6 Types of Headaches and When to See a Doctor

One of the most common conditions or symptoms most patients complain to their doctor about is one or more types of headaches. 

KEY POINTS:

• Headaches are basically classified into primary and secondary headaches. 
• Primary headaches are the most coomon, and they affect about 46% of the adult population.
• Secondary headaches are mostly linked to underlying health conditions.
• 6 types of headaches discussed elaborately in this article are:
• Tension headache
• Migraine
• Cluster headache
• Sinus headace
• Hormonal headache
• Rebound headache

Headache is a global problem that affects people of all ages, races, income levels, and geographical areas. A good percentage of the global adult population has had headaches at least once.

Headaches are classified into primary and secondary headaches: 

Primary headaches are common headaches. They have no specific cause, although factors, such as muscle tension, stress, or lack of sleep may be a trigger. Primary headaches affect about 46% of the general adult population. The 3 main types of primary headaches are tension headache, migraine, and cluster headaches.

Secondary headaches are linked to underlying health conditions such as sinusitis, traumatic events, hormonal changes, high blood pressure, or tumors.

Types of Headaches

Each type of headache has its own cause. Some of the causes may be harmless while some may be a cause for concern and the accompanying symptoms may indicate if you need immediate medical attention.

Tension Headaches

Tension-type headache: This is a benign and most common type of primary headache. It feels like there is a tight band around the head. 

A tension headache is the most prevalent type of headache. it can be experienced by anyone, but they are more common in adults and older teenagers. Tension headaches tend to run in families and studies have revealed that it is three times more common in women than in men.

Causes and triggers of tension headache

Also known as muscle contraction headache. Tension headache occurs when the muscles of the neck and scalp muscles become tense or contract. The contractions of the muscles can be a reaction to stress, anxiety, depression, or head injury.

Common triggers of tension headaches include:

• stress and anxiety
• poor sleep
• caffeine
• alcohol
• hunger and dehydration
• straining your eyes from staring at the screen for a long time
• Keeping your head in one position for a long period such as when reading or working on the computer
• sleeping with your neck in an odd position

Common symptoms

• Mild to moderate but not severe pain
• Feels like a tight grip around the head (not just on a spot or side)
• The pain is worse on the head, temples, or back of the neck, and possibly in the shoulders.

 Treatment options

1. Lifestyle changes: lifestyle changes that can be used to manage tension headaches has to do with avoiding or reducing the triggers. This includes:

• not skipping your meals, especially breakfast
• getting enough sleep and rest
• stay hydrated
• Practice good sitting posture when working, reading, or doing other activities.
• Always exercise the neck and shoulders when reading or working on computers or doing other close work that involves sitting for a long time in one position.
• avoiding any food that may trigger your headache
• Change your pillow or sleeping position 

2. Over-the-counter pain relievers: OTC pain relievers such as paracetamol, aspirin, and ibuprofen are safe and effective for treating this type of headache.

3. Relaxation techniques: relaxing may help to decrease the frequency and severity of headaches. You may get relief with biofeedback or other activities that can help you to relax such as meditation, yoga, breathing exercise, and massage.

When to see a doctor for tension headaches

Call or see a doctor if the headache:

• occurs after an injury to the head
• is accompanied by fever and vomiting 
• if light and noise make the pain worse
• cause you to have blurred vision or you find it difficult to speak
• if you have a stiff neck
• Start experiencing frequent headaches while you are over the age of 50.

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Migraine Headaches

A migraine is a severe pounding pain that usually occurs on one side of the head. This type of headache can be extremely painful and it can make it difficult to carry out your daily activities.  Migraine attacks can last for 4 hours to 3 days if left untreated.

Migraine often starts at puberty and mostly affects those between 35 and 45 years. Because of hormonal influences, it is twice more common in women than in men.

There are 4 stages in migraine, though not everyone experiences all the stages. These four stages are prodrome, aura, attack(the headache), and post-drome. There are 3 types of migraine depending on the stage of migraine one experiences  – 

migraine with aura

migraine without aura

migraine aura without headache.

Causes and triggers

The exact cause of migraine is unknown, some medical experts believe that it can be caused by abnormal brain activity. 

It tends to run in the family. So, your chance of having them is high if you have a close family member who has them.

Some factors that can trigger migraine are:

• stress and fatigue
• anxiety and depression

• skipping meals
• lack of sleep
• alcohol consumption
• too much caffeine
• Onset of menstruation
• certain smells
• exposure to sunlight.

Common symptoms

The symptoms of migraine are not the same for everyone. It differs depending on the type of migraine. But  the common symptoms are

• pounding pain that gets worse when you move around. it is usually accompanied by
• Nausea
• vomiting
• sensitivity to light and sound 

you may also experience 

• Concentration problems
• Tummy ache
• dizziness (lightheadedness)

 Treatment options

1. Medication: includes painkillers like ibuprofen and paracetamol, triptans, and ergotamine to manage symptoms. 
2. Lifestyle changes: some of the recommended lifestyle changes include:

• Not skipping meals 
• Proper sleep and rest
• Cut down your caffeine intake.

3. Breathing and relaxation exercises: engage in yoga, meditation,  breathing and any other relaxation exercise.

When to see a doctor for migraines

contact your doctor if 

• the migraine is too severe or getting worse, or if it lasts longer than usual
• the migraines occur more than once a week
• you are having a hard time controlling your migraines
• the pattern of your headache changed or it suddenly felt different.

Cluster Headaches

This is a rare and most severe type of primary headache. Also known as a suicidal headache, this type of headache is characterized by a sudden attack of extremely painful headaches that comes in clusters. It usually recurs at the same time of the day or night for several weeks.

Cluster headache occurs on one side of the head, usually behind or around one eye, and continues with a migraine-like headache and nausea. The intensity of pain gets worse 5 to 10 minutes after it starts and lasts for about 3 hours. 

Cluster headaches mostly affect adults 20 years and older. it is more common in men than in women, according to WHO, it affects 6 men to a woman.

Causes and triggers of cluster headaches

The exact cause of cluster headaches is unknown, but it is believed to be related to the sudden release of histamine or serotonin in the body. Some of the things that may trigger cluster headaches are:

• Alcohol
• Smoking cigarettes
• Bright light
• Strong smell
• Exercise 
• Moving to a higher altitude
• Heat, either hot weather or a bath
• Nitrates containing foods such as bacon or beef
• The use of cocaine 

Common symptoms of cluster headaches

• sudden onset of stabbing pain around or behind one eye
• headache gets worse 5 to 15 minutes after it starts
• Redness or watery of the eye, 
• runny or blocked nose on the affected side
• eyelid droop
• feeling restless or agitated
• sweating on the forehead

Treatment options

Cluster headaches cannot be cured and since they occur suddenly, over-the-counter drugs like paracetamol are not fast and effective for treating them. The ways to treat cluster headaches involve: 

• Acute treatments: this option relieves cluster headaches within 15 to 30 minutes. They include the use of Oxygen therapy, sumatriptan injections, sumatriptan or zolmitriptan nasal spray 
• Preventive treatments involve using certain medications to prevent the onset of cluster headaches. This includes the use of calcium channel blockers like verapamil, corticosteroids, noninvasive vagus nerve stimulation (VNS), nerve blockers, and anti-seizure medications like topiramate.
• Another preventive treatment method is lifestyle changes which involve avoiding triggers. Stop smoking and drinking alcohol.

When to see a doctor for cluster headaches

Because this type of headache is rare and severe, it is advised that you see a doctor when you experience them for a proper diagnosis, to rule out any other underlying medical condition which may have similar symptoms, and to get proper treatment.

Sinus Headaches

Most times, migraine and tension headaches have been misdiagnosed as Sinus headaches. According to the American migraine foundation, 90% of the time, migraine with nasal symptoms has been self-diagnosed as a sinus headache.

Sinus infection known as sinusitis causes pressure and pain in the sinus resulting in sinus headache. Sinus headache feels like a continuous pain inside the cheeks, forehead, and sometimes the nose bridge. It may feel like a migraine but it is not accompanied by nausea or vomiting nor is it worsened by light, or noise as in migraine headaches.

Causes and triggers

Sinus headache is caused by a sinus infection(sinusitis) and any other factor that could cause sinus infection can also trigger sinus headache. This includes:

• Allergies
• Cold
• Chronic inflammation
• Structural issues such as nasal polyps

Common symptoms

Common symptoms associated with sinus headaches are

• Fever
• Nasal congestion
• Thick, colored mucus discharges from the nose.
• Pain that feels worse when you lean forward
• Postnasal drip with a sore throat 
• The feeling of fullness in the ears.

Treatment options

1. Addressing underlying sinus issues: To get rid of a sinus headache, you have to treat the cause. This includes taking allergy medication for sinus infections caused by allergy.

2. Pain relievers such as ibuprofen and paracetamol can help to relieve the pain. Over the Counter cold medications can also help to relieve pain and a blocked or runny nose. OTC antihistamines may help if the headache is caused by allergies

3. Nasal irrigation can help to rinse off most of the thick mucus and relieve the symptom of sinusitis which in turn will help to get rid of sinus headaches.

When to see a doctor for sinus headaches

You can manage sinus headaches at home with OTC medication if it is not causing you too much pain. However, consult your doctor if:

• the pain gets worse after initially getting better
• symptom continues for more than 10 days without improving
• you have a fever that stays on for more than 3–4 days

Hormonal Headaches

Fluctuation in hormone levels during the menstrual cycle, pregnancy, and menopause is one of the main factors why most women have severe headaches mostly confused as migraine. It can last for a few hours or days and can be worsened by movement, light, or noise.

Causes and triggers

Hormonal headaches are triggered by a change in estrogen and progesterone levels.

Factors that can cause changes in levels of hormones and trigger hormonal headaches are:

• menstruation
• pregnancy
• lactation
• menopause
• taking oral contraceptive
• Hormone replacement therapy

Common symptoms of hormonal headaches 

The main symptom of hormonal headaches is migraine accompanied by:

• loss of appetite
• Tiredness
• Sensitivity to light and noise
• blurred vision.
• Nausea and vomiting,
• Dizziness 

Treatment options

1. Hormonal therapy: A licensed doctor may prescribe medication with a lower dose of estrogen to relieve symptoms or recommend starting the next cycle of contraception early. This means you have to skip last week’s hormone-free placebo pills. Doctors usually recommend this method for three to six months, to reduce the frequency of headaches.

2. Lifestyle changes that can help with hormonal headaches include: 

• avoiding or reducing stress,
• not skipping meals
• get a good night sleep
• exercise regularly.

3. Pain relievers such as:

• over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen
• triptans, which are migraine-specific medications that can reduce the intensity of a migraine attack

 When to see a doctor for hormonal headaches

Talk to a doctor if:

• You are pregnant and experiencing severe headaches. Since some headache medicines can harm the developing fetus, your doctor will prescribe the best medication for you.
• you are in menopause taking hormone replacement therapy and experiencing headaches. Your doctor may adjust the dosage. 

Rebound Headaches

This is the most common secondary type of headache. Also known as medication overuse headache. It occurs as a result of frequent use of certain medications.

It may affect up to 5% of the general population. Women experience it more than men. It usually occurs as a result of regular, long-term, or excessive use of pain relievers or headache-treating medications

Causes and triggers of rebound headache 

The same medications initially intended for relieving headaches and other pain can trigger subsequent headaches if they are used too often or for a long period. These medications which  can be OTC pain relievers or  prescription – only medicine (POM) include:

• Common pain relievers such as paracetamol and aspirin 
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen 
• Migraine medicines such as triptans and ergotamine
• opioids
• Daily intake of caffeine may also trigger or worsen  rebound headaches

Common symptoms

The symptoms of rebound headaches may differ depending on the type of headache that was initially treated and the medication taken. rebound headaches typically:

• occur almost every day. 
• They may feel worse when one just wakes up from sleep
• headache may be mild like the tension type of headache or severe like the migraine type of headache
• pain gets better with the use of pain relievers but the pain returns when the medication wears off

 Other symptoms are:

• Nausea.
• Insomnia and restlessness.
• tiredness and Irritability.
• having a hard time concentrating
• anxiety and depression
• memory problems.

Treatment options

1. Identifying and discontinuing trigger medications. Consult your doctor before stopping your medication if it is prescribed and you are still undergoing treatment.

2. Detoxification. You can break the cycle of headaches by either immediately stopping the pain medication, or gradually withdrawing from the usage of the drugs.

3. Preventive measures

• stick to the instructions on the label of the headache-preventing medications  and your doctor’s instruction
• Use pain relieving medication only when necessary.  Unless recommended by your doctor, do not take pain relievers more than once or twice a week.
• Avoid taking caffeine or products that contain caffeine when taking pain-relieving medications especially those that contain caffeine.

When to see a doctor for rebound headaches

Consult your doctor if:

• You usually have more than one headache a week.
• You take medication to relieve headaches more than twice a week.
• Your headache only improves when you take more than the recommended dose of the prescribed or nonprescription pain medicines.
• The pattern of your headache changed.

Conclusion

Almost everyone has experienced headaches at one point or the other in their lives. Knowing and recognizing the different types of headaches can help to effectively prevent and manage headaches.

Headaches can be managed using different medications depending on the type of headache. Lifestyle modifications can also be used to prevent or reduce the frequency of headaches occurring.

A headache can be an indication of a serious medical condition. So don’t rush to pop drugs into your mouth whenever you have a headache.

It is recommended that you consult with a healthcare professional to determine the exact underlying cause of your headache if you experience frequent headaches. The doctor will develop a personalized treatment plan that will work for you.