Headaches: Types, Symptoms, and Treatment

Types of headaches

There are many types of headaches. The International Headache Society has defined several patterns of headache in order to help people with headaches find their most effective treatment. The main types are described below, but it is important to note that there are also other kinds, including secondary headaches which have an identifiable cause. As many as 90 percent of all primary headaches fall under these major categories. List of headaches can include:

• Cervicogenic headaches
• Chronic Daily headaches
• Migraine headaches
• Cluster headaches
• COVID-19 headaches
• Headaches as a side effect of medicine or lifestyle
• Exercise headaches
• Post-traumatic headache
• Daily persistent headaches
• Headaches during pregnancy and postpartum
• Cough headaches
• Tension headaches

Primary headaches are disorders in which the pain can not be traced back to another problem. Secondary headaches are ones that have an identifiable cause, such as a tumor or a dental procedure.

Some headache types like cluster headaches and migraines may occur with other symptoms, such as disturbed vision, vomiting and nausea, sensitivity to light and sound, and weakness on one side of the body.

Common Headache Symptoms

A headache can have many different symptoms. Most headaches are not dangerous, but severe or long-lasting pain may indicate a serious problem that requires medical attention. Possible symptoms include:

• Throbbing pain
• Pain in one specific location
• Pulsating or throbbing
• Pressure around the head, neck and scalp
• Pain on one side of the head
• Pain that worsens with activity
• Nausea and vomiting (particularly in people who experience migraines)
• Light and/or sound sensitivity (in migraine sufferers)
• Sensitivity to smells (in some migraine sufferers)
• Loss of appetite, disturbed sleep, mood changes or fatigue
• Symptoms include pain which varies in severity, location and quality. The person may experience associated symptoms such as nausea, vomiting, sensitivity to light or sound.

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Headache Risk Factors

The following risk factors can serve as indicators for those who may have more serious underlying causes for headaches. Those who don't fall under any of these risk factors are likely to be experiencing more common headaches.

• 50 years and older
• No history of similar headaches
• Abnormal neurologic findings
• Change in headache pattern
• High-risk co-morbidities
• New findings on history or examination

Causes of headaches 

A number of factors can be related to the cause of headaches. Causes for common headaches include:

Alcohol - Drinking too much alcohol can trigger a headache in some people. Drinking water may help to make you feel better, but stop drinking alcohol if it doesn't resolve the problem.

Bad posture - Slumping your shoulders or hunching over your desk at work for long periods of time can contribute to tension-type headaches

Stress - can contribute to headaches, especially stress that's ongoing or chronic.

Sleep problems - Men with sleep apnea are more likely to experience headaches than those without sleep apnea. A disruption of sleep patterns (sleeping during the day and staying awake at night) may also increase the risk of headache.

Hormonal changes - Headaches may occur during or after menstruation. Some women experience migraines that are related to reproductive hormones, while others report headaches related to oral contraceptive use.

Dietary factors - Migraine sufferers commonly identify certain foods as triggers of their migraine attacks. Excessive caffeine, alcohol, monosodium glutamate (MSG), aspartame, nitrates, tyramine and stress are common dietary triggers of migraine attacks. Foods containing these ingredients may cause headaches in some people.

Headaches are a very common ailment that most people experience at some point throughout their life. They can be debilitating for many reasons - they affect daily life, the ability to work.

There are a number of causes for more serious headaches that are best discussed with your healthcare provider.

Diagnosing headaches

When diagnosing your headaches, your providers will start by paying attention to your health history and completing an exam. For your health history, information that can help with diagnosis of a headache may include:

• Age at onset
• Presence or absence of aura and prodrome
• Frequency, intensity, and duration of attack
• Number of headache days per month
• Time and mode of onset
• Quality, site, and radiation of pain
• Associated symptoms and abnormalities
• Family history of migraine
• Precipitating and relieving factors
• Exacerbation or relief with change in position (eg, lying flat versus upright)
• Effect of activity on pain
• Relationship with food/alcohol
• Response to any previous treatment
• Review of current medications
• Any recent change in vision
• Association with recent trauma
• Any recent changes in sleep, exercise, weight, or diet

A physical examination that can help with diagnosis includes looking at:

• Blood pressure and pulse
• The head, neck, and shoulder regions
• Neck arteries
• Your spine and neck muscles

If needed, your doctor may also order further neurologic examination, sensory tests, or imaging.

Treatment for headache

The treatment will depend on the type of headache sufferer has - there are specific medications available for migraine sufferers, for example. The following headache treatments are general treatment options for all forms of headache.

Exercise - Often helps to prevent or relieve tension-type headaches by increasing the circulation and relaxing muscles.

Lifestyle changes - Avoiding alcohol, tobacco, caffeine; sleeping well; getting regular exercise; maintaining a healthy weight; learning stress management techniques (yoga, deep breathing); eating a healthy diet.

Medication - Non-steroidal anti-inflammatory drugs (NSAIDs) are the first line of treatment for mild to moderate pain. Muscle relaxants can reduce tension headaches. Specific medication is available for migraine sufferers.

Treatment may depend on the person's age, headache type and other underlying conditions. For more serious headaches, such as those that are very severe or last a long time, medical attention should be sought.