Pretty much everyone has endured the suffering of a headache. They’re one of the most common ailments in the world. But headaches can be as unique as the people who are affected by them. You might have a fleeting ice cream headache, or a migraine that last months. Understanding what causes each type of headache and what it feels like are the first steps to finding relief.
Headaches can be much more than a nuisance. For some they are debilitating. “I often get a migraine two days prior to starting my period,” says Aisha Muhammad, MD, a pediatrician in London. “I have to avoid making any important meeting plans,” she says. She has even had to change her shifts because of her migraines.
Muhammad is hardly alone. Migraines are the sixth most debilitating disease in the world, and affect some 39 million Americans, according to the Migraine Research Foundation(opens in new window).
Know Your Headache
Headaches can be related to hundreds of conditions, so saying that you “have a headache” is a bit vague. What is a headache? “Headaches refer to any pain within the head, face,” and may include the neck, explains Jonathan Cabin, MD, a Beverly Hills-based head and neck surgeon. “This pain may be centralized to one portion or emanate throughout all areas.”
Some of the most common headaches include:
Tension headaches: Most headaches are this kind. They are often characterized as a tight feeling, like a band around the head, which may cause tenderness in the scalp, neck, or shoulders. The pain is mild to moderate, and has a slow onset. Tension headaches generally begin in puberty, and are more common in women.
Migraines: Migraine sufferers may experience several symptoms along with their headache, including nausea, vomiting, lightheadedness, and sensitivity to light. Migraine pain is usually moderate to severe, one-sided, and characterized by a pulsating pain. Migraines are also noted to have distinct phases, though not everyone will experience each. These may include:
- The premonition phase, which affects the mood and can start days before the headache;
- An aura phase, which can cause visual, sensory, or motor changes;
- The headache phase, which may include throbbing pain and sensitivity to light and motion. This phase may also include depression, anxiety, and fatigue.
- And the resolution phase, in which pain may subside and fatigue, irritability, and anxiety occur.
These headaches often start in puberty and can be a lifelong disorder. Migraines are more common in women because of hormonal influences, and they most affect people between 35 and 45. They can be extremely disruptive to your daily routine.
Cluster headaches: Cluster headaches are relatively less common. These headaches are usually concentrated behind one eye, and other common symptoms include: swelling eyelids, redness and/or watery eyes, runny or congested nose, and swelling of the forehead. Episodes typically occur frequently, with severe pain that may last for weeks or months. These headaches usually affect people in their twentiess and older, and unlike with migraines and tension headaches, they afflict men more commonly than women.
Other Kinds of Headaches
Some headaches may be a symptom of another condition. It’s important to recognize such headaches, known as secondary headaches, because they may point to an underlying disease, perhaps even a life-threatening one that requires immediate treatment. Even when it’s not life-threatening, treating the underlying issue can usually bring relief.
Some types of secondary headaches include:
- Medication overuse headache. The most common secondary headache disorder,(opens in new window) medication overuse headaches typically affect women more than men. It seems counterintuitive, but they’re caused by the overuse of pain medication to treat headaches. This headache pain is characterized by almost daily pain, usually upon awakening. These headaches usually stop when the pain medication is discontinued, which can be tough at first but your doctor can help you.
- Cold stimulus headaches (brain freeze). Also known as ice cream headaches.
- Thunderclap headache, Relatively uncommon but serious. Thunderclap headaches are often a red flag of a life-threatening condition. They tend to strike suddenly and with severe pain, peaking within 60 seconds. Thunderclap headaches may also be accompanied by other concerning symptoms like nausea or vomiting, an altered mental state, fever, and/or seizures.
- Sinus headache. Characterized by pain, pressure and fullness in the cheeks, brow and forehead, and a stuffy nose, sinus headaches can be confused with migraines because they, too, can worsen when you bend forward. Unlike migraines, however, sinus headaches aren’t usually accompanied by nausea or sensitivity to noise or bright light.
Self-Management for Headaches
Generally, a well-balanced lifestyle can play an important role in dealing with headaches like migraines and tension headaches.(opens in new window) Managing stress levels, not skipping meals, sleeping regularly, and even improving your posture may be important for headache management and prevention. Here are some tips for dealing with headaches.
- Find a dark, quiet room to rest. For headaches that cause symptoms like nausea and sensitivity to noise and light, like migraines, resting in a room that’s quiet and dark can provide much-needed relief.
- Ice or heat the pain. You can apply a cold (or hot, if that feels better) compress to your head or neck to help dull some migraine pain. A hot shower, warm bath, or a heating pad can relax tense muscles during a migraine attack as well. A heating pad to ease your tense muscles is also an effective treatment for tension headaches.
- Drink a small amount of caffeine. In the early stages of a migraine, caffeine can help alleviate migraine pain or give an extra boost to over-the-counter pain relievers like acetaminophen or ibuprofen. Research suggests that having at least 100 mg of caffeine (roughly one cup of coffee) may enhance the pain-relieving benefits of some OTCs.
- Try OTCs. Pain relievers you can buy at the store are typically the first line of treatment for tension headaches. But, as clinicians warn, treating tension headaches too frequently with OTCs can be harmful as well. “Over-the-counter non-narcotic pain relievers can be used to treat the occasional tension headache,” says, Jose Posas, III, MD(opens in new window), a neurologist at Ochsner Health System in New Orleans. However, using aspirin, ibuprofen, or acetaminophen three or more days per week can result in rebound headaches, so don't overdo it.
- Try to relax. If you’re someone who suffers from tension headaches frequently, practicing relaxation techniques can help you learn how to release tension from your muscles as a preventive solution.
When to See a Doctor
“In general, if headaches aren’t properly recognized and treated, people can tend to have a diminished quality of life,” says Cabin. And they’ll suffer through pain that may have been avoided. See your doctor if you notice your headaches:
- Are happening more frequently than usual
- Are becoming more severe than usual
- Don’t get better or get worse after taking over-the-counter medications
- Interfere with your daily life, by keeping you from working, sleeping, or other activities
- Cause you distress
A headache can be a symptom of other problems, from the relatively benign, like sinus or ear infections, to extremely serious issues like, tumor, stroke, or brain aneurysms. Go to the emergency room, or call 911(opens in new window), if you have the worst headache you have ever felt, a sudden severe headache, or one accompanied by:
- Confusion or difficulty understanding people talking to you
- High fever
- Stiffness in your neck
- Troubled vision
- Difficulty speaking
- Difficulty walking
- Nausea that is not clearly related to other issues, such as the flu
Headaches are a part of pretty much all of our lives. But they shouldn’t define it. If you have headaches regularly, seek help. It may be possible to get past the pain.