If your head is throbbing, you're not alone. Headache is one of the most common and debilitating pain conditions in the world. According to the World Health Organization, almost half of the adults in the world have had a headache in the past year. The World Health Organization also names headache the third leading cause of disability in the world and the number one cause of disability in individuals under the age of 50.
Headaches are a major cause of absenteeism from work and school. They also cause a heavy personal toll in terms of social life, family life and anxiety and depression due to fear of the next headache. Headaches affect people of all races, ages and where in the world they live.
A comprehensive headache classification guide was established by the International Headache Society and includes more than 150 headache categories.
Based on research, a practical headache classification divides headaches into two main categories primary and secondary headaches.
Primary headaches are those that aren't the result of another medical condition. The category includes tension-type, migraine and cluster headaches.
Secondary headaches, or those that result from another medical or neurological condition, include sinus headaches, medication overuse headaches, or headaches that occur because of an infection, disease of the blood vessels in the brain, head injury, trauma, or more serious condition such as a tumor.
Yes, headaches, especially migraines, have a tendency to run in families. Children who have migraines usually have at least one parent who also suffers from them. Headaches also can be triggered by certain environmental factors that are shared in a family’s household, such as:
Stress, pollution, noise, lighting and weather changes are other environmental factors that can trigger headaches for some people.
People with migraines may inherit abnormalities in certain areas of the brain as well as the tendency to be affected by certain migraine triggers (like fatigue, bright lights, weather changes and others.)
Headache pain results from signals interacting among the brain, blood vessels, and surrounding nerves. During a headache, specific nerves of the blood vessels are activated and send pain signals to the brain. It’s not clear, however, why these signals are activated in the first place.
There is a migraine “pain center,” or generator, in the mid-brain area. A migraine begins when overactive nerve cells send out impulses to the blood vessels. This causes the release of prostaglandins, serotonin, and other substances that cause swelling of the blood vessels in the vicinity of the nerve endings, resulting in pain.
Headaches that occur suddenly (acute onset) are usually caused by an illness, infection, cold, or fever. Other conditions that can cause an acute headache include sinusitis (inflammation of the sinuses), pharyngitis (inflammation or infection of the throat), or otitis (ear infection or inflammation).
In some cases, the headaches may be the result of a blow to the head (trauma) or, rarely, a sign of a more serious medical condition.
Common triggers of tension-type headaches or migraine headaches include:
Other causes of headaches include eye strain and neck or neck and back strain caused by poor posture.
When headaches become progressive and occur along with other neurological symptoms, they can be the sign of a disease process in the brain, such as:
The good news for people who get headaches? An effective treatment plan can be started once you get a correct headache diagnosis. If you have headache symptoms, the first step is to go to your family physician. They'll perform a complete physical examination and a headache evaluation. During the headache evaluation, your doctor will ask you about your headache history. They'll ask you to describe your headache, including what they feel like, how often you get them, how long they last, how much pain they cause, what foods and events trigger them and other questions. You'll also be asked questions about your lifestyle: what you eat, how much caffeine you drink, your stress level, sleeping habits, and work issues to name a few.
A headache evaluation may include a CT scan or MRI if the doctor thinks there might be a problem with your central nervous system. Both of these tests produce cross-sectional images of the brain that can reveal abnormal areas or problems. Skull X-rays are not helpful. An EEG (electroencephalogram) may not be needed unless you've ever passed out during a headache.
If your headache symptoms become worse or become more frequent despite treatment, your family physician might refer you to a headache specialist or neurologist.
Your family physician may recommend different types of treatment. Or they may recommend further testing or refer you to a headache specialist.
The proper treatment will depend on several factors, including the type and frequency of your headache and its cause. Not all headaches require medication management. Treatment may include education, counseling, stress management, biofeedback, as well as medications. The treatment you are prescribed will be tailored to meet your specific needs.
When your doctor starts a treatment program, keep track of the results and how the treatment program is working. Keep your scheduled follow-up appointments so that your doctor can check your progress and make changes in the treatment program as needed. Keeping a headache diary can be extremely helpful to measure progress, or the lack of progress.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 08/16/2018