A bad headache can be debilitating and lead to lost time at work and with family and friends. Whether you have headaches frequently or only occasionally, you may be able to reduce them by identifying and avoiding triggers. It is also important to note that headaches tend to be a lot more than just head pain themselves. They tend to be a part of a syndrome, a constellation of signs and symptoms.
Types of headaches
Most headaches are primary headaches, meaning they aren’t a symptom of another serious underlying health issue. The most common primary headaches include:
- Tension headache. Tension headaches develop slowly and cause dull, moderate pain, usually on both sides of the head and sometimes on the back of the head or neck.
- Migraine headache. Migraines cause throbbing pain, nausea and/or vomiting, sensitivity to light or sound, various vision changes, dizziness, numbness or weakness on one side of the body or face, speech changes, fatigue, and/or trouble focusing. They can last several hours or up to several days. There is also chronic migraine, where a person has migraine headaches and has a headache at least half the days of the month.
- Cluster headache. Cluster headaches are a pretty rare type of primary headache where the head pains develop suddenly and occur in a series or cluster. They always cause pain on the same side in the front of the head and behind one eye. It is one of the most severe pains one can experience. They also cause the same eye to be red or watery and/or droopy and nose to be runny or stuffy on the same side.
- Secondary headaches are caused by health issues like acute sinusitis, concussion, ear infection, hangover, the flu, high blood pressure, brain tumor or brain aneurysm, to name a few.
Headache triggers are unique to each individual. The most common migraine headache triggers include hunger, lack of sleep, fatigue, stress, caffeine withdrawal, weather changes, certain foods, food additives and alcohol.
Migraines can also be triggered by certain smells, bright lights, alcohol, being around smoke, estrogen level changes in women and taking certain prescription medications.
Some of these factors can also cause tension headaches, such as hunger, fatigue, stress and poor posture.
How to prevent headaches
To prevent headaches, you first must understand what triggers them. If possible, write down the frequency, intensity and duration of your headaches. Also, consider your diet, medications, caffeine intake, sleep patterns, alcohol intake, stress level, environment, menstrual cycle (for women) and any other health issues you have. Write down those details as well. We call that a headache diary, and it is an important part of your headache treatment regimen.
Perhaps you notice that you experience headaches after drinking alcohol or eating certain types of foods. Or maybe they come on when you’re stressed at work or didn’t get enough sleep the night before. Once you notice a pattern, you can make lifestyle changes to reduce your headache triggers, such as avoiding specific foods or going to bed earlier.
The appropriate treatment depends on the type of headache:
- Tension headache. For occasional tension headaches, you can use an over-the-counter pain reliever, like ibuprofen or acetaminophen. Consistent sleep, regular exercise and stress-reducing activities can also help. For more chronic conditions, your provider may prescribe a medication like a tricyclic antidepressant shown to be effective as a headache preventative.
- Migraine. Migraines can be treated with rescue medications to relieve pain and preventive medications to help prevent future migraines.
- Cluster headache. These are typically managed with oxygen treatment or prescription medications.
When to see your health care provider
Most headaches are not caused by serious illnesses, but some warrant medical care. You should call 911 or go to your nearest emergency department if your headache is sudden and severe or accompanied by high fever (greater than 102 degrees), stiff neck, confusion, trouble understanding speech, fainting, nausea, vomiting (not related to a hangover or the flu), or difficulty seeing, speaking or walking.
See your primary care provider if you start having headaches that are more severe or frequent than usual, that do not improve with the appropriate use of over-the-counter medications, cause you distress, or affect your ability to sleep, work or participate in your daily activities.
Michele Morgan, MD