Headaches and Migraines

An Overview of Headaches and Migraines

Whether you suffer from a headache disorder or have a loved one who does, you know that a headache or migraine can be a painful, exhausting experience. The good news is that headaches and migraines are treatable, usually through a combination of medications and behavioral therapies, like trigger avoidance or lifestyle changes.

By gaining knowledge about your specific headache or migraine type and triggers, you are taking the first step to being proactive in your health care.

Be assured that you can live well with headaches or migraines.

A view of a throbbing headache.

What Are Headaches and Migraines?

The vast majority of headaches are primary headaches, meaning they develop on their own. The three most common types of primary headaches are:

  • Tension-type headaches
  • Migraines
  • Cluster headaches

Tension-type Headaches

Tension-type headaches are the most common. In fact, experts estimate that nearly 80 percent of people will experience a tension-type headache at some point in their life.

The experience of a tension-type headache resembles its name. It feels like a tight grip or band around your whole head. This is why tension-type headaches are often referred to as muscle contraction headaches. That being said, while we don't know exactly what causes tension-type headaches, experts believe that these headaches stem from a person's nerves and not from muscle tightening in the head, neck, or scalp.

Tension-type headaches have also been referred to as stress headaches, since stress is a common trigger. That being said, tension headaches are very real, and not psychological ("in your head"), as may be suggested by the name.

 

Migraines

Migraine is another primary headache disorder that is much more debilitating than a tension-type headache. The pain of a migraine headache is throbbing (like a drum beating on your brain) and tends to affect one side of the head.

Migraines are frequently associated with nausea and/or vomiting, and a sensitivity to sound and light. Tension-type headaches, on the other hand, may cause a sensitivity to sound or light, but not both, and do not lead to nausea or vomiting.

In addition, a person with a migraine is usually unable to work or engage in a social activity. This is in contrast to a tension-type headache, which is usually more bearable. 

Cluster Headaches

Cluster headaches are much less common than tension-type headaches and migraines. They are extremely painful, disabling headaches that can be so severe they are often referred to as "suicide headaches."

Cluster headaches cause a stabbing, piercing pain around one eye or temple, and they tend to occur at night. In fact, cluster headaches run like clockwork, often occurring at the same time each night (this is why they are sometimes also called "alarm clock headaches").

 

Rare Primary Headache Disorders

Besides cluster headaches, there are other rare types of primary headache disorders like:

The good news is that these headache disorders are benign and not life-threatening. That being said, before being diagnosed with one, a neurologist or headache specialist will first want to rule out more serious causes of your headache, as certain life-threatening medical conditions (like a brain bleed or clot) can mimic these primary headache disorders.

Secondary Headaches

Secondary headaches are headaches that occur as a result of some other condition. For example, people with giant cell arteritis—a blood vessel problem—can develop a headache, one that affects the temple or scalp.

With secondary headaches, there are usually other clues that point to a diagnosis other than simply a headache or migraine With giant cell arteritis, for example, a person may also report weeks to months of fatigue, body aches, and jaw pain after eating food.

 

Other examples of secondary headaches include menstrual migraines, which occur around the time a woman is menstruating (when her estrogen levels fall), and caffeine withdrawal headaches, which occur when a person skips or delays their usual daily caffeine intake. 

Three Things to Know About Headache & Migraines

Migraines are Not Just Headaches

Migraine is a neurological disorder and is more than a headache. You may be surprised to learn that a migraine attack consists of four phases (although not everyone experiences all of them). These four phases include:

This is why a migraine attack can be a grueling experience. It starts with prodrome symptoms (like yawning, fatigue, and food cravings) in about 35 percent of people with migraines.

Then, about 20 to 30 percent of people with migraines experience auras, which may include a number of reversible neurological symptoms like vision changes (most common), sensory disturbances (like numbness and tingling), and language problems (like difficulty finding words).

 

After the headache part of a migraine attack, a person can then have postdrome symptoms that can last hours to days. These symptoms include irritability, fatigue, anxiety, depression, or scalp tenderness. 

While enduring four phases of a migraine attack is unpleasant, the good news is that it may help explain why you feel the way you do before or after a migraine headache.

Treating Headaches Can Cause a Headache

The treatment of headaches varies based on the diagnosis. For instance, most people with tension-type headaches do not seek treatment from a doctor because over-the-counter medications are generally sufficient. 

Migraines are more disabling and often require a prescription medication, like a triptan. People with chronic tension-type headaches and migraines also usually require a preventive medication to thwart off head pain before it begins.

While these medications (both over-the-counter and prescription) can be effective, taking them too frequently can actually lead to a medication overuse headache—a double whammy.

It can be challenging, even for a doctor, to tease apart whether your headache is from medication overuse or is part of your original headache disorder. That's why it's important to take headache and migraine medication under the guidance of a physician. Do not take more that the recommended dose, which is usually no more than 10 to 15 times a month, depending on the specific medication. 

Complementary Therapies Can Soothe Headaches

Some people prefer to avoid medications altogether for their headaches (especially mild migraines or tension-type headaches) and find that rest, a walk, food, a glass of water, a cup of coffee, temple massage, or other home remedies can soothe their head pain. 

Others find that a combination of medication and self-soothing remedies work. Still, others turn to complementary therapies, which are utilized to prevent headaches from occurring in the first place. These include:

If You Have Recently Been Diagnosed With a Headache Disorder or Migraine

Keep a Headache Diary

By keeping a headache diary, you may be able to identify one or more of your headache triggers. In fact, sometimes just recording your symptoms, headache therapies, and lifestyle patterns (like sleep, diet, and stress)—and reading your notes with your doctor—can be quite revealing.

Be Committed to Your Treatment

There are a number of headache and migraine therapies available, and what works for a friend or family member may not work for you. Try to be patient and remain committed to your care with your headache specialist or neurologist. That being said, if you have a gut feeling that you need a different treatment plan, seeking a second opinion is OK.

While there may not be a cure for your headaches or migraines, most people can learn to manage them. Still, you need a plan that works for you. If yours starts to fail you, be sure to get in touch with your doctor. 

Consider Some Lifestyle Changes

While your migraines and headache disorder may seem unpredictable and out of control (you don't know when an attack will occur), there are some lifestyle habits you can engage in to regain control. 

For example, obesity has been linked to migraines. So managing a healthy weight through a combination of daily exercise and nutritious meals may help your migraines, in addition to your heart and overall health. Caffeine consumption has also been linked to headache disorders, so moderating or eliminating your intake can minimize attacks. 

Finally, be good to yourself. Take the time to de-stress and enjoy life, whether that be spending time with friends and family, watching a movie, or taking a walk in the fresh air.

Expect the Unexpected

Even when you think you have avoided all your potential triggers, headache and migraine attacks can still mysteriously occur, as they are complex, unpredictable disorders. If you do slip and trigger a headache or migraine (you didn't get enough sleep or overworked yourself), don't be hard on yourself—it happens, you are human. 

A Word From Verywell

While being diagnosed with a headache disorder or migraine can be overwhelming, there are effective treatments available, and headache and migraine research is constantly evolving. Remain hands-on in your headache health. As always, if you or someone you know struggles with headaches or migraines, seek guidance from a healthcare professional. 

Sources:

Chowdbury D. Tension type headache. Ann Indian Acad Neurol. 2012 Aug;15(Suppl 1):S83-S88.

Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders: 3rd Edition (beta version). Cephalalgia. 2013;33(9):629-808.

Lyngberg AC, Rasmussen BK, Jørgensen T, Jensen R. Has the prevalence of migraine and tension-type headache changed over a 12-year period? A Danish population surveyEur J Epidemiol. 2005;20(3):243-9.

Ornello R. et al. Migraine and body mass index categories: a systematic review and meta-analysis of observational studies. J Headache Pain. 2015;16:27. 

Torelli P, Jensen R, Olesen J. Physiotherapy for tension-type headache: A controlled study. Cephalalgia. 2004;24:29–36.

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