Headaches are one of the most common adult health problems. Most are not serious but may occur again and again.
The most common headaches are tension headaches (the dull, aching, pressing headaches that often develop after a difficult day at work or school or during times of physical or emotional stress). Most adults experience them from time to time. While some people rarely have tension headaches, others may have them daily (chronic).
Tension headaches are sometimes described as a feeling of having one's head in a vise or having a tight band around it. Usually, the discomfort is on both sides of the head. The neck, upper back and shoulder muscles may feel tense and tight, and the scalp may feel sensitive or painful. If the headache is severe, the person may be nauseous or have no appetite. Tension headaches are sometimes, but not always, related to contraction or spasm in the muscles of the head and neck.
Most people do not need to see a doctor for help unless the headaches become frequent or severe. Mild tension-type headaches usually get better with home treatment or go away on their own. Severe or frequent tension-type headaches often require a combination of home treatment and prescription medication.
Cluster headaches are recurring, severe headaches that cause deep, stabbing pain, usually around the temple or eye. The headache often occurs with a stuffy or runny nose, tearing and redness in one eye and a droopy eyelid. A cluster headache usually lasts about 30 to 60 minutes and then quickly goes away. The headaches often begin at night, right after the person has gone to sleep, but they can occur at any time of day.
Cluster headaches occur during periods of time called cluster periods or episodes. During a cluster period, the individual is likely to have headaches and may have several headaches every day. A cluster period may last for days or months and then not occur again for weeks, months or even years. Cluster headaches are more common in men than women, and there is no known cure. Medication and home treatment help reduce how often headaches occur, the severity of the pain and how long they last.
Migraine headaches usually affect only one side of the head and often occur with nausea, vomiting and extreme sensitivity to light or sound. The headache pain is often described as throbbing or piercing and may range from mild to very severe. Although migraine headaches are usually one-sided, some people have headaches on both sides of the head. In some people, the pain may switch sides each time a headache occurs.
Migraine headaches occur repeatedly. A migraine typically lasts four to 24 hours but can last up to three days. Some people have symptoms, such as visual disturbances, 15 to 30 minutes before a headache starts. This symptom is called an aura. Migraines are most common in girls and women between the ages of 15 and 44. Some people have several headaches per month, while others have them much less often. Depending on the frequency and degree of pain, migraines may be treated with several different medications.
Hormone changes may trigger migraines headaches. While the reason is not clear, changes in estrogen and progesterone seem to play a role. Some women report having migraines just prior to or just after their periods, as well as when they are pregnant or are experiencing menopause.
Children and teenagers often have headaches along with sore throats, colds, sinus problems or other infections. They also may have tension headaches from stress and emotional strain. Approximately one-third of people who have migraine headaches first began having them as teenagers.
Causes and Risk Factors
Headaches have many causes, including:
- Muscle strain in the neck, upper back or shoulder muscles
- Emotional stress
- Certain drugs
- Eating or drinking cold foods and liquids
- Coughing or sneezing
- Eye strain
- Alcohol, caffeine or other drug use or withdrawal
- Exposure to smoke or fumes from chemicals, including carbon monoxide
- Medical procedures, such as the aftereffects of a spinal tap
- Dental problems or procedures, such as pain from grinding the teeth or from a root canal
- Changes in the levels of chemicals in the body (neutrotransmitters)
Although rare, headaches in adults or children may be a sign of a serious illness. Other symptoms, such as vomiting, dizziness or changes in vision, may also be present. Some serious illnesses or injuries that can cause headaches include:
- A head injury that damages the brain, fractures the skull or causes bleeding in or around the brain
- Brain tumor (growth in the brain that creates pressure in the skull)
- Alcohol, caffeine or drug abuse
- Problems with pregnancy
- Aneurysm (bulging in a blood vessel of the brain)
- Other health conditions, such as high blood sugar (hyperglycemia), low blood sugar (hypoglycemia), low blood calcium levels (hypocalcemia), kidney failure (uremia), glaucoma (nerve damage at the back of the eye), Lyme disease (bacterial infection spread by ticks) or inflammatory problems (lupus or temporal arteritis)
Most headaches are treated with prescription or over-the-counter medicines. Patients have also experienced relief using stress management techniques, massage therapy and alternative medicine.