Friday, March 24, 2023

Where Headaches Are And What They Mean

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What Headache Symptoms Require Immediate Medical Care

What is Causing Your Headaches?

If you or your child has any of these headache symptoms, get medical care right away:

  • A sudden, new, severe headache
  • A headache that is associated with neurological symptoms such as:
  • Headache with a fever, shortness of breath, stiff neck, or rash
  • Headache pain that awakens you up at night
  • Headaches with severe nausea and vomiting
  • Headaches that occur after a head injury or accident
  • Getting a new type of headache after age 55
  • Symptoms requiring an appointment with your health care provider or a headache specialist

    Contact your health care provider if you or your child has any of the following symptoms:

    • Three or more headaches per week.
    • Headaches that keep getting worse and won’t go away.
    • Need to take a pain reliever every day or almost every day for your headaches.
    • Need more than 2 to 3 doses of over-the-counter medications per week to relieve headache symptoms.
    • Headaches that are triggered by exertion, coughing, bending, or strenuous activity.
    • A history of headaches, but have noticed a recent change in your headache symptoms.

    Front Of Your Head And Face

    A headache behind your eyes and nasal passages can be due to allergies, such as hay fever, which can also produce symptoms similar to that of the common cold.

    However, true sinus headaches tend to be rare. These headaches usually turn out to be migraine, which can cause pain over the sinuses.

    A headache behind your eyes is rarely related to eyestrain.

    If you think youre having sinus headaches, consider seeing your doctor to get a diagnosis. Your doctor can help determine if your headache is truly caused by allergies, or if it could be migraine.

    Pain in the back of your head can be due to arthritis of the neck. Pain tends to get worse when you move.

    This type of headache can also be due to poor posture or neck problems such as a herniated disc.

    A back of the head headache, often accompanied by neck pain, can also be a sign of a low-pressure headache, otherwise known as spontaneous intracranial hypotension . Its caused by low spinal fluid pressure in the brain.

    Another sign of SIH is that the pain eases when you lie down, but worsens when you:

    • engage in physical activity

    This type of headache can occur following a lumbar puncture. If youve recently had this procedure and develop a headache, see your doctor as soon as possible for treatment.

    What Causes These Different Types Of Headaches

    The pain you feel when you have a headache is due to signals that your body gets from the brain, blood vessels, and nerves. When a headache comes on, specific nerves are turned on that send pain signals to your brain that something is wrong.

    Primary headaches mean that the headache itself is the problem, which is why these types of headaches may be painful but typically are not dangerous.

    They are often triggered by things such as:

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    How Do Medical Professionals Diagnose Tension Headaches

    The key to making the diagnosis of any headache is the history given by the patient. The health care professional will ask questions about the headache to try to help make the diagnosis. Those questions will try to define the quality, quantity, and duration of the pain, as well as any associated symptoms. The person with a tension headache will usually complain of mild-to-moderate pain that is located on both sides of the head. People with tension headaches describe the pain as a non-throbbing tightness, that is not made worse with activity. There usually are no associated symptoms like nausea, vomiting, or light sensitivity.

    The physical examination, particularly the neurologic portion of the examination, is important in tension headaches because to make the diagnosis, it should be normal. However, there may be some tenderness of the scalp or neck muscles. If the health care professional finds an abnormality on neurologic exam, then the diagnosis of tension headache should be put on hold until the potential for other causes of headaches has been investigated.

    What Are The Different Types Of Headaches

    Headache Chart: What Does Headache Location Mean?

    While there are over 150 different kinds of headaches, all fall into one of two categories: primary or secondary.

    Primary Headaches

    Primary headaches are those that are not due to another condition. Studies and Research shows that primary headaches are composed of multiple entities that cause episodic and chronic head pain in the absence of an underlying pathologic process, disease, or traumatic injury. Some of the most common types of primary headaches include migraines, tension headaches, and cluster headaches.

    Secondary Headaches

    This type of headache is due to an underlying/secondary medical condition. Occasionally, they can be caused by a serious medical problem but can also be due to something simple and easy to fix. Different causes of secondary headache can include brain tumors, trauma, infection, aneurysm, neck injury or tension, brain injury, and meningitis.

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    Seeking Treatment For Chronic Daily Headaches

    The standard treatment is an over-the-counter painkiller usually an anti-inflammatory like ibuprofen or an analgesic like acetaminophen. Simple home remedies and creature comforts can go a long way as well staying hydrated, getting rest in a cool dark room, and keeping ones eyes away from harsh lights.

    When these do not suffice, treatments are usually individualized by a doctor. Depending on the cause of your headache, a doctor may attempt to relieve the pain through various pharmacological therapies, including anticonvulsants, combination treatment of caffeine and analgesics, antidepressants, or triptans.

    In severe cases of chronic daily headaches, depending on the cause, nerve blocks and interventions such as Botox injections may help relieve the pain. Alternative or herbal treatments may help some patients with migraine. However, it is still heavily advised to review any supplements or herbal medication with your doctor to avoid unwanted drug interactions.

    What Triggers Headaches And Migraines

    Common triggers of tension headaches or migraines include:

    Cluster headaches

    Cluster headaches are the most severe type of primary headache. Cluster headaches come in a group or cluster, usually in the spring or fall. They occur one to eight times per day during a cluster period, which may last two weeks to three months. The headaches may disappear completely for months or years, only to recur later. The pain of a cluster headache is:

    • Intense with a burning or stabbing sensation.
    • Located behind one of your eyes or in the eye region, without changing sides.
    • Throbbing or constant.

    New daily persistent headaches

    New daily persistent headaches come on suddenly and last for more than three months. They typically occur in people who werent having frequent headaches before. The pain of NDPH is:

    • Constant and persistent without easing up.
    • Located on both sides of the head.
    • Not responsive to medications.

    Sinus headaches

    Sinus headaches are the result of a sinus infection, which causes congestion and inflammation in the sinuses . People, and even healthcare providers, often mistake migraines for sinus headaches. Symptoms of sinus headaches include:

    • Bad taste in mouth.
    • Pain that gets worse with sudden head movement or straining.
    • Mucus discharge .

    Medication overuse headaches

    • Headaches becoming more frequent.
    • More days with headaches than without.
    • Pain thats worse in the morning.

    Headaches in children

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    Barriers To Effective Care

    Lack of knowledge among health-care providers is the principal clinical barrier. Worldwide, on average, only 4 hours of undergraduate medical education are dedicated to instruction on headache disorders. A large number of people with headache disorders are not diagnosed and treated: worldwide only 40% of those with migraine or TTH are professionally diagnosed, and only 10% of those with MOH.

    Poor awareness extends to the general public. Headache disorders are not perceived by the public as serious since they are mostly episodic, do not cause death, and are not contagious. The low consultation rates in developed countries may indicate that many affected people are unaware that effective treatments exist. Half of people with headache disorders are estimated to be self-treating.

    Many governments, seeking to constrain health-care costs, do not acknowledge the substantial burden of headache on society. They might not recognize that the direct costs of treating headache are small in comparison with the huge indirect-cost savings that might be made if resources were allocated to treat headache disorders appropriately.

    What Are Secondary Headaches

    Epidural Headaches: What You Need To Know

    Secondary headaches are those that are due to an underlying structural or infectious problem in the head or neck. This is a very broad group of medical conditions ranging from dental pain from infected teeth or pain from an infected sinus, to life-threatening conditions like bleeding in the brain or infections like encephalitis or meningitis.

    Traumatic headaches fall into this category including post-concussion headaches.

    This group of headaches also includes those headaches associated with substance abuse and excess use of medications used to treat headaches . “Hangover” headaches fall into this category as well. People who drink too much alcohol may waken with a well-established headache due to the effects of alcohol and dehydration.

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    Treatments For Cluster Headaches

    Cluster headaches are not life threatening, but they can cause severe pain and significantly affect your quality of life.

    Over-the-counter painkillers, such as paracetamol, are not effective for cluster headaches because they’re too slow to take effect.

    Instead, you’ll need to have one or more specialist treatments.

    3 main treatments are available to relieve pain when taken soon after a cluster headache starts.

    These are:

    • sumatriptan injections which you can give yourself up to twice a day
    • sumatriptan or zolmitriptan nasal spray which can be used if you do not want to have injections
    • oxygen therapy where you breathe pure oxygen through a face mask

    These treatments usually relieve the pain of a cluster headache within 15 to 30 minutes.

    The Organisation for the Understanding of Cluster Headache has more information about the medicines used to treat cluster headaches.

    What Are The Symptoms Of A Headache

    Headache symptoms depend on the type of headache. The frequency of headaches and the intensity of the symptoms may vary, too. Typical headache symptoms include:

    • Slow onset of the headache

    • Head usually hurts on both sides

    • Pain is dull or feels like a band or vice around the head

    • Pain may involve the back part of the head or neck

    • Pain is mild to moderate, but not severe

    Tension type headaches typically do not cause nausea, vomiting, or sensitivity to light .

    The symptoms of a headache may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

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    What Are The Symptoms Of Cluster Headaches

    Cluster headaches are headaches that come in groups separated by pain-free periods of months or years. A patient may experience a headache on a daily basis for weeks or months and then be pain-free for years. This type of headache affects men more frequently. They often begin in adolescence but can extend into middle age.

    • During the period in which the cluster headaches occur, pain typically occurs once or twice daily, but some patients may experience pain more than twice daily.
    • Each episode of pain lasts from 30 to 90 minutes.
    • Attacks tend to occur at about the same time every day and often awaken the patient at night from a sound sleep.
    • The pain typically is excruciating and located around or behind one eye.
    • Some patients describe the pain as feeling like a hot poker in the eye. The affected eye may become red, inflamed, and watery.
    • The nose on the affected side may become congested and runny.

    Unlike people with migraine headaches, those with cluster headaches tend to be restless. They often pace the floor and/or bang their heads against a wall. People with cluster headaches can be driven to desperate measures, including suicidal thoughts.

    Immediate Action Required: Phone 999 If:

    Types of Headaches : FireEmblemHeroes
    • your headache occurs suddenly and is very severe it may feel like a blinding pain
    • your headache occurs after a severe head injury

    You have an extremely painful headache and:

    • slurred speech or memory loss
    • a very high temperature, feel hot and shivery, and have a stiff neck or a rash
    • drowsiness or confusion
    • severe pain and redness in one of your eyes

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    What To Expect At Your Office Visit

    Your provider will take a medical history and will examine your head, eyes, ears, nose, throat, neck, and nervous system.

    Your provider will ask many questions to learn about your headaches. Diagnosis is usually based on your history of symptoms.

    Tests may include:

    • Blood tests or a lumbar puncture if you may have an infection
    • Head CT scan or MRI if you have any danger signs or you have been having headaches for a while

    Location: Back Of Your Head And Neck

    If your headache hangs around the back of your head, you may be dealing with a cervicogenic headache. Known as a secondary headache, this type of head pain doesn’t originate in your head but rather radiates up from your neck, according to Baystate Health.

    Indeed, cervicogenic headaches are often caused by neck problems or injuries , per the Cleveland Clinic. The pain usually begins at the base of your skull and radiates up one side of your head. “This is because there is functional connectivity of pain sensitive structures in the head and neck regions,” Dr. Monteith says.

    Difficulty moving your head and pain that grows worse when you move your neck are other telltale signs of a cervicogenic headache, according to the Cleveland Clinic.

    Still, another type of headache called occipital neuralgia can also be the source of stabbing pains in the upper neck, back of the head and behind the ears, Dr. Monteith says. Like cervicogenic headaches, occipital neuralgia pain often starts in the neck and then spreads upwards.

    With occipital neuralgia, pain results from the irritation or injury to the occipital nerves, which span from the neck to the back of the head and up to the scalp, according to the National Institute of Neurological Disorders and Stroke . This also explains why people with this condition can experience symptoms such as scalp soreness and light sensitivity.

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    Ever Wonder Why You Suffer From Headaches More Than The Next Person A Neurologist Discusses Triggers Symptoms Treatment And Techniques To Alleviate Pain

    Headaches can strike at any moment. Whether you experience a spontaneous headache or are starting to suffer from them more frequently, recognizing what type of headache it is may help you address it and reduce your symptoms and overall risk.

    What Triggers a Headache?

    Some people are innately more susceptible to headaches due to genetics, but more often than not, lifestyle factors are at play, says neurologist Andro T. Zangaladze, MD. Stress, diet, poor sleep, poor posture, alcohol, caffeine, smoking, dehydration, and other environmental exposures such as strong smells and bright lights can all provoke headaches.

    Common Headache Types

    When diagnosing headaches, our first goal is to classify whether or not they are due to underlying brain damage, explains Dr. Zangaladze. Headaches with no underlying causes are known as primary. Secondary headaches may indicate various complications ranging in severity, such as head trauma, stroke, a tumor, allergies or sinus issues, metabolic changes, or certain medication side effects.

    There are nearly 150 different types of headaches, notes Dr. Zangaladze, but the most common include:


    • Tension Mild to moderate, dull headaches often caused by stress.


    What You Can Do

    Most headaches are episodic, or only occur a couple of times a month . Headaches are considered chronic when you experience 15 or more headache days a month, impacting the way you function.

    How Do Medical Professionals Diagnose Cluster Headaches

    What different types of headaches are there?

    The diagnosis of cluster headache is made by taking the patient’s history. The description of the pain and its clock-like recurrence is usually enough to make the diagnosis.

    If examined in the midst of an attack, the patient usually is in a painful crisis and may have the eye and nose watering as described previously. If the patient is seen when the pain is not present, the physical examination is normal and the diagnosis will depend upon the history.

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    If The Pain Is Around Your Eyes

    According to Johns Hopkins Medicine, head pain in and around your eyes can be a classic sign of a cluster headache. Cluster headaches get their name because these headaches tend to occur in groups or clusters, with the pain lasting up to three hours. When these groups of headaches occur, they may happen multiple times a day or days apart. Once the episode is over, you may not experience another cluster headache for weeks or even years.

    According to Johns Hopkins Medicine, the pain from a cluster headache is intense and often concentrated behind one eye. It typically peaks within 10-15 minutes, and there may be eyelid drooping or swelling on the side of the eye pain. In addition, restlessness and agitation can develop as well as sweating. You may also develop a stuffy or runny nose. Cluster headaches are one of the most painful types of headaches but also one of the rarest, with males more commonly affected by them than females.

    “They are very painful, like a hot poker in the eye,” said a spokesperson for the National Headache Foundation and the director of headache and pain medicine at the Icahn School of Medicine at Mount Sinai in New York City.

    If you experience cluster headaches or think you may be experiencing them, talk with your healthcare provider about preventive therapies and treatments.

    When To Worry About A Headache

    You can take care of many types of headaches by yourself, and your doctor can give you medication to control most of the tougher headaches. But some headaches call for prompt medical care. Here are some warning signs for when you should worry about headaches:

    • Headaches that first develop after age 50
    • A major change in the pattern of your headaches
    • An unusually severe headache
    • Head pain that increases with coughing or movement
    • Headaches that get steadily worse
    • Changes in personality or mental function
    • Headaches that are accompanied by fever, stiff neck, confusion, decreased alertness or memory, or neurological symptoms such as visual disturbances, slurred speech, weakness, numbness, or seizures
    • Headaches that are accompanied by a painful red eye
    • Headaches that are accompanied by pain and tenderness near the temples
    • Headaches after a blow to the head
    • Headaches that prevent normal daily activities
    • Headaches that come on abruptly, especially if they wake you up
    • Headaches in patients with cancer or impaired immune systems

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