Headaches are widespread and felt by almost everyone.
Experts estimated that 50 to 75 percent of adults had a headache in 2020. Often, headaches are short term and mild, but some can be debilitating and disrupt your daily life.
There are several kinds of headaches caused by various factors such as our environment, the medication we take, and other causes. Many treatment options are available to help manage the pain.
Headache disorders are painful, with discomfort felt in the head, neck, and shoulders. A headache occurs because of a primary or secondary cause.
Primary headaches, like migraine or tension headaches, are among the most common headaches that lead people to seek medical treatment, and they affect an estimated 3 billion people each year.
This type of headache isn‘t a symptom of any disease but a disease on its own. It is a “primary“ headache because it is the main concern.
Often, stress and disruptions in your sleep patterns cause these headaches.
Secondary headaches manifest as a symptom of another health disorder. Different types of illnesses and disorders can cause a headache, including:
- medication overuse
- high blood pressure
- mental health conditions
- head injury or trauma
- nerve disorders
- sinus congestion
Tension-type headache (TTH)
Tension-type headache (TTH) is the most common primary headache disorder. TTH may also significantly impact the quality of life for those affected.
TTH causes head pain that may occur across both sides and the front and back of the skull. In other words, your entire head may feel pain.
People affected by TTH may easily ignore the headache episodes because the pain tends to be mild to moderate, not aggravated by daily physical activity, and doesn‘t cause disability.
However, if untreated, TTH may become a chronic (long-term) issue that leads to complications like:
- sleep disruption
- jaw muscle and joint disorders
A cluster headache is rare, affecting less than 1 percent of the population.
This headache frequently occurs throughout the day. Its symptoms are brief but may be very severe. The pain usually becomes focused around one eye, leading to tearing and redness. In addition, the nose may run or become congested on the same side of the face, and the eyelid may droop.
Medication-overuse headache (MOH)
The long-term and excessive use of medication to treat a headache can cause medication-overuse headache (MOH). This condition is considered a secondary headache disorder. MOH is also sometimes described as “rebound headache“ or “medication withdrawal headache.“
MOH commonly occurs with chronic migraine episodes or tension headaches. One of the features of MOH is taking pain medication for at least 10 days per month for more than 3 months.
A 2022 review indicated MOH as a factor in people who experience disability from chronic migraine, since the medication they take to treat their migraine headaches leads to more headaches.
New daily persistent headache (NDPH)
A new daily persistent headache (NDPH) is a sudden onset headache that doesn‘t stop within 24 hours and reoccurs almost daily. Although not as common as some other headache types, it may cause disabling symptoms and affect your quality of life.
Only an estimated 0.03 to 0.1 percent of the general population experience NDPH, but its pain is constant with an unknown cause. It typically develops in those with no previous or significant headache history.
A type of primary headache, exertional or exercise headache happens when you participate in strenuous activities or exercise. According to a 2020 review, those who receive a diagnosis of exercise headache experience throbbing pain on both sides of the head. There is typically no nausea or vomiting, but the pain may be pulsating.
Hemicrania continua is a chronic and persistent headache that always occurs on one side of the face and head. Additionally, people with the condition may experience periods of severe pain instead of the constant pain already felt, making this a debilitating headache.
To fit the criteria for this headache, you must:
- have a one-sided daily or continuous headache of moderate intensity
- experience additional short-lived and piercing head pains
- feel it for more than 3 months without shifting sides or pain-free periods
- respond to treatment with the medication indomethacin
Headaches are common in pregnancy.
A 2021 review of studies estimated that 10 to 17 percent of pregnant people experience primary headaches or migraine.
During pregnancy, you may experience stress and significant hormonal changes that lead to headaches.
Some medications can be harmful to the mother or fetus. Using medication-free remedies such as an ice pack or taking medications that are safe during pregnancy would be recommended. For example, the doctor may suggest alternative therapies before prescribing medication to manage your symptoms.
Migraine is a primary headache disorder that is recurrent and often lifelong. Usually, the pain is intense and throbbing in only one area of the head.
Other symptoms of a migraine headache include:
- light sensitivity
- sound sensitivity
This type of headache is more common in women by a 2-to-1 ratio when compared with men, which may be attributed to female hormones.
A 2018 review of studies suggests that migraine in females can be influenced by hormone fluctuations, such as those seen in:
- the menstrual cycle
- the use of oral contraceptives
- those undergoing hormone replacement therapy
The cause of migraine headaches may be a combination of factors, but researchers believe it may also be due to changes in the activity of the brain’s nerve pathways and chemicals.
Stages of Migraine Headaches
Migraine headaches can be predictable because some start with an aura. An aura is a visual disturbance that can appear as:
- flashing lights
- zigzag lines
- temporary vision loss right before the headache
Migraine headaches are sometimes preceded by a prodrome, or “preheadache,“ and some migraine episodes may have an aura before or during the headache.
Here are all the stages of migraine headaches:
- Premonitory phase. May occur as early as 3 days before a migraine headache, and you can experience symptoms such as fatigue, mood changes, and muscle tenderness.
- Aura. Approximately one-third of migraine attacks include an aura, which may last only minutes and develops gradually.
- Headache. Throbbing pain or other associated symptoms may occur during this stage.
Migraine is a type of headache disorder. Some people describe this type of headache as feeling like a migraine attack. Migraine is classified as:
- a moderate-to-severe headache
- aggravated by routine physical activity
- lasts hours to 2 to 3 days
Migraine attacks can occur anywhere from once a week to once a year.
In children, migraine (with or without a headache) can involve:
- abdominal discomfort
Migraine and other types of headaches can be triggered by things like diet, activity, and environmental factors. Common triggers include:
- bending over
- lifting overhead
- physical inactivity
- jet lag
- hard liquor
- drinking too much
- allergy or sinuses
- loud music
- environmental noise
- food or eating
- certain foods
- soft drinks
- not eating a nutritious diet
- skipping meals
- changes in sleep habits
- motion from a vehicle
- bright or flashing light
- computer screen
- fluorescent light
- sun exposure
If you are experiencing headache symptoms three or more times per month, it may be time to see a doctor.
Also, consider seeking preventive treatment if the headaches impact your quality of life or cause additional problems like stress, depression, or other concerns.
It is also important to talk with your doctor if you are having new headaches or a different type of headache.
Your doctor may perform a physical exam to diagnose your headache. Other diagnostic stepsTrusted Source include:
- Analyzing your medical history. The doctor will ask detailed questions about your headaches, such as when they started, frequency of episodes, pain characteristics, triggers or worsening factors, aura symptoms, and history of preventive medications.
- Comparing your symptoms to the International Classification of Headache Disorders (ICHD-3). Medical professionals use the ICHD-3 to check criteria and properly diagnose a headache, since there are several types with similar shared symptoms.
- Determining if an aura is present. If you experience an aura before your headaches, this may be a sign you experience migraine headaches.
- Asking you to complete a migraine questionnaire. Doctors may ask you to complete a standardized questionnaire about your symptoms and medical history that can give more insight.
- Potentially requesting medical imaging to rule out other causes. If there is concern that you could be having secondary headaches, the doctor may order imaging tests of the brain, such as a CT or MRI scan, to ensure conditions such as a stroke or tumor aren‘t the cause.
- Performing an eye exam. Since eyestrain can cause headaches, a routine eye exam may uncover any other vision or eye concerns contributing to your headache, if any. Consider that problems such as swelling due to a brain tumor or inflammation can also cause changes that would be detected during an eye exam.
- Ordering lab blood tests. To rule out other potential causes for your headache, lab testing of your blood will show your doctor if there are any other concerns, such as infection.
- Performing a spinal tap. In some cases, brain conditions like inflammation and bleeding may cause headaches. A spinal tap, also known as a lumbar puncture, involves using a long needle to pull cerebrospinal fluid from your spine to be analyzed.
A review in 2021 analyzed headaches and their relationship with COVID-19. It discussed other recent studies estimating the prevalence of the symptom and found that headaches are present in 10 to 20 percent of COVID-19 cases.
Even though there is still much to learn about the effects of COVID-19, researchers believe the virus may cause inflammation in the brain, leading to a headache. However, more research is needed to be sure.
Treatment varies based on the type of headache.
A doctor may recommend various treatments for primary headaches. First, they look to treat the underlying cause of the headache.
If there is not one, several medication are available to manage your symptoms. These include:
- Acute treatments. Acute treatments are used to help treat a headache and its symptoms after it starts. These include:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- nasal sprays
- Preventive treatments. Preventive treatments are taken regularly to help limit how often headaches occur and the severity of symptoms. These can include:
- antiseizure medications
- injectable medications, like Emgality
- antipsychotic medications
- calcium channel blockers
Besides medication, there are alternative treatments for headaches as well.
For example, noninvasive vagus nerve stimulators are handheld devices that transmit mild electrical stimulation to your vagus nerve through the skin. This can help relieve headache pain.
Other alternative treatments include:
- heat therapy
- diet changesTrusted Source
- oxygen therapy
When treating a migraine headache disorder, the doctor aims to relieve your symptoms while also preventing migraine attacks.
Some common medications for ongoing migraine headaches include:
- sumatriptan (Imitrex)
- lasmiditan (Reyvow)
- ubrogepant (Ubrelvy)
Surgical procedures and injections are also options to treat headaches or migraine. Doctors may use these invasive procedures and injections when medications or other alternative treatments are unsuccessful.
These procedures include:
- nerve blocks
- trigger point injections
- botulinum toxin type A (Botox)
Alternative treatments to consider for headache or migraine may be:
- supplements such as magnesium and riboflavin (vitamin B2)
- relaxation training
- cognitive behavioral therapy
- mindfulness and meditation
- aerobic exercise
When thinking about how to prevent your headaches or migraine attacks, it may be best to identify and avoid your triggers.
For example, you notice your headaches get a bit worse when you have two cups of coffee instead of one. In this case, you would always try to avoid the second cup and look for alternate ways to get your energy boost.
Also, if your headaches are getting worse or seriously impacting your daily life, it may be time to speak with a doctor. They can identify what is causing your headache or the type of headache you have and treat it appropriately.
Even though headache disorders are common, you shouldn‘t always ignore them. Instead, it is best to listen to your body and seek help if needed.