Ever wonder why you suffer from headaches more than the next person? A neurologist discusses triggers, symptoms, treatment, and techniques to alleviate pain.
Headaches can strike at any moment. Whether you experience a spontaneous headache or are starting to suffer from them more frequently, recognizing what type of headache it is may help you address it and reduce your symptoms and overall risk.
What Triggers a Headache?
Some people are innately more susceptible to headaches due to genetics, but more often than not, lifestyle factors are at play, says neurologist Andro T. Zangaladze, MD. Stress, diet, poor sleep, poor posture, alcohol, caffeine, smoking, dehydration, and other environmental exposures – such as strong smells and bright lights – can all provoke headaches.
Common Headache Types
“When diagnosing headaches, our first goal is to classify whether or not they are due to underlying brain damage,” explains Dr. Zangaladze. Headaches with no underlying causes are known as primary. Secondary headaches may indicate various complications ranging in severity, such as head trauma, stroke, a tumor, allergies or sinus issues, metabolic changes, or certain medication side effects.
There are nearly 150 different types of headaches, notes Dr. Zangaladze, but the most common include:
- Tension (more common) – Mild to moderate, dull headaches often caused by stress.
- Migraine without Aura (more common) – Severe headaches with throbbing pain or pressure on one side or throughout the whole head. These symptoms are often bad enough to interfere with daily activities.
- Migraine with Aura (less common) – Severe headaches that start with non-headache symptoms known as Aura. Aura may involve visual interruptions, such as blind spots or sensitivity to light, as well as sensory changes, such as numbness or tingling, which can last for several minutes to a half an hour. Aura is resolved once the headache starts.
- Cluster – (less common) Mild to severe headaches that occur back-to-back within a short period of time. These often wake people in the middle of the night. Other common symptoms include a runny nose and eye redness and/or tearing.
Certain characteristics of a headache, such as location, help narrow down a diagnosis and determine treatment, adds Dr. Zangaladze. A tension headache often presents with whole-head tension, specifically in both temples. Most other headaches target one side. Cluster headaches cause severe, piercing pain, with or around the eye.
- Sinus (more common) – Mild to moderate headaches that cause feelings of congestion or fullness in the cheeks/and or ears. Sinus headaches frequently trigger migraines, as mechanisms of many headaches overlap. When headaches coincide, they may be referred to as “mixed headaches.”
- “Thunderclap” – (less common) – Intense, sudden, and short headaches that feel like a stabbing pain.
Thunderclap headaches can be primary or secondary, notes Dr. Zangaladze. “These ‘thunderclap’ sensations can be scary and should be addressed with your physician,” he explains. “They don’t always have an underlying cause, but in some cases, they can be indicative of something more dangerous, such as a brain bleed. Warning signs of neck tightness, numbness, vision loss, or loss of consciousness would warrant seeking immediate medical care.”
What You Can Do
Most headaches are episodic, or only occur a couple of times a month (or less). Headaches are considered chronic when you experience 15 or more headache days a month, impacting the way you function.
Headache treatment, depending on frequency and intensity, may be abortive, prophylactic, or a combination of both, mentions Dr. Zangaladze. “Abortive treatments are intended to mitigate symptoms after they’ve already begun, while prophylactic medicines work to prevent them altogether. However, every headache – and person – is unique and should be approached from an individual perspective.”
In addition to medication, it’s important to pinpoint and figure out how to avoid your headache triggers, such as certain foods, suggests Dr. Zangaladze. Try to keep a “headache journal,” tracking what you consume, what you’re exposed to, or your sleep habits, and address any patterns or triggers you see. Holistic treatment, such as herbal, mineral, or vitamin supplements, may also aid in headache prevention and relief.
“The last thing you want to do is brush off persistent symptoms because you’re getting ‘used to’ them,” says Dr. Zangaladze. “If you’re experiencing new or worsening complications, whether your headaches are chronic or not, you should talk to your physician about next steps and whether you could benefit from specialty care.”