headache.
Preventive medicines. These medicines
are prescribed by your healthcare provider. They are taken daily to stop a headache
Some headaches may need medical
attention right away. This may include a hospital stay for observation, diagnostic
testing, or even surgery. Treatment depends on the condition causing the headache.
recovery depends on the type of headache and other health problems you may have.
If you know what triggers your
headache, staying away from the trigger can prevent a headache. Reducing stress can
or prevent headaches caused by stress. Migraine and cluster headaches may be prevented
by taking a daily preventive medicines.
Most headaches can be managed with
over-the-counter pain relievers. But call your healthcare provider right away if you
have a severe headache plus:
- Stiff neck
- Shortness of breath
- Muscle weakness
- Double vision
- Change in level of consciousness.
Symptoms that may suggest a more serious headache include:
- Worst headache ever, or new type of headache
- Recurring headaches in children
- Headaches that start early in the morning
- Headache that follows a head injury
- Pain that gets worse with strain, such
as a cough or a sneeze
- Vomiting without nausea
- Sudden onset of pain
- Headache that is becoming more severe or continuous
- Personality changes
- A headache is pain or discomfort in the head or face area.
- Types of headaches include migraine, tension, and cluster.
- Headaches can be primary or secondary. If it is secondary, it is caused by another
- Staying away from your headache
triggers is the best prevention.
- Mild to moderate headaches can be managed with over-the-counter medicines, but tell your
healthcare provider if your headache is severe and you have other symptoms.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
- Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure