Headaches: Types, causes, treatment, prevention, when to see a doctor

Key takeaways

• A headache is a neurological problem that can cause pain around the head and neck region.
• There are different types of headaches, such as primary, tension, and cluster headaches. Understanding each type will help with proper treatment and management.
• Most headaches are harmless. But sometimes, they could be symptoms of life-threatening medical conditions. It is best to speak to a doctor if you experience a severe headache that persists or interferes with your daily activities.

Headaches are a common neurological disorder that can significantly disrupt your daily life. From dull throbbing sensations to sharp, intense pains, headaches come in various forms and can stem from a wide range of causes.

In this article we delve into the fascinating world of headaches, exploring their different types and possible ways to alleviate the discomfort. 

What is a headache?

A headache is a pain that is felt around the head, face, or neck. This pain can be described as a sharp, dull, pounding, or throbbing pressure on these upper body parts. 

Headaches can be complicated. They can happen for different reasons, come with different symptoms and require different treatment approaches. Some people can experience it as much as 15 days in a month while others may experience it only once or twice a year.

Headaches are linked to issues that relate to the central nervous system the muscles, nerves, and blood vessels around the head and neck. 

Causes of headaches

The major cause of a headache is the stimulation of pain receptors in the brain. Things that trigger headaches, such as stress, change in hormones, and certain medications can stimulate pain receptors called nociceptors. Nociceptors react to the triggers by sending messages to structures in the brain. 

Due to the wide range of possible headaches, medical conditions, too, can trigger headache disorders.

"Some of these medical conditions include viral infections such as influenza and COVID, bacterial infections like meningitis, and medical conditions like ruptured aneurysm (brain bleeding)” said Naomi Jean-Baptiste, a practicing Florida-based emergency medicine doctor and founder of Hope4med, an organization which helps healthcare professionals deal with burnout.

Lifestyle factors such as obesity, alcohol consumption, smoking, stress, and dehydration can also lead to headaches.

Other possible causes of headaches include:

• Anxiety
• Lack of sleep
• Skipping meals
• Depression
• Loud noises

What does a headache feel like?

Here are a few sensations you might feel if you've got a headache:

• Aching pain: Headaches can feel like dull constant pain or sharp piercing pain. You can feel them either on one side of the head or on both sides.
• Pounding or pulsating pain: Some headaches such as migraine could arrive with a stop-start pounding sensation making it feel like your head is splitting.
• Pressure: Headaches like tension headaches are associated with a tight band-like feeling which puts pressure around the head.
• Sensitivity to light and sound: Headaches can often cause an increased sensitivity to light (photophobia) and sound (phonophobia) and it worsens on exposure to bright lights or loud noises.
• Tenderness or stiffness in the neck and shoulder muscles: Headaches can be accompanied by muscle pains or stiffness in the neck and shoulder area, especially if the headache is tension-related.
• Nausea or vomiting: In some cases, headaches can be associated with feelings of nausea or vomiting.

Are headaches life-threatening?

Studies have shown that 96% of all headaches are mild and harmless and can be treated at home. When headaches are severe, they are often a result of an underlying medical condition. In such a case, it will be necessary to run further tests for proper diagnosis.

Severe medical conditions that can begin with a headache include:

1. Stroke: This neurological disorder is the second-leading cause of death. A 2015 study was conducted on 263 patients in Iran to observe the relationship between headaches and stroke. The results showed 49 out of 263 patients had headaches while living with stroke.
2. Meningitis: This is inflammation of membranes covering the brain and can be caused by bacteria, viruses, or fungi. Headaches can occur in people with bacterial meningitis.
3. Subarachnoid hemorrhage:  This is a form of stroke that causes bleeding in the brain and is caused by the rupture of a blood vessel in the brain. Most with subarachnoid hemorrhage experience a sudden headache known as a thunderclap headache which could quickly increase to the highest level of severity in less than two minutes and could be potentially deadly if ignored.

Types of headaches

There are at least twelve different types of headaches that could affect a person. They can be broadly classified into two main groups, namely:

• Primary headaches
• Secondary headaches

Primary headaches

A primary headache is one that is unrelated to any underlying health condition. Dr. Jean-Baptiste explained that the brain cannot feel pain, and the pain that people with primary headaches experience is due to inflammation of the nerves and muscles around the head and neck.

Types of primary headaches include:

1. Migraine headaches

With an estimated 1 billion people living with migraine headaches, this neurological disorder is extremely common, and the figures may be higher due to a large number of undocumented cases.

Migraine headaches can occur either on one side of the head or both sides. The pain might be accompanied by nausea or light sensitivity. Because these migraine attacks can last for a long time, they can interfere with work, school, or other activities.

Migraine can be further subdivided into 3 classes namely:

• Migraine with aura
• Migraine without aura
• Chronic migraine

Stages of Migraine Headaches

Research has also shown that migraine headaches occur in four major stages, which could last from a few minutes to at least four days.

1. Prodrome: This is the initial stage of migraine headaches and lasts for 24–48 hours. It is characterized by symptoms like sweating, vision difficulties, yawning, and unexplainable mood changes.
2. Aura: Auras are symptoms that could be present before the headache or along with the headache, such as seeing bright lines, tingling sensations, and hearing sounds. Auras can last from five to 60 minutes and are often reversible.
3. Headache: At this stage, one side of your head or both sides could be pounding furiously. Vomiting, insomnia, and neck pain may also follow suit. It might last anywhere between four to 72 hours.
4. Postdrome: This is the fourth stage of migraine headaches, and it is characterized by fatigue, a lack of concentration, and sharp pain as a result of sudden head movements.

2. Tension headaches

Tension headaches, also known as stress headaches, are so common that people consider them to be normal. These headaches are usually mild or moderate and could last for as little as 30 minutes.

Though the exact cause of tension headaches is not known, studies have shown that genetics, nutrition, and the environment play a major role. Tension headaches usually feel like there's a band tightly wrapped around your head, and they could occur frequently.

3. Cluster headaches

Though the least common type of primary headache, cluster headaches have a reputation for being painful, and they're more common in men than in women.

It begins when an important nerve known as the trigeminal nerve is triggered. The headaches could cause non-stop sharp pain or there could be occasional days off. During a cluster attack, many people, instead of seeking relief in a quiet place, tend to pace around agitatedly.

Secondary headaches

Secondary headaches are headaches that are caused by an underlying medical condition.

"Some medical conditions that could cause secondary headaches include high blood pressure, brain tumors, inflammation, and infections.” Dr. Jean-Baptiste explained.

Managing these types of secondary headaches effectively requires identifying and treating the root condition.

Types of secondary headaches include:

1. Medication overuse headache

This headache also known as rebound headache is caused by the frequent use of painkillers to cure an already existing headache.

Instead of being a relief, these drugs then become the source of the headache. In most medication overuse headaches, the patient is already living with migraine. 

As with all other drugs, when these painkillers are overused, it could lead to side effects such as bleeding in the stomach and intestines.

2. Thunderclap headache

Just like thunder, this headache strikes suddenly and lasts for one minute or less. The pain it brings along has led it to be described as the "worst-ever headache".

Thunderclap headaches can be a sign of a potentially serious underlying medical condition such as a blood clot, blood vessel rupture, or an intracerebral hemorrhage (bleeding in the brain).

Some possible symptoms of a thunderclap headache include nausea, vision loss, and vomiting.

3. Post-traumatic headache

Brain injuries can occur unexpectedly. They may result from a slip and fall on a wet floor, a head collision during sports, or even a car accident. 

Post-traumatic headaches could begin as soon as 7 days after a traumatic incident or a year later.

Scientific studies have also shown that post-traumatic headaches are triggered after a brain injury either by a chemical imbalance or the activation of nociceptors.

Treatment for headaches

Most headaches will subside with adequate rest, painkillers, and drinking plenty of water. In some cases, these are barely enough, and stronger measures have to be taken to treat headaches.

Depending on the type of headache, different medications could be prescribed for proper treatment. Some classes of these medications include:

• Non-prescription and combination analgesics
• Nausea relief drugs
• Triptan drugs
• Calcium channel blockers
• Ergot derivative drugs.

Some alternative headache treatments include yoga, biofeedback, meditation, and acupuncture which might be helpful to some people living with headaches.

How to prevent a headache

Preventing a headache is more effective than curing one, you get to save costs and make the best use of your days without succumbing to compulsory bed rest.

Living a healthy lifestyle is key to preventing headaches, says Dr Jean-Baptiste. She also suggested the following tips to prevent headache:

• Don't skip meals
• Drink plenty of water
• Sleep at a scheduled time daily. (7-9 pm)
• Reduce or eliminate caffeine completely
• Exercise regularly
• De-stress often (listen to calming music, take a walk, go on a trip)

When to see a doctor

Some headaches could stubbornly resist all home treatment methods, but at what stage should you see your doctor?

Dr. Jean-Baptiste recommends speaking to your doctor if you observe strong, sudden headaches which increase in intensity in a short time, this could indicate bleeding in the brain and require immediate medical intervention.

In addition, the presence of new changes in behavior and convulsions should prompt you to see a doctor. Your doctor may order for some tests to determine whether what you are experiencing is a secondary headache which requires treating the underlying medical condition.

Checking in with your doctor after a head injury especially one that involved loss of consciousness could be life-saving, too.

Further, symptoms like a stiff neck, rash, or a fever should not be ignored as they could be symptoms of diseases that could make one prone to headaches such as meningitis.

Wrap up

In summary, headaches can be a nuisance but with proper understanding and proactive measures, we can effectively manage and prevent them.

By understanding the different types of headaches and their causes, we can minimize the impact of headaches on our lives and promote a healthier, pain-free existence.