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Headaches & Migraines
cause. Headaches are one of the most common
types of pain. In fact, in the United States, 7 out of
10 people report having at least one headache each
year. The pain may occur all over the head or in one
part of the head, such as the front of the head. The
pain can also move to different parts of the head.
Headache pain can be on the surface of the head or
deep in the head. The pain can be sharp, throbbing,
constant, and/or dull. Most headaches last for a few
hours but some can last for weeks.
Headaches are very rarely a symptom of a serious disorder, but sometimes they are
(see below) and require urgent medical attention.
WHAT CAUSES HEADACHES?
There are many possible causes of headache. Headache pain comes from outside of
the brain. Many people do not know that the brain does not have any sensory nerves
that register pain. Rather, the pain from a headache comes from the stretching of, or
tightening in, the following structures:
1. The outer linings of the brain and spine, which
are known as meninges.
2. Blood vessels, which are tube shaped structures
that carry blood to and from the heart.
3. The scalp, which is the layer of skin and tissues
that cover the head.
4. Muscles in the face, neck, scalp, and other parts
of the head. About 3 of 4 headaches are caused by
tension in the neck or scalp muscles.
The most common cause of headache is stress. This stress can be due to many factors
such as nervousness, hunger, changes in weather, exposure to strong sunlight, poor
positioning of the body, loud noise, being in a stuffy environment, traveling too much,
or sleeping too much. Waking up after drinking too much alcohol can also lead to
headaches. Drugs such as nicotine (present in cigarettes) and caffeine (present in many sodas, teas,
and coffees) can cause headaches. Eating something unusual can also lead to headaches, as can
reactions to certain foods and beverages. For example, some people can develop migraine headaches
(described in the next section) by eating chocolate, cheese, or drinking red wine.
Substances that are added to foods such as food colorings, sugars, and salts, can also cause
headaches. Toothaches, ear infection, head injury, inflammation of air-filled openings in the bones
surrounding the nose (known as facial sinuses), and cervical osteoarthritis can also cause headaches.
Cervical osteoarthritis is a painful, worsening condition that affects joints between bones in the neck.
Disturbances of a nerve in the head or neck can also cause a headache. Headache pain is not limited
to coming from any one nerve.
Some causes lead to concern amongst some about when to go to the emergency room for a headache,
such as high blood pressure and brain tumors. Tumors are tissues that grow more rapidly than normal.
Headaches can also be caused by aneurysms, which is a weakening of the wall of a blood vesselm,
causing it to expand like a balloon, sometimes leading it to burst. Increased pressure in the skull can
also cause headaches. Headaches can be caused by temporal arteritis, which is an inflammation of
arteries in the brain and scalp. Arteries are blood vessels that carry blood away from the heart.
Temporal arteritis is suspected in elderly people when the scalp is painful to the touch.
Meningitis, which is an inflammation of the meninges (the three outer coverings of the brain) can lead
to headaches as well. A buildup of blood (known as a subarachnoid hemorrhage) between the first two
inner layers of meninges that cover the brain can cause headaches. This buildup of blood can be due
to damage from a traumatic accident, such as a car accident.
ARE THERE DIFFERENT TYPES OF HEADACHES?
Yes. There are many different types of headaches. Some headaches are normal responses to
something that is bothering the body, such as hunger. These types of headaches usually go away in a
few hours and leave no after affects. Another type of headache is a tension headache, which is caused
by tightening of the muscles in the neck, face, and scalp. The tightening of these muscles are caused
by stress or positioning the body poorly.
A more painful and continuous type of headache are migraine headaches and cluster headaches.
Migraine headaches are so painful that they prevent people who experience them from doing anything.
Visual difficulties and/or stomach problems occur before and/or during a migraine headache. Cluster
headaches cause intense pain behind one eye. This pain can wake someone up during the night for
weeks or months. Neither migraine headaches nor cluster headaches indicate that a worsening
disorder is present.
ARE THERE OTHER SIGNS AND SYMPTOMS THAT OCCUR ALONG WITH HEADACHES?
stomach (nausea), vomiting, disturbances of vision (such as blurry vision), and/or disturbances of
sensation (such as weakness of an arm or leg). Other danger signs include drowsiness, confusion, and
loss of consciousness. If these symptoms occur along with a headache, you should seek immediate
medical attention.
HOW DO I KNOW WHAT IS CAUSING MY HEADACHE?
Below is a list of indicators that may suggest the particular causes of a headache. Please keep in mind
that these are possibilities and that you should consult your doctor for more information. You should
also consult your doctor if your symptoms do not match the patterns described on the following list:
FEVER: Headache with a temperature over 100 degrees.
EPIDURAL HEMORRHAGE: An epidural hemorrhage is bleeding outside of the outermost layer that
covers the brain. Symptoms include a headache with a head injury in the past few days, in addition to
feeling unusually drowsy, and/or vomiting, or feeling nauseous (sick to one's stomach). No temperature
over 100 degrees Fahrenheit (F). If this applies to you, it is an emergency, and you should get medical
help immediately.
HEAD INJURY: Headache with a head injury within the past few days, without feeling unusually
drowsy and/or vomiting, or feeling nauseous. No temperature over 100 degrees Fahrenheit (F). A
continuous headache is common following a head injury.
RAISED PRESSURE IN THE EYE: Severe pain in and around one eye, blurry vision in that eye, and
nausea or vomiting. No temperature over 100 degrees Fahrenheit (F). No head injury within the past
few days. If this applies to you, it is an emergency and you should get medical help immediately.
SUBARACHNOID HEMORRHAGE: A subarachnoid hemorrhage is bleeding between the first two
layers that cover the brain. Symptoms are headache, nausea and vomiting, as well as two or more of
the following symptoms: dislike of bright light, drowsiness or confusion, and pain when you touch your
chin to your chest. No temperature over 100 degrees Fahrenheit (F). No head injury within the past
few days. No severe pain in and around one eye. If this applies to you, it is an emergency and you
should get medical help immediately.
INFLAMMATION OF ARTERIES IN THE HEAD: Nausea and vomiting as well as a sudden throbbing
pain in the side or sides of the head. No temperature over 100 degrees Fahrenheit (F). No head injury
within the past few days. No severe pain in and around one eye. No dislike of bright light, drowsiness
or confusion, or pain when you touch your chin to your chest. If this applies to you, it is an emergency
and you should get medical help immediately.
MIGRAINE HEADACHES (see section above on different types of headaches for description): Nausea
as well as disturbed vision that occurs with vomiting, followed by pain on one side of the head. No
temperature over 100 degrees Fahrenheit (F). No head injury within the past few days. No severe pain
in and around one eye. No dislike of bright light, drowsiness or confusion, or pain when you touch your
chin to your chest. No sudden throbbing pain in the side or sides of the head.
DRINKING TOO MUCH ALCOHOL: Experience of a similar headache while waking up the past
several days or more out of the past week. The headache occurs only when drinking a lot of alcohol
the night before. No temperature over 100 degrees Fahrenheit (F). No head injury within the past few
days. No nausea or vomiting.
TENSION, BRAIN TUMOR, OR HIGH BLOOD PRESSURE: Experience of a similar headache while
waking up the past several days or more out of the past week. The headaches do not occur only when
drinking a lot of alcohol the night before. No temperature over 100 degrees Fahrenheit (F). No head
injury within the past few days. If the pain is in the back of the head, tension or high blood pressure is
a more likely cause than a brain tumor. If nausea and vomiting is present and the headache reoccurs
and is experienced while waking up, this indicates a brain tumor. If the group of symptoms mentioned
in this paragraph applies to you, it is an emergency and you should get medical help immediately.
SINUSITIS: Sinusitis is inflammation of air-filled openings (known as facial sinuses) in the bones
surrounding the nose. Symptoms are a current or recent stuffy nose and a dull pain and pain to the
touch around the eyes and cheekbones that worsens when bending forward. No temperature over 100
degrees Fahrenheit (F). No head injury within the past few days. No nausea or vomiting. No similar
headaches while waking up the past several days or more out of the past week.
COMMON COLD: Headache and a current or recent stuffy nose. No dull pain or pain to the touch
around the eyes and cheekbones that worsens when bending forward. No temperature over 100
degrees Fahrenheit (F). No head injury within the past few days. No nausea or vomiting. No similar
headaches while waking up the past several days or more out of the past week.
NERVOUSNESS, TENION HEADACHES: Headache and feeling tense or under stress and/or having
poor sleep. No temperature over 100 degrees Fahrenheit (F). No head injury within the past few days.
No nausea or vomiting. No similar headaches while waking up the past several days or more out of the
past week. No current or recent stuffy nose.
STRAIN ON NECK MUSCLES: Headache that occur after reading or doing work that requires you to
be close to something, such as sewing. No temperature over 100 degrees Fahrenheit (F). No head
injury within the past few days. No nausea or vomiting. No similar headaches while waking up the past
several days or more out of the past week. No feeling tense or under stress and/or having poor sleep.
COMMON CAUSES SUCH AS: Hunger, drinking more alcohol than usual, being in a stuff, noisy,
smoky area, exposure to strong sunlight. Headache, with the common causes just mentioned,
occurring in the 12 hours before the headaches began. No temperature over 100 degrees Fahrenheit
(F). No head injury within the past few days. No nausea or vomiting. No similar headaches while
waking up the past several days or more out of the past week. No feeling tense or under stress and/or
having poor sleep. Headache does not occur after reading or doing work that requires you to be close
to something, such as sewing.
MEDICATION SIDE EFFECT: Headache in addition to taking medication and/or taking birth-control
pills. No temperature over 100 degrees Fahrenheit (F). No head injury within the past few days. No
nausea or vomiting. No similar headaches while waking up the past several days or more out of the
past week. No feeling tense or under stress and/or having poor sleep. Headache does not occur after
reading or doing work that requires you to be close to something, such as sewing. The common
causes mentioned in the last section have not occurred within 12 hours before the headache began.
You should talk to your doctor if you think a medication side effect is causing your headache.
WHAT IF MY HEADACHES DON'T GO AWAY?
If your headaches do not go away within 2 hours, reoccur several times a week, are accompanied by
other symptoms (see above), or do not respond to self-help treatments (described below), you should
contact your doctor immediately to determine the cause and plan for treatment. The doctor will ask
where the pain is, what the pain is like, and when the pain occurs. The doctor will do a general
physical examination and should examine the head and neck. If the doctor believes that the cause
may be something serious, such as a brain tumor, he/she may ask for special tests to be done that
produce pictures of the bones of the head and the brain. Two of the most commonly used tests to do
this are a Computerized Axial Tomography (CT) scan and a magnetic resonance imaging (MRI) scan.
An MRI scan produces clearer pictures but is more expensive.
HOW ARE HEADACHES TREATED?
Preventing headaches is the most important issue to focus on, since many headaches are caused by
things that can be easily avoided. This is especially true if the person knows what is causing the
headache. See above for a section on causes of headaches. If a headache has started, and it is not a
migraine or cluster headache (see above), the following steps should help relieve the headache:
Lying down.
Relaxing in a hot bath.
Sleeping for a few hours.
Taking a mild pain medication (not aspirin).
Taking slow deep breaths and/or thinking of pleasant thoughts.
Avoiding things that can make the headache worse, such as loud noise.
Massaging and stretching the muscles in the shoulders, neck, scalp, and face.
Migraines and cluster headaches are usually treated with medication.
WHO GETS MORE HEADACHES, MALES OR FEMALES?
Headaches are more common in females.
WHAT AGE DO PEOPLE USUALLY GET HEADACHES?
Headaches are more common in people over age 20.
WHAT ELSE IS A HEADACHE KNOWN AS?
Headache is also known as cephalalgia, cephalodynia, encephalalgia, and encephalodynia.
WHAT IS THE ORIGIN OF THE TERM, HEADACHE?
Headache comes from the Anglo Saxon word "heafod" meaning "headache," and the Old English
word, "acan" meaning "to hurt." Put the two words together and you have "to hurt head."
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