What type of headache do you have? How to tell

Man with a headache, holding his temples

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Even though headaches have no single cause, that pain in your noggin can qualify as a legitimate neurobiological disorder.

Armed with more education about headache causes and available treatments, people with this kind of pain no longer have to suffer needlessly. But the key to getting the right kind of treatment is understanding what type of headache you have.
What headache type do you have?

If you often have headaches, or even just pain that isn’t frequent but that disrupts your whole day, the good news is that help is available, and treatment options are increasing. Unfortunately, many headache sufferers don’t know about many newer treatment options because they just deal with the pain on their own.

Determining what type of headache you have is the first step to finding appropriate treatment. According to a 2008 survey by the National Headache Foundation (NHF), 73% of headache sufferers reported experiencing more than one type of headache. For this majority, it is essential to determine headache type in order to develop a specific treatment plan.

“Educating yourself on different types of headache is important,” says Lisa Mannix, MD, Board Member, National Headache Foundation and practicing physician. “However, it is best to make an appointment with your healthcare professional to obtain an accurate diagnosis and to establish the appropriate treatment plan.”

With all the different headache types and the variety of symptoms among individual sufferers, the National Headache Foundation (NHF) offers some characteristics of common headaches, so you can track your symptoms to get the right kind of help.

6 different headache types

1. Tension headaches

Approximately 78 percent of adults experience a tension-type headache at some point in their lives, making it the most common form of headache.

The pain is often described as pressing or tightening, of mild to moderate intensity and occurs on both sides of the head. There are two general classifications of tension-type headache: episodic and chronic, and can vary in frequency and severity.

Chronic tension-type headache can also be the result of anxiety or depression. Changes in sleep patterns or insomnia, early morning or late day occurrence of headache, feelings of guilt, weight loss, dizziness, poor concentration, ongoing fatigue and nausea commonly occur.

As common as tension-type headaches are, the causes and symptoms of these headaches are more complicated and unique than many might realize. Often people do not seek medical attention when they should because they assume that the cause of their headache is “just” tension.

2. Migraine headaches

More than just a “bad headache,” migraine pain and associated symptoms affect 29.5 million Americans. Both men and women experience migraines, although women are three times as likely to suffer from them.

Migraine is characterized by throbbing head pain, usually located on one side of the head, often accompanied by nausea and sensitivity to light and sound. Most migraine occurs episodically; however, 10 million Americans have chronic headache (15 or more days per month). The attacks may last four to 72 hours. Many people experience episodic migraines that evolve over time to chronic migraine.

According to the American Migraine Study II (AMS II) – A Ten Year Report Card, conducted for the NHF, 52% of the people whose headaches fit the medical definition of migraine remain undiagnosed, and migraine is misdiagnosed as sinus or tension-type headache almost as often as it is correctly diagnosed. Nearly six out of 10 (57 percent) people with migraine continue to rely solely on general over-the-counter pain relievers or on no medications at all to relieve pain.

Many things may trigger a migraine. Triggers may include diet, stress, environment, odors/perfumes, emotions, medications and hormonal fluctuations. With proper diagnosis and treatment, migraine can be effectively managed.

3. Chronic daily headaches

Chronic daily headache (CDH) refers to a broad range of headache disorders occurring more than 15 days a month — in many cases daily — for a period of at least three months.

The main kind of chronic daily headache (CDH) is further subdivided into two distinct categories: headaches lasting more than 4 hours and headaches lasting less than 4 hours. There may be as many as 5% of the population encountering severe headaches on a daily or near-daily basis, and these people make up the majority of consultations to specialists.

In many cases, those with CDH are incorrectly given the chronic tension type headache diagnosis.

The NHF says that people with chronic daily headaches often overuse pain relief medication, which can start or sustain the frequency patterns seen with CDH. Analgesics, triptans and ergotamine medications all have the potential to cause chronic daily headaches.

4. Sinus headaches

Sinus headache symptoms may include tenderness over the sinus, a deep dull ache exaggerated by head movements or straining accompanied by nasal discharge, ear sensation or fullness, and facial swelling.

In fact, the NHF notes that the vast majority of people who think they are experiencing “sinus” problems are actually suffering from a vascular type of headache. When sinus disease is the cause of the headache, an accompanying fever is often present, and x-rays or a sinus CT scan will indicate some sinus blockage. One or both nostrils are blocked and the pain extends over the cheek or forehead. The area is tender to the touch.

Allergic reactions and tumors in the sinuses also can produce inflammation, swelling, and blockage of the sinuses. However, vascular headaches can cause similar symptoms. Whether the symptoms of headache are due to sinus disease should be determined through an examination by a physician.

5. Cluster headaches

There are an estimated one million cluster headache sufferers in the United States; about 90 percent of these sufferers are male. Cluster is one of the least common types of headache, and the cause is unknown.

Cluster headache refers to the characteristic grouping or clustering of attacks. The headache periods can last several weeks or months and then disappear for months or years. Sufferers are generally affected in the spring or autumn, and, due to their seasonal nature, cluster headaches are often mistakenly associated with allergies.

With typical cluster headaches, the pain is almost always one-sided, usually localized behind the eye or in the eye region, and may radiate on the same side to the face or neck. The eyelid may droop, and the sinus becomes congested on the side of the head where the pain occurs.

Cluster sufferers report that even small amounts of alcohol or smoking will precipitate an attack during a cluster cycle, but not during cluster-free times.

Unlike migraines, which can last an entire day or potentially several days if left untreated, according to a 2021 study from the University of Texas Health Science Center at Houston, cluster headaches typically last anywhere from 15 to 180 minutes. While it’s uncommon to have more than one migraine a day, it is possible for someone to have up to eight cluster headaches over a 24-hour period.

6. Secondary headaches

An organically-caused secondary headache is not a disease itself; rather it is a symptom of another disease or disorder.

Organically-caused headaches can include tumors, infection, high blood pressure, diseases of the brain, eye, ear and nose, blood clots, and aneurysms to name a few. These conditions can be life-threatening so immediate evaluation by a doctor is recommended.

Some signs that the headache is related to a serious disorder include a change in headache pattern; headaches associated with a medical problem or neurological symptoms such as focal weakness, loss of consciousness or confusion; pain that becomes progressively more severe or is the ‘worst’ headache ever experienced.

How to figure out what kind of headache you have

Although headaches are rarely life-threatening, they can make work more difficult, or take the enjoyment out of your favorite leisure activity. While painful and sometimes debilitating, the majority of headaches people encounter do not indicate a more serious problem.

Keep a headache diary. Identifying patterns among headache triggers, timing, duration and pain level and location offers useful information to share with your healthcare professional to help determine the headache type you are dealing with.

Educate yourself about headaches. Specific headache resources are available on the NHF Web site to educate sufferers on possible headache types, symptoms, and potential treatment options.

Educate yourself about treatment options — both medication and non-medication. Treatments can have varying results from patient to patient so it is important that a sufferer understands how each option may work for them on an individual basis.

See your healthcare professional. If you are experiencing headache pain that affects your life, make an appointment with your healthcare provider specifically to discuss your headache problem and seek accurate diagnosis and treatment.

In rare cases, a headache may warn of a serious illness. Get medical help right away if you have a headache after a blow to your head, or if you have a headache along with fever, confusion, loss of consciousness, or pain in the eye or ear.

Over-the-counter OTC pain medication - acetaminophen
Image by maxxyustas/Envato

When treating a headache, don’t overdo on headache meds

If you have a lot of headaches, be careful not to overuse headache medications, such as aspirin, ibuprofen or acetaminophen. In fact, experts advise not taking certain pain-relief medicines for headaches more than three times a week.

Overuse can cause “rebound” headaches, making headaches more frequent and more painful. People with repeating headaches, such as migraines or tension headaches, are especially at risk.

Over-the-counter medicines can reduce the pain — but they’re not the only options.

“Lifestyle changes to relax and reduce stress might help, such as yoga, stretching, massage, and other tension relievers,” says Dr Linda Porter, an NIH expert on pain research.

“Know what kind of headache you have and, if you can’t manage it yourself, seek help,” Porter says. “Remember there are preventive behavioral steps and medicines that can help manage headaches. But if the pain is severe or lasting, get medical care.”

Nancy J Price & Betsy Bailey

Nancy J Price & Betsy Bailey

We're Nancy and Betsy, and we've been adventuring in the digital world since the mid-90s -- truly making us that type of entrepreneurial internet pioneer Gen X is known for! We started Myria.com back in 1998 and later launched SheKnows.com -- among various other online and print projects. Our partnership has spanned decades and crossed state lines (multiple times!). Nancy currently resides Arizona, and Betsy's newest home base is Minnesota. It's been an incredible journey of collaboration and innovation. You can read more about our story here!

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