Headaches and Migraines
If your head hurts, the first step in making the pain going away is to find out why your head hurts. Your headache could be a tension, cluster, sinus, or rebound headache-or even a migraine. The more you know, the easier it is to stop or prevent headache pain.
Why your head hurts If you think about it, it’s strange that headaches even exist. The brain itself can’t feel pain, so what gives? Experts now think surrounding tissues, brain chemicals, blood vessels, and nerves produce the pain signals. “We know a lot more than we did 20 years ago about what causes headaches,” says Charles Flippen, MD, associate professor of neurology at the David Geffen School of Medicine at UCLA. “We know what areas of the brain are generating pain, but we don’t have the whole picture.” That said, here are 14 headache types, their causes, and more importantly-how to make them go away.
Much like overuse of nasal decongestants can lead to a perpetually stuffy nose, rebound headaches are chronic headaches caused by medication overuse.
How often is too often? Regularly taking any pain reliever like acetaminophen (Tylenol), aspirin, or ibuprofen (Advil, Motrin) more than twice a week, or taking triptans (migraine drugs) for more than 10 days a month, can put you at risk for rebound headaches in just a few months.
Don’t try to treat these on your own. A doctor can help you stop the culprit drug, using alternatives until it’s out of your system.
This is the most common type of headache, which usually feels like a constant aching or
pressure-rather than throbbing-on both sides of the head or at the back of the head and neck.
Triggers can include stress, anxiety, bad posture, and clenching your jaw, and these headaches can become chronic, although they usually aren’t severe. Experts aren’t sure of exact cause, although it may be due to altered brain chemicals or mixed signals in the nerves leading to the brain.
These usually respond to over-the-counter pain relievers, such as aspirin, ibuprofen, or acetaminophen. Stress-relief may help.
There are dental-related conditions that can trigger headaches or face pain, such as bruxism and temporomandibular joint disorder (TMJ).
Bruxism is grinding your teeth at night, while TMJ affects the joints, located just in front of your ear, which connect the jaw to the skull.
TMJ can be caused by bad jaw alignment, stress, poor posture (like sitting at a computer all day), or arthritis, which affect the cartilage, muscles, or ligaments in the jaw.
Your dentist can help diagnose these types of headaches, and treatment includes stretching the jaw, hot or cold packs, stress reduction, and bite
These one-sided headaches are short-lived (15 minutes to 3 hours), but excruciating. These are so painful they’re sometimes called the suicide headache. (Check out this video about how to tell the difference between cluster headaches and migraines).
Cluster headaches recur regularly, even multiple times daily, over a certain period of time and then may be followed by a headache-free period of months or even years. There may be redness and tearing in one or both eyes. More common in men than women, cluster headaches can be treated with triptans or oxygen (OTC painkillers may not help). Triggers can include alcohol, cigarettes, high altitudes, and certain foods.
Migraines are severe headaches that are three times as common in women as men. The cause isn’t clear, but genes do play a role, and brain cell activity may affect blood vessel and nerve cell function.
One common migraine trigger is change, including hormones, stress, and sleeping or eating patterns.
“If you know skipping meals is a trigger, don’t skip meals while menstruating and having a late night,” says Peter Goadsby, MD, director of the Headache Center at the University of California, San Francisco. Treatment can include acetaminophen, ibuprofen, or triptans (such as Imitrex or Zomig), which are drugs that help treat or prevent migraines.
You love your coffee, but it can be a cruel companion. For example, if you have two cups of
coffee every day at 9 a.m., and then miss those cups when you oversleep on Saturday-boom!-you can end up with a caffeine withdrawal headache.
You will be more likely have them, though, if you drink a lot (say, five cups of coffee a day), then go cold turkey.
You have two options, Dr. Goadsby says, “You can take caffeine when you normally do and feed the addiction, or quit altogether.”
Orgasm-induced headaches are caused by, well, having an orgasm.
These are relatively rare and are more common in younger people, particularly men, Dr. Flippen says. They usually start shortly after intercourse begins and end in a “thunderclap” headache at climax.
A dull headache can often linger for hours or a day. Dr. Flippen says that there is often no known cause for these headaches and they usually go away on their own. He does recommend seeing a doctor, however; in rare cases they can be a sign of something more serious. A dose of pain reliever before sex may help ease the pain.
Early morning headaches
If you’re waking up in pain, there are several possible culprits. Migraines are more likely to happen in the morning, or medication may be waning in your body as you sleep, which causes a rebound headache, Dr. Goadsby says.
Sleep apnea sufferers may also be more prone to headaches early in the day, as are those with dental headaches.
Finally-and this one is the least likely, so relax all of you hypochondriacs out there-it could be a symptom of a brain tumor, Dr. Goadsby says.
These types of headaches win the gold medal for overdiagnosis, according to Dr. Goadsby.
People with migraines often mistake them for sinus headaches. (One study found that 88% of people with a history of sinus headaches probably had migraines instead.) Symptoms like sinus pressure, nasal congestion, and watery eyes can happen in both types.
A true sinus headache is related to an infection and comes with nasal discharge that is green or tinged with red, says Dr. Goadsby. Sinus infections often resolve with time or antibiotics, if necessary, and shouldn’t cause nausea or light sensitivity, which are migraine symptoms.
Ice cream headache
Brain freeze! Most people have experienced the shooting head pain that can occur while enjoying a icy cold drink or treat on a hot day. People with migraines may be especially prone to them.
They have an impressive medical name-sphenopalatine ganglioneuralgia-but they’re not all that serious. Experts think a cold sensation on the roof of the mouth can cause an increase in blood flow to one of the brain’s arteries.
The cure? Take a momentary break from the frosty goodness until the pain subsides, or sip warm water to help constrict the brain artery.
Chronic daily headaches
If you have a headache at least 15 days per month for more than three months you’re considered to have chronic daily headaches, says Dr. Goadsby.
These could be caused by overuse of pain medications (ie, rebound headaches), head injury, or in rare cases, meningitis or tumors.
If there is no obvious cause, it could be because your body’s pain signals are heightened or not working properly.
These headaches may respond to antidepressants; beta blockers like atenolol, metoprolol, or propanolol (used to treat high blood pressure and migraines); anti-seizure medications like gabapentin or topiramate; pain relievers like naproxen (Aleve); and even Botox injections.
As if PMS wasn’t bad enough, the sudden drop in estrogen right before your period can sometimes trigger migraines, Dr. Flippen says.
These usually occur between three days before and two days after your period has started. Other women may have PMS-related headaches that aren’t migraines.
These arrive about six days or so before your period, at the same time as any moodiness, cramping, or other PMS symptoms. Dr. Flippen recommends over-the-counter headache remedies; magnesium supplements may also help PMS-related head pain.
Some people may experience headaches that mainly show up on the weekend. These are thought to be caused by oversleeping on weekend mornings, going to bed later at night, or caffeine withdrawal.
Also, if your stress level is high all week, the weekend release may trigger a headache.
Over-the-counter pain medications can be helpful, as can sticking to your regular sleep-wake schedule.
Most headaches aren’t an emergency, but there are a few symptoms that warrant rapid attention, says Dr. Flippen. One is a sudden onset headache that is quickly “explosive.” Another is when a headache comes with a fever or extreme rise in blood pressure, or if it occurs after a blow to the head or exertion.
Other problematic symptoms include vision or speech change, neck stiffness, dizziness, loss of sensation, or muscle weakness on one side of the body. Call 911 if you have these worrisome symptoms in addition to headache.