Below:
 • What causes headaches?
 • How do I know which type I have?
 • Tension headaches
 • Migraines
 • Cluster headaches
 • When should I see a doctor about a headache?
 • Additional Information

Note: This article has been localised for an Irish audience.

Despite the pain you're feeling and the place it seems to originate, it's not your brain that's aching; it has no pain receptors. It's the skin, muscles, and blood vessels that cover the skull and the nerves that run from your brain to your head and face that cause the discomfort we call a headache. Different types include tension headaches, migraines, and cluster headaches. High blood pressure, eye or sinus problems, and brain tumours or infections can also cause head pain in rare cases.

Each of the three major headache types has different symptoms and responds to different treatments. Here's what you need to know about each:

Why you hurt

Pain results from stress-related muscle tension in the neck, shoulders, and head. Researchers think that fluctuations in brain chemicals called neurotransmitters, which regulate the perception of pain, may also play a role. Symptoms

•A dull ache frequently described as a vice-like squeezing of the head, sometimes accompanied by a stiff or sore neck.

•Pain usually above the eyes or in the back of the head.

•Usually moderate pain.

•Pain may fade in and out over the course of a day or several days.

What to do

For occasional tension headaches, try over-the counter analgesics: aspirin, paracetamol, or ibuprofen. But be careful not to overuse them; that can lead to so-called rebound headaches (headaches brought on by withdrawal from these medications). Furthermore, be aware that aspirin and ibuprofen can be dangerous for people with peptic ulcer disease. For chronic headaches, see your doctor; prescription migraine drugs or antidepressants (which can also block pain signals) can often help if your headaches are unusually severe or frequent. To prevent tension headaches, stay away from activities that strain your neck muscles, such as reading while looking down. Consider acupuncture too; many tension headache sufferers say regular treatments lessen both the severity and frequency of their headaches.

Why you hurt

Nobody really knows what happens in migraine but there are a number of theories. It may be that during a migraine, the blood vessels in your head swell and press on nearby pain receptors. Fluctuations in levels of neurotransmitters may also play a role. Other possible triggers include hormonal changes that accompany menstrual periods (most migraine sufferers are women), oral contraceptives, changes in sleep patterns, skipping meals, changes in the weather, bright or flashing lights, excessive noise, stress, and some foods¾particularly chocolate, red wine, aged cheeses, and smoked meats. Your genes may also predispose you to getting migraines. Most people who get migraines have their first attack before age 30.

Symptoms

•Mild to severe pulsing or throbbing pain, usually on one side of the head, that lasts from several hours to several days.

•Pain usually gets worse if you move around or look at bright light or hear loud noise.

•Pain often interferes with daily activities and may cause nausea or vomiting.

•Headaches are sometimes preceded by visual changes called auras that are probably caused by the blood vessels constricting before they swell and thus reducing blood flow to the brain. During an aura you may lose your vision or see shimmering, jagged, or flashing lights or colours. Some people also feel nauseated or irritable right before a migraine begins.

What to do

Over-the-counter pain relievers such as aspirin and other analgesics can be helpful for mild cases. But for frequent or severe migraines, prescription drugs are probably your best bet. Your doctor can help you choose from a wide range, including beta blockers and calcium channel blockers, which keep blood vessels from swelling, and antidepressants, which increase neurotransmitter levels. Newer drugs such as tryptophans have also proved very useful. Some people think that acupuncture, relaxation exercises, yoga, biofeedback, and the herbal remedy feverfew can also be helpful. Of course you should also eat regular meals, get plenty of sleep, and avoid foods that trigger migraines for you. Drugs like ergotamine and surmatriptan can help stop a migraine once it starts.

Why you hurt

Cluster headaches are much less common than tension headaches or migraines. They may be caused by swelling blood vessels in the head. Some researchers suspect that people get cluster headaches when they are not getting enough oxygen for some reason. Fluctuating neurotransmitter levels may play a role. Other suspected triggers include alcohol, cold or hot wind, high altitude, stress, and smoking. Cluster headaches occur most often in spring or autumn. Most sufferers are male.

Symptoms

•Knifelike pain limited to one side of the head, often in or around one eye, that usually lasts no more than an hour.

•Headaches in clusters, either several times in one day or for several days in a row, with recurrences at the same time of day, usually for six to eight weeks at a time.

•Nighttime onset, perhaps painful enough to wake you.

•Tearing in the eye on the affected side, or redness or swelling around the eye, or a droopy eyelid.

•A stuffy or runny nose along with the headache.

What to do

To prevent cluster headaches from occurring, doctors usually prescribe migraine medications. Once you have pain, inhaling oxygen is the only treatment known to bring relief. For some people herbal remedies such as Feverfew also show promise. Feverfew may ease the pain of cluster headaches, but can have side effects like mouth ulcers.

•Your headaches get stronger and more frequent.

•Your headaches last more than 24 hours or recur two or three times per week.

•If you also have numbness, blurred vision, memory loss, or dizziness.

•If you get a headache after hitting your head.

•If exercise brings on the headache.

•If your headaches interfere with daily life.

•If your headache is accompanied by a fever over 38 degrees Celsius (100 degrees Fahreinheit), you find it painful to bend your head forward, or light hurts your eyes.

•If the headache is accompanied by nausea, vomiting, or drowsiness.

•If you have severe pain around one eye with blurred vision.

Click here for further information on migraine or contact The Migraine Association of Ireland. They can be contacted at 01 8724137 or through their website at www.migraine.ie

This article has been revised by Vhihealthe for its audience and may contain, among other things, information or medical practices that are unique to Ireland. Neither Consumer Health Interactive nor the original author make any warranty as to the accuracy of the article as revised, and assume no responsibility for modified content.

First published September 17, 2001
Copyright © 2001 Consumer Health Interactive

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