Headaches are one of those things most of us learn to live with. A long day at work, a sleepless night, a missed meal, or an infection can leave your head pounding.
Often, the pain passes with rest or a pain reliever. But when headaches keep coming back, or start to feel different, brushing them off may be a mistake.
A headache can be benign, or it can be a symptom of something else. The challenge is knowing the difference.
In this post, we’ll look at the different types of headaches, what triggers them, and which warning signs to watch for so you can respond appropriately instead of just reaching for another paracetamol.
Primary vs. Secondary Headaches
There are headaches that are conditions in their own right. Others are due to some other medical problem. The first we call “Primary headaches,” and the other, “Secondary headaches.”
A. Primary headaches
These are not symptoms of another underlying disease. The headache itself is the problem, and there are four kinds of headaches that account for much of this category.
1. Tension-type headaches
A tension headache is the most common type of headache. Imagine a band tightening around your head…from the front, to the sides and back. It usually causes mild to moderate pain that affects the forehead and temples.
Tension headaches are triggered by stress, anxiety, poor sleep, hunger, and muscle strain.
So rest, hydration, stress management, gentle stretching, and the occasional over-the-counter pain relievers can help resolve this kind of headache.
2. Migraines
Migraine attacks involve intense throbbing or pulsing pain, frequently on one side of the head. Migraines often come with nausea or vomiting, sensitivity to light, sound, or smells, and pain that worsens with movement or routine activity.
Before or during an attack, some people experience seeing flashing lights, zigzag lines, blind spots, tingling, or temporary speech or vision changes.
A person with migraine might need to lie in a dark room because ordinary light, noise, or movement makes the symptoms worse. Attacks can last from four to 72 hours.
Like tension headaches, they can be triggered by stress, hormonal changes, irregular sleep, skipped meals, dehydration, alcohol or caffeine, bright lights, strong smells, and certain foods. So it’s best to avoid these triggers.
3. Cluster headaches
Cluster headache is less common than migraine or tension-type headache, but its intensity can be extreme. It typically causes severe pain around one eye, accompanied by symptoms like tearing, eye redness, a drooping eyelid, or a blocked or runny nostril on the same side.
Attacks usually last 15 minutes to three hours. Attacks usually come like clockwork, usually at night, 1-2 hours before bedtime. Unlike someone with migraine who may prefer to lie still, a person having a cluster attack may pace or feel unable to sit still.
We still don’t know exactly why cluster headaches happen. At risk are men aged 20-50 who smoke and drink.
4. Stabbing headaches
This causes brief, sharp pains that feel like being stabbed by an ice pick. Each stab usually lasts only a few seconds and may occur in different parts of the head.
So someone might experience a sudden jab near the temple that disappears almost immediately, only for it to happen again later. The causes are still unclear, but somehow related to overly sensitive pain nerves.
These headaches are considered harmless, and treatment is deemed unnecessary for occasional episodes.
B. Secondary headaches
These types of headaches come as a symptom of some illness or condition.
1. Infection-related headaches
You get headaches when you get “sick,” like when you have an infection. Viral infections can cause headaches together with fever and body aches.
The headaches disappear when the flu, which is the underlying condition, resolves itself.
2. Sinusitis-related headaches
Inflammation of the sinuses causes nasal congestion and discomfort around the forehead or cheeks. These headaches come with thick nasal discharge and a reduced sense of smell.
3. Headaches following blows to the head
Bump your head on the wall, and a headache may soon follow. Falls, accidents, and sports injuries are the same.
The blow can cause a concussion, which can lead to headaches.
4. Blood vessel-related headaches
A blood vessel can tear and bleed, get blocked, and get inflamed. You get headaches if this thing happens in certain parts of the body, like the brain.
Some of the most dangerous secondary headaches involve blood vessels in the brain (eg., bleeding, stroke, and other vascular conditions).
A classic warning sign is a “thunderclap headache.” It is a kind of pain often described as the worst headache any person has ever experienced, with pain levels reaching maximum intensity within seconds to about a minute.
This is a medical emergency. Go to the ER immediately.
5. Eye-related headaches
Prolonged screen use, reading, or driving can lead to eye strain and cause dull headaches.
Uncorrected vision and wearing unsuitable eyeglasses are the same.
Then there’s when the pressure inside the eye rises rapidly (acute angle-closure glaucoma).
Symptoms include severe eye pain, a red eye, blurred vision, halos around lights, and nausea or vomiting. This one requires immediate medical attention because delayed treatment can permanently damage vision.
6. Skull pressure-related headaches
A brain mass, impaired circulation of cerebrospinal fluid (CSF), or other neurological problems can increase pressure inside the skull, which can be very dangerous.
Symptoms include nausea or vomiting, drowsiness or confusion, blurred or double vision, brief vision “gray-outs,” light sensitivity, balance problems, weakness or numbness, and a rhythmic whooshing sound in the ears that matches the pulse (pulsatile tinnitus).
Headache Patterns To Watch Out For
A headache that develops gradually over several hours, for example, raises different questions from one that becomes excruciating in seconds.
Here are five patterns you should be paying attention to:
1. A headache that strikes suddenly
A headache that reaches maximum intensity within seconds to about a minute is called a thunderclap headache.
One possible cause is an aneurysm rupture.
Seek emergency medical care immediately.
2. A headache that keeps coming back
Recurring headaches, especially when they interfere with work, sleep, or daily activities, or become more frequent or change in character, deserve medical attention.
Your doctor can help diagnose the problem and start you on the proper treatment.
3. A headache triggered by coughing, exercise, or straining
Some headaches begin during strenuous activity, sexual activity, coughing, sneezing, or straining.
For instance, someone may experience sudden head pain while lifting a heavy weight at the gym or while straining during a bowel movement.
These can be harmless and caused by intense exertion, heat, dehydration, high altitude, low blood sugar, and blood-vessel dilation during exertion.
You should seek medical help when there’s vomiting, fainting, neck stiffness, double vision, confusion, weakness or numbness, and seizures.
(Note: This is not the same as feeling light-headed when exercising, which has something to do with blood flow and breathing. What we are talking about here is actual head pain.)
4. A headache that changes in frequency or severity
Pay attention when a familiar headache starts behaving differently.
Maybe someone who usually gets a mild headache once a month now experiences pain several days a week. Or a headache that used to respond to ordinary treatment becomes persistent and progressively worse.
A changing pattern does not automatically indicate a serious disease, but you should not ignore headaches that get worse and more frequent.
5. A headache accompanied by other symptoms
As we said earlier, when there’s vomiting, fainting, weakness or numbness, and seizures in addition to the pain, you should seek immediate medical care.
How To Manage and Prevent Headaches
1. Start with the basics.
Drink water. Dehydration can cause headaches, particularly after heavy sweating and water loss.
Eat regularly. Skipping meals can trigger headaches in some, including those with migraines.
Get adequate sleep. Insufficient sleep and irregular sleep schedules contribute to attacks.
Take a break from screens. Prolonged screen use contributes to eye strain, poor posture, or discomfort.
2. Manage the root, not the symptom.
Paracetamol and certain nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help relieve some headaches. However, running to them at every instance may only be dealing with the symptom, masking the real problem.
Deal with the underlying issue, if there is one, and the headaches will resolve themselves.
(Taking excessive amounts of painkillers because of returning headaches can actually cause headaches. We call them “rebound headaches” or “medication overuse headaches.”)
3. Identify your triggers.
Some people notice that headaches follow specific events like:
Sleeping much less than usual
Skipping meals or becoming dehydrated
Changes in caffeine intake
Alcohol consumption
Stress or a sudden change in stress levels
Certain hormonal changes
Being exposed to bright lights
Consuming specific foods (eg., chocolate)
Triggers vary. If your headaches occur after skipping breakfast, for example, try maintaining consistent meal times.
4. All headaches are not equal.
Treat different kinds of headaches differently. A headache that improves with rest needs a different approach from a recurring migraine.
And a sudden severe headache with new neurological symptoms, or a headache with fever and neck stiffness, should be considered an emergency.
If your headaches persist despite reasonable self-care, become more frequent, or interfere with work and sleep, you should come and see a doctor.
You don't have to panic every time your head hurts, but understanding your headache pattern and knowing when to seek help can be a lifesaver.
If your headaches are recurring, affecting your daily life, or changing in character, consult your doctor rather than relying on pain relievers indefinitely.
BloodWorks Lab has tests and assessments that may be required by your doctor to monitor your health, diagnose underlying conditions, or determine the source of those headaches.
Book your appointment today.
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