Types of Headaches

Nearly 90 percent of headaches can be classified into three general categories: tension, cluster, and migraine.

Tension-Type Headaches

Tension-type headaches are often associated with the tightening of muscles of the back and shoulders. This may be caused by a reaction to emotional and physical stress, anxiety, or depression. Tension-type headaches are believed to be the most common cause of head pain. If you have chronic tension headaches (occurring 3 or more times weekly for 6 months or longer), see your doctor.

Symptoms of a tension-type headache include:

• Steady pain that doesn’t pulse
• Tightness, fullness, or pressure over the top of the head, both sides of the head, or back of the neck
• Discomfort that’s not made worse or only slightly made worse by everyday activities
• Learning to relax by using biofeedback, meditation, music, visualization, hypnosis, or taking a stress-management class may help prevent tension-type headaches.

Cluster Headaches

Cluster headaches are very painful and occur mainly in middle-aged men. The pain from a cluster headache gets worse quickly and lasts from 30 minutes to 2 hours, then recurs within a few hours. There is no signal before a cluster headache begins or any sign that it is going to end.

Symptoms of a cluster headache include:

• Steady, sharp pain in or around one eye, occurring in episodes that often begin at the same time each day
• Watering and redness of one eye, with nasal congestion on the same side of the face
• Swelling of eyelid

If you have a cluster headache, don’t lie down—this usually makes the pain worse. Over-the-counter pain relievers may not work for cluster headaches, because they take effect too slowly. Your doctor may prescribe a medication or suggest oxygen therapy.

Migraine Headaches

Migraine headaches may be associated with changes in the nerve system and chemicals in the brain and dilation (widening) of the blood vessels in the head. Possible triggers of migraine headaches include hunger, fatigue, bright light, alcohol or caffeine, excitement or stress, certain medications, environmental factors, and certain foods.

Symptoms of a migraine headache include:

• Throbbing, pulsating, or pounding pain
• Pain more often on one side of the head
• Pain made worse by walking or everyday activities
• Painful light sensitivity or nausea

About 20 percent of people who have migraines see bright spots, flashes of light, or areas of blindness just before the headache strikes. These symptoms are called an aura. Some people have great bursts of energy and activity just before a migraine starts.

Most migraines require professional diagnosis and treatment. See your doctor to discuss appropriate treatment. He or she may prescribe a medication to relieve your pain.

Preventing Headaches

For many headaches, including cluster, migraine, and tension-type headaches, a headache calendar may help you to identify possible triggers. Use a headache calendar to record everything you eat, your sleep and exercise patterns, and your work or home activities. Women should also record their menstrual cycles, because hormonal changes can trigger headaches.

To prevent headaches, avoid any triggers you’ve identified with your headache calendar and follow these general guidelines:

• Avoid skipping or delaying meals. Eat three to six small meals a day.
• Have a regular pattern of sleep and aerobic exercise.
• Reduce stress. Headaches are often the result of fatigue, tension, and emotional upset.
• Be aware of your posture. Avoid craning forward.
• Stop smoking. It can trigger headaches or increase their intensity.

Caring for Headaches

• Do exercises that help you relax. Ask your doctor to show you some of these exercises, or call your local hospital to see if they offer any exercise classes for relaxation.
• Over-the-counter pain relievers, such as aspirin, acetaminophen, or ibuprofen, can often control a headache. However, be careful of overuse. Taking too much pain medication for too long can result in a “rebound” effect, which causes headaches to return. Children should not take aspirin because it may be linked to a dangerous condition called Reye’s syndrome.
• Relax or sleep in a dark, quiet room with your head elevated.
• Apply a cool or warm compress to your head for pain relief.
• Take a hot or cold shower.
• Massage your neck muscles.