What is a headache?
“A headache is pain or discomfort in the head or face. Headaches vary greatly in terms of the location and intensity of the pain, and how often they occur,” said Mina Abu Gosh MD, an internal medicine doctor at PIH Health Lambert Medical Office Building. “Almost all people have headaches during their lifetimes,” added Dr. Abu Gosh.
The brain tissue doesn’t have pain-sensitive nerve fibers and doesn’t feel pain. But, other parts of the head can be responsible for a headache including:
- A network of nerves that extends over the scalp
- Certain nerves in the face, mouth, and throat
- Muscles of the head, neck, and shoulders
- Blood vessels found along the surface and at the base of the brain
Different types of headaches are described below.
In migraines, symptoms other than pain occur as part of the headache. These may include nausea and vomiting, lightheadedness, sensitivity to light (photophobia) and sound (phonophobia), and other visual symptoms. Migraines also have distinct phases. But, not all people have each phase. The phases of a migraine headache may include:
- Premonition or prodromal phase. A change in mood or behavior may occur hours or days before the headache.
- Aura phase. A group of visual, sensory, or motor symptoms can precede the headache. Examples include vision changes, hallucinations, numbness, changes in speech, and muscle weakness.
- Headache phase. This is the period during the actual headache with throbbing pain on one or both sides of the head. Sensitivity to light and motion are common, as are depression, tiredness (fatigue), and anxiety.
- Resolution phase. Pain lessens during this phase, but may be replaced with tiredness, irritability, and trouble concentrating. Some people feel refreshed after an attack, others don't.
Tension headaches are the most common type of headache. Stress and tight muscles are often factors in tension-type headaches. These are common symptoms:
- 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 be in the back part of the head or neck
- Pain is mild to moderate, but not severe
Tension type headaches typically don't cause nausea, vomiting, or sensitivity to light.
Cluster headaches usually occur in a series that may last weeks or months.
These are the most common symptoms of a cluster headache:
- Severe pain on one side of the head, usually behind one eye
- The eye that is affected may be red and watery with a droopy lid and small pupil
- Swelling of the eyelid
- Runny nose or congestion
- Swelling of the forehead
What causes a headache?
Headaches are classified as primary or secondary.
- A primary headache means the headache itself is the main health problem, but other factors such as muscle tension or exposure to certain foods may be triggers. Other things that may help cause the headache include medicines, dehydration, or hormone changes.
- A secondary headache is related to an underlying health condition. An example of this would be a headache caused by a neck injury, eye problems, or an infection in the jaw, teeth or sinus.
How are headaches treated?
The goal of treatment is to stop headaches from occurring. Good headache management depends on finding what type of headache you have. Management may include:
- Staying away from your known triggers, such as certain foods and beverages, lack of sleep, and fasting
- Changing eating habits
- Resting in a quiet, dark environment
- Taking medicines as recommended by your healthcare provider
- Controlling stress
- Migraine and cluster headaches may need specific medicines. These include:
- Abortive medicines. These are medicines prescribed by your healthcare provider. They act on certain receptors in nerves and blood vessels in the head to stop a headache in progress.
- Rescue medicines. These medicines include pain relievers bought over the counter, to stop the headache.
- Preventive medicines. These medicines are prescribed by your healthcare provider. They are taken daily to stop a headache from starting.
- Some headaches may need medical attention right away. This may include a hospital stay for observation, diagnostic testing, or even surgery. Treatment depends on the condition causing the headache. Full recovery depends on the type of headache and other health problems you may have.
Can headaches be prevented?
If you know what triggers your headache, staying away from the trigger can prevent a headache.
Dr. Abu Gosh advises, “Reducing stress can ease or prevent headaches caused by stress. Migraine and cluster headaches may be prevented by taking a daily preventive medicines.”
To find a PIH Health family medicine doctor, visit PIHHealth.org/FM or call 888.365.4450.
© 2000-2020 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.