The major types of headaches and when to seek medical attention

You can identify your type of headache based on a few common signs.Science Photo Library/Getty Images
  • The most common types of primary headaches are tension headaches, migraine headaches, and cluster headaches.
  • Secondary headaches are the result of another medical condition, and can include a sinus or allergy headache, hangovers or dehydration, and concussions.
  • Here's how to identify your type of headache and when you need to seek medical attention.
  • This article was medically reviewed by Vernon Williams, MD, sports neurologist and director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, CA.

Headaches are extremely common and can occur for a variety of reasons. Most headaches are relatively harmless, but can still be very annoying. And some headaches can be the result of a separate condition, which may require medical treatment.

Here's what you need to know about the most common types of headaches, how to figure out which one you have, and what you can do for prevention and treatment.

Primary headaches

Primary headaches originate in the head and are not caused by another, underlying medical condition. Advertisement

These headaches — which include cluster headaches, migraine headaches, and tension headaches — affect the pain receptors in the brain. In fact, each one is commonly identifiable by a specific type of head pain.
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A combination of brain chemicals, nerves, muscle tension, and even genetics can all play a role in the development of primary headaches, and doctors can't always pinpoint one exact cause.

"The cause for these headaches is uncertain and it is not very clear why some suffer from them and others do not," says Oluwatosin Thompson, MD, a neurologist at GBMC Healthcare in Towson, Maryland.
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Tension headaches

Tension headaches are the most common type of primary headache, occurring in about half of women and one-third of men, according to the World Health Organization.

Tension headaches occur when the muscles around the scalp become tight, and it commonly feels like your head is being squeezed. Common triggers for tension headaches include:
  • Stress
  • Eye strain
  • Depression
  • Fatigue
  • Alcohol use or caffeine use
Tension headaches can be treated with over-the-counter pain medications like aspirin, ibuprofen (Advil), or acetaminophen (Tylenol). Some people with chronic tension headaches — tension headaches for more than 15 days per month — will be treated with muscle relaxers to help prevent headaches. Advertisement

Managing stress and learning relaxation techniques can also help prevent and treat tension headaches. A 2019 study published in Rooyesh-e- Ravanshenasi Psychological Journal looked at 55 women with chronic tension headaches who kept a journal of their headache symptoms. Researchers found that those who were taught stress management and muscle relaxation techniques, in addition to being treated with muscle relaxers, had fewer headaches than those who were only treated with muscle relaxers.

Migraine headaches

Migraine headaches involve a throbbing or pulsing pain, usually in one side of the head. They may be accompanied by nausea, vision changes, and weakness. About 12% of Americans experience migraines, and women are three times more likely than men to have these headaches.

There also appears to be a genetic link, with migraines running in families, Thompson says, but scientists are still trying to understand the role that genetics play in migraines. It's believed that genetics account for 34% to 57% of the variability in whether or not a person develops frequent migraines. Advertisement

Migraines are reoccurring, so an important step in treatment is identifying triggers, says Leann Poston, MD, a physician trained at Wright State University School of Medicine who is now a medical writer.

These vary for each individual, but common triggers include:

  • Certain foods. For some people, chocolate, yeast, and processed meats can trigger migraines, although scientists aren't sure why.
  • Hormonal changes. Women might find they experience migraines at a particular time during their menstrual cycle. One of the most common is menstrual migraine, which occurs 2 to 3 days before the start of your period; 7% to 19% of women suffer from these migraines.
  • Lack of sleep and stress. Scientists have identified migraine as a maladaptive response to stress. It's believed stress or a lack of sleep that they might cause hormonal changes that trigger migraines.
To find your triggers, keep a migraine journal, noting everything that happened in the days leading up to a migraine. With time, a pattern will likely emerge, Poston says.Advertisement

Occasional migraines can be treated with over-the-counter medications like aspirin, Advil, or Tylenol, but overuse of these can actually trigger migraines, Poston says. This is called a rebound effect. It occurs when the medication wears off your body goes through withdrawal, which can cause headaches. Talk to your doctor about appropriate ways to use over-the-counter medications to treat your migraines; generally speaking use once a week is safe.

There are also prescription medications that can help prevent migraines if taken as soon as symptoms appear, such as triptans and topiramate. Overall, you should consult your doctor to develop a migraine treatment plan that works for you.

Cluster headaches

Cluster headaches are a less common type of primary headache that is characterized by severe pain in one side of the head, particularly concentrated around the eye. This is often accompanied by tearing, drooping eyelids, and nasal congestion. These headaches occur in "clusters" lasting for weeks or months, Poston says. Advertisement

Cluster headaches are more common in men than women. Doctors don't understand exactly what causes them. If you're experiencing a cluster headache, it's a good idea to see a doctor to rule out any more severe conditions.

"The most serious aspect of cluster headaches is making sure that the diagnosis is correct and another secondary cause of headaches is not missed," Poston says.

Secondary headaches

Secondary headaches are caused by another medical condition. These commonly include: Advertisement

  • Dehydration or hangover. Dehydration causes the pressure in the blood vessels in the skull to change, which can lead to a headache. Excessive alcohol consumption can cause dehydration, which is why you might experience a headache when you have a hangover. Drinking water can help alleviate these headaches. Read more about how much water you're supposed to drink each day for optimal health.
  • Sinus or allergy headache. Headaches can accompany seasonal allergies, or be caused by pressure in the sinuses. This happens when swelling in the sinuses from allergies causes pressure in the head. Treating the underlying condition will alleviate the headache. Read more about how to get rid of allergies and how to clear your sinuses with a neti pot.
  • Concussion. Concussions occur after your brain receives an injury, such as when you bump your head too hard or experience head-to-head contact during sports. Symptoms include headache, decreased coordination, nausea, and confusion. Seek medical attention if you suspect a concussion.

When to seek medical attention

In rare cases, secondary headaches are caused by more serious medical conditions, such as aneurysms, tumors, or meningitis.

To be safe, you should seek medical attention if you experience any of the following symptoms:

  • A sudden and severe headache
  • A persistent headache, if you have no history of chronic headaches
  • Confusion
  • Vision changes
  • Vomiting
Poston says that it's important to trust your intuition if something seems wrong or "just off." When it comes to headaches, it's better to seek medical attention early than to wait it out. Advertisement

"These serious headaches are rare, but they do occur, and delays in treatment can result in more serious outcomes," Poston says.

The bottom line

There are many different types of headaches, and while most of them are not dangerous, all of them can be irritating and painful. If you're experiencing frequent or severe head pain, it's worth checking in with your doctor, who can help you learn how to relieve and manage headaches.

For more information, read about how to get rid of a headache, and the best home remedies for headaches. Advertisement

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