Over 95% of people experience at least one headache in their lifetime. But there are many kinds of head, neck, face, and eye pain. Researchers have identified over 200 different headache types, varying in intensity, location, duration, and cause. Determining the kind you have is essential for proper management, and it can help you know if your symptoms are a sign of something serious.
This article covers the most common types of headaches, how to find relief, and when to get help.
What Are the Most Common Types of Primary Headaches, and How Are They Treated?
Healthcare providers break headaches into two categories based on their causes: primary and secondary. Primary headaches are neurological disorders that arise on their own. This type includes migraine, tension, and cluster headaches, among others.
Tension Headache
Tension headaches are the most common type, causing a band of mild to moderate pain or pressure along the temples or in the neck. This type also causes nausea, vomiting, and sensitivity to light or sound. Muscular tension in the head and neck often causes tension headaches. Triggers include stress, sleep problems, hunger, or dehydration.
Common treatments to relieve symptoms include over-the-counter (OTC) pain relievers, prescribed muscle relaxers, or tricyclic antidepressants. Acupuncture, massage, and other relaxation methods help prevent attacks.
Migraine
Migraine causes moderate to severe shooting pain, often on one side of the head, that lasts hours to days. Other symptoms include light or sound sensitivity and nausea, and most people who get migraines experience migraine with aura, in which sensory or visual distortions precede attacks.
Abnormal activity in the brain’s trigeminal nerve, which regulates pain and sensation from the head, causes migraine. They are more common among people assigned female at birth. Bright lights, stress, poor sleep, skipping meals, and certain foods like chocolate, red wine, and cured meat can trigger migraine attacks.
Medications for migraine attacks include triptans, ergots, as well as non-steroidal anti-inflammatory drugs (NSAIDs) or other analgesics. Anticonvulsants, beta-blockers, calcium channel blockers, and certain antidepressants are preventative medications.
Cluster Headache
Cluster headache causes piercing pain behind one eye, a drooping eyelid, tearing, and congestion. Attacks last 15 minutes to several hours and come in clusters—weeks to months of daily or nearly daily headaches, which often strike at night—followed by at least one month of remission.
Researchers have not identified the exact causes of cluster headaches, but triggers include alcohol, cigarette smoke, overexertion, and bright lights. Healthcare providers prescribe triptans, oxygen therapy (breathing oxygen from a respirator), corticosteroids, or dihydroergotamine (DHE) injections for attacks. Steroids, allergy medications, blood pressure medications, and calcitonin gene-related peptide (CGRP) blockers prevent cases.
Hemicrania Continua
Hemicrania continua is a rare, severe headache that causes persistent pain on one side of the head. Additional symptoms include eye swelling, congestion, runny nose, nausea, and light and sound sensitivity. The exact cause of this rare headache is unknown, and this type doesn’t have triggers.
Adults assigned female at birth are at the highest risk. Treatment options include Tivorbex (indomethacin) and corticosteroids.
Ice Pick Headache
Ice pick headaches are characterized by brief, sharp, stabbing pain and tears in one eye or the temple. Attacks last about 10 seconds and cause nausea and light and sound sensitivity. The exact causes aren't known, and people assigned female at birth are more susceptible. Tivorbex (indomethacin) is the primary treatment.
Thunderclap Headache
Thunderclap headaches are considered the most painful type and reach their maximum intensity within one minute of onset. This type can be primary or a sign of brain hemorrhage (bleeding). These headaches last about five minutes and have no triggers. They are always a medical emergency; healthcare providers treat primary cases with Tivorbex (indomethacin).
Hypnic Headache
Hypnic or “alarm clock” headaches occur at night and disrupt sleep. They typically affect people over 60 and cause dull or throbbing unilateral (one-sided) pain that lasts anywhere from 15 minutes to four hours. Medications for this type include Carbolith (lithium carbonate), Sibelium (flunarizine), and Tivorbex (indomethacin).
What Are the Most Common Types of Secondary Headaches?
Secondary headaches arise as symptoms of other diseases or health conditions. They’re the headaches you get when you have allergies, feel sick, or hit your head, among other causes.
Allergy or Sinus Headache
Inflamed sinuses from allergies or respiratory illnesses cause headaches that feel like squeezing, pressure, or pain in the cheeks, brow, or forehead. Symptoms worsen when you bend or lean; some also experience achy teeth, fatigue, and congestion. Sinus headaches resolve as the inflammation subsides. OTC pain relievers effectively manage symptoms.
Post-Traumatic Headache
Post-traumatic headache (PTH) occurs after a head or neck impact. Symptoms appear within a week of an injury, such as whiplash or a traumatic brain injury (TBI). It causes headache symptoms as well as TBI symptoms such as confusion, fatigue, irritability, and anxiety. PTH treatments include NSAIDs, analgesics, caffeine, and triptans.
Hormone Headache
Hormone headaches arise due to fluctuations in the female sex hormone, estrogen. These headaches are typically one-sided and caused by menstruation, pregnancy, birth control, and hormone replacement therapy (HRT). Along with pain, symptoms include light sensitivity, sore scalp, appetite loss, dizziness, and nausea.
Healthcare providers may recommend NSAIDs or prescribe triptans, oral birth control, or hormone treatments for this issue. Antiseizure, tricyclic antidepressants, and certain anti-hypertensive (blood pressure) medications treat severe cases.
Caffeine or Alcohol-Related Headaches
In regular coffee or tea drinkers, caffeine withdrawal can cause headaches and trigger migraine attacks. Caffeine causes physical dependency, so reintroducing caffeine resolves the issue.
Alcohol also triggers migraines and causes hangover headaches. Hangover headache is a form of withdrawal due to dehydration, poor sleep, intestinal irritation, and inflammation. OTC pain relieving medications help ease fatigue, sweating, nausea, light and sound sensitivity, and irritability that these headaches cause.
Exertion Headache
Exercising too much can lead to exertion headaches, which last anywhere from five minutes to two days. This type of headache causes throbbing, bilateral pain that sets in after intense physical effort. Researchers aren’t sure what causes this headache, and there aren’t any standard therapies, though reports note Tivorbex (indomethacin) may be effective.
Hypertension Headache
A headache is a symptom of extreme hypertension (blood pressure measuring over 180/120), a medical emergency known as a hypertensive crisis. Additional symptoms include nausea, vomiting, breathing difficulties, nosebleeds, and anxiety. Along with pain-relievers, medications that treat high blood pressure help relieve this headache.
Spinal Headache
A spinal headache is a rare complication of lumbar puncture—an invasive treatment used for back pain diagnostic testing or to administer local anesthesia. In this procedure, providers use a syringe to collect fluid or administer anesthesia from the spinal canal. This fluid disruption lowers pressure on the brain, which can cause dull pain in the front of the head. Spinal headache symptoms worsen when you stand, cough, sneeze, or move.
Spinal headaches typically occur within five days of a lumbar puncture and usually independently resolve within two weeks. Lying down, OTC pain relievers, and caffeine help ease symptoms.
Medication Overuse Headache
Medication overuse headache (MOH) occurs when you take too many NSAIDs, triptans, or other pain relievers for primary headaches. MOH is a headache occurring on 15 or more days per month, developing as a consequence of regular overuse of acute or symptomatic headache medication (on 10 or more, or 15 or more days per month, depending on the medication) for more than three months.
While all pain-relieving medications can cause this effect, it’s especially common with opioids and medications containing butalbital, such as Fioricet. Stopping the use resolves this issue.
How Can I Identify My Headache Type?
Since different headaches can resemble each other, the only way to know what you have is to seek a diagnosis from a healthcare provider. A healthcare provider may diagnose you by evaluating the following:
- Medications
- Family history of headache
- Timing, duration, intensity, and location of symptoms
- Any associated symptoms, such as nausea, light sensitivity, or visual problems
- Any known triggers or activities that make symptoms worse
- Age of first onset
In cases of suspected stroke, brain hemorrhage, or other issues, healthcare providers may call for imaging or additional tests, including:
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Blood tests
- Urinalysis (urine test)
- Lumbar puncture
When to Contact a Healthcare Provider
In general, if headaches are significantly impacting your life, seek care. Call a healthcare provider if you experience:
- Changes in headache patterns, worsening pain, or other symptoms
- Treatments that are ineffective or less effective
- Medication side effects like irregular heartbeat, cough, depression, fatigue, nausea/vomiting, pale or blue-tinted skin, diarrhea, constipation, cramps, and thirst
- Pregnancy or plans to become pregnant
- Frequent headaches requiring you to take pain medications more than three times a week
- Headache pain that gets worse when lying down
When to Call 911
While most headaches aren’t a sign of anything dangerous, certain warning signs indicate a medical emergency. Call 911 if you experience:
- Sudden onset of extremely severe headache (thunderclap headache symptoms)
- Severe headache alongside fever or neck stiffness
- Seizure, loss of consciousness, personality changes, or confusion
- Headache shortly after exercise or injury
- New onset of vision problems, weakness, and numbness
Can You Prevent Headaches?
Depending on the type you have, you may be able to prevent headaches. Lifestyle changes and certain habits can help with primary headache disorders. Standard prevention methods include:
- Keeping a headache diary: Track any known triggers (and avoid them), medications, and headache patterns.
- Drinking water: Prevent dehydration by drinking enough water.
- Maintaining healthy habits: Avoid using illicit drugs, smoking, or drinking alcohol.
- Sleeping well: Get sufficient, uninterrupted sleep every night (seven to eight hours for adults), and go to bed and wake at consistent times.
- Managing stress: Avoid tension, migraines, and other types of headaches by managing stress with healthy means, such as yoga, meditation, or relaxing activities.
Do Headaches Cause Other Complications?
Most headaches don’t cause complications. However, chronic cases raise the risk of mood disorders. In one study of people seeking care for headaches, nearly 20% had depression, and almost 14% had anxiety.
There also are several rarer complications:
- Status migrainous: This is a severe migraine attack that lasts 72 hours or more and affects one’s ability to function.
- Stroke: A type of stroke known as migrainous infarction can arise following migraine with aura.
- Persistent aura without infarction: This complication causes migraine aura to persist for a week or more.
- Migraine-associated seizure: Also known as migralepsy, this is when seizures arise due to migraine with aura.
Summary
There are many different types of headaches. Primary headaches—those arising in the absence of other diseases—include migraine, tension, and cluster headaches. Secondary headaches, which are symptoms of different diseases, include headaches due to sinus infection and those due to accident or injury, among others.
If you experience regular or debilitating headaches, it’s critical to seek medical care. With proper diagnosis, healthcare providers can connect you to treatment and prevention options. The sooner you get help, the better the outcome.
