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Headaches

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What are Headaches?

What are Headaches?

A headache is the sensation of pain that occurs in the head or upper neck. It is very common to experience an occasional headache, but some individuals experience frequent headaches that affect their quality of life. Headache disorders can be from a secondary source, such as an illness, or from a primary source which may be genetic, such as migraine.

A headache may feel concentrated in certain areas or be generalized (in the whole head), including the back of the head, on the right side of the head, in the skin, muscle and nerves of the head and neck, or in the sinuses.

For chronic or recurring headaches, it is important to see your healthcare provider or doctor for medical evaluation and to get care. Severe headaches accompanied by symptoms such as nausea, vomiting, seizures, weakness, and/or fever may require immediate medical attention.

Headaches vs. migraine

What is the difference between a headache and migraine? A headache is a symptom of many different conditions, including tension headaches. It may have pain that ranges from mild to moderate in severity but does not have other symptoms. Migraine features repeated attacks of a pulsing or throbbing headache that is often concentrated on one side of the head. Migraine pain may range from moderate to severe and may last for several hours to days. It may also be accompanied by symptoms such as light and sound sensitivity, nausea, and vomiting.

Types of Headaches

Types

There are many different types of headaches. Headaches can be episodic, meaning occasional, or occur daily or near-daily, called chronic headaches. Most headaches fall into two broad categories:

  1. Primary headache: Tension headache, migraine, and cluster headache are considered primary headaches and the most common to experience. Primary headaches are thought to be genetic and a medical condition itself, not caused by a separate medical condition or injury.
  2. Secondary headaches: These types of headaches are directly caused by an underlying medical condition, trauma, or injury. Examples of secondary headaches are those caused by sinusitis, vascular disease, and head trauma. Certain warning signs, such as a thunderclap or sudden onset of a severe headache, may indicate that the headache could require immediate medical attention.

Types of headaches include:

  • Tension headache: If you experience a tight band of pressure or pain around the head, it may be a tension headache. This type of headache is mild to moderate in pain and usually has no other associated symptoms.
  • Migraine: A migraine attack may cause moderate to severe pain and can last longer than headaches, from hours to several days. It often causes other symptoms such as nausea, vomiting, visual disturbance/aura, and sensitivity to light, odor, and sound. Migraine can interfere with daily functioning. Your healthcare provider can help provide symptom relief and medical treatment.
  • Chronic headache disorders: If a headache is experienced 15 days or more in a month for 3 months or more, this is considered a chronic headache. Chronic migraine and chronic tension-type headaches are the most common chronic headache disorders.
  • Cluster headaches: Cluster headaches are short but intense one-sided headaches that may end in 15 minutes or last up to three hours at a time. They may occur once every other day or up to eight times on the same day. Some individuals experience cluster headaches around the same time each day or in noticeable patterns. It may be triggered by smoking or alcohol use. The pain is often associated with a teary, red, or droopy eye, or a runny nose.

Other headache types:

  • Medication overuse headache may be associated with the overuse of medication or as a symptom of withdrawal, typically in people who have migraine already
  • New Daily Persistent Headache (NDPH). A type of headache that occurs suddenly and continues daily for more than three months where the person has no previous history of headaches. Most know when the headache started by the date or an event.
  • Sinus headaches. Facial pain in the nasal or sinus pathways as a result of an infection is often called a sinus headache. Acute sinusitis, nasal polyps, and chronic rhinosinusitis may cause pain in the forehead region and eyebrows with heaviness and pressure in this type of headache.

More to explore

Signs & Symptoms of Headaches

Symptoms

There are several signs and symptoms of headaches, with some symptoms resolving independently, and others needing proper care. Headache symptoms can range from mild and moderate to severe and debilitating. It is essential to know that specific headache symptoms may indicate a serious or even life-threatening underlying condition that requires immediate medical care.

Some types of headaches are associated with unique symptoms that characterize the condition. This includes tension headaches, cluster headaches, migraine, and sinus headaches. If you are experiencing symptoms associated with spinal headaches, promptly seek medical attention.

Migraine symptoms include:

  • Pain that may be one-sided and throbbing
  • Nausea, vomiting
  • Light and sound sensitivity
  • Pain worsened by movement
  • Attacks that last for 4 hours to 3 days

Tension headache symptoms include:

  • Tightening band of pain surrounding the head
  • Constant pressure in the face, head and/or neck
  • Pain on both sides of the head

Cluster headache symptoms include:

  • Pain on one side of the head, often behind or around one eye
  • Pain peaks in 5-10 minutes after onset and continues for up to 3 hours
  • Red, swollen, and teary eyes and nose
  •  Sleeplessness
  • Agitation
  • Sensitivity to light, sounds, and smells

Sinus headache symptoms include:

  • Brow pain above the eyes
  • Pressure in and around eyes, nose, and mouth
  • Facial pain and heaviness
  •  Worsening pain when reclining or bending forward
  • Stuffy nose
  • Fatigue

Spinal fluid leak headache symptoms include:

  • Worsens within 15 minutes of standing
  • Disappears or improves after 30 minutes of reclining
  • Pain all over, in the neck, or on both sides of the head
  • Dizziness and/or double vision
  • Neck pain or stiffness
  • Hearing loss
  • Ringing in the ears
  • Sensitivity to light

What Causes Headaches?

Causes

The exact causes of a headache are not fully known. Genetics and other factors may play a role in migraine and other headache disorders. Specific triggers that may cause a headache are categorized as a primary cause or a secondary cause.

Primary headaches, such as migraines, tension, or cluster headaches, may be genetic. Secondary headaches are caused by a trigger or more than one event that causes headache symptoms to develop. There is a wide range of causes of secondary headaches, which may be associated with infection, environment, injury, cancer, and other external causes.

Food-related triggers of attacks in people with migraine include:

  • Tyramine, a chemical found in chocolate, caffeine, smoked fish, hard sausage, soy products, and other foods
  • MSG (monosodium glutamate), a flavor enhancer found in spices, broths, and fast foods
  • Nitrates, found in deli meats and hot dogs
  • Artificial sweeteners found in diet foods and soda
  • Skipped meals or delayed meals, which cause a drop in blood sugar
  • Alcohol

Environmental-related triggers of migraine include:

  • Weather changes from sudden drops or increases in humidity or temperature
  • Bright lights, loud noises, and strong odors
  • Seasonal allergies or sinus-related pressure

Other migraine triggers include:

  • Menstruation, due to hormonal changes
  • Illness, caused by flu, COVID-19, and other viruses
  • Injury or head trauma from an accident or fall
  • Alcohol or drug use or withdrawal
  • Use of certain medications or their withdrawal

Headaches in children

The most common types of headaches in children are tension headaches and migraines. Headaches in children are often bilateral, where the pain occurs on both sides of the head, but young children may be unable to articulate the problem. Other indicators of headache in children are if they are cranky and upset, rub their eyes and head, act sleepy, lazy, or have light or noise sensitivity. Children may experience headaches with various triggers, including taking certain medications, certain foods, dehydration, eye strain, sleep problems, and more.

At NewYork-Presbyterian, our multidisciplinary team of headache experts, including pediatric neurologists, provide comprehensive care for pediatric headaches. With dedicated centers for treating headache disorders, our specialists provide full assessments and create customized treatment plans for headaches in both adolescents and children.

Headache Prevention

Prevention

One method that may help prevent headaches or decrease their recurrence is by keeping a headache diary to track potential triggers, the time of day the attack occurs, and headache symptoms. This can help your doctor better understand the type of treatment and modifications that may alleviate your headaches and associated symptoms. Other important factors for headache prevention include getting enough sleep, staying hydrated, eating frequent meals, and managing stress.

There is a range of treatment options available for headaches, including medications, injections, devices, and supplements, that your doctor or healthcare provider may recommend for headache prevention.

Get Care

Trust NewYork-Presbyterian for Care to Address Your Headaches

Headache specialists at NewYork-Presbyterian, including doctors from Columbia Headache and Face Pain Center and Weill Cornell Headache Program, provide the latest diagnostic services and treatment approaches for headache, migraine, and their associated symptoms.

Schedule an appointment with our headache experts to learn more about the various treatment options available. With a complete team of headache doctors, including neurologists, we offer seamless access to our network of Neurology services for targeted and coordinated treatment.