A headache or cephalalgia is a pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck.
The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the pain-sensitive structures around the brain. Nine areas of the head and neck have these pain-sensitive structures, which are the cranium (the periosteum of the skull), muscles, nerves, arteries and veins, subcutaneous tissues, eyes, ears, sinuses and mucous membranes.
There are a number of different classification systems for headaches. The most well-recognized is that of the International Headache Society. Headache is a non-specific symptom, which means that it has many possible causes. Treatment of a headache depends on the underlying etiology or cause, but commonly involves analgesics.
Here you can find the most common types and how to treat them:
1. DOUBLE-SIDED HEAD SQUEEZER
Symptoms: Daily pain on both sides of the head, which feels as if it is being squeezed.
Possible cause: Medication rebound headaches are caused when you stop taking regular painkillers, triggering withdrawal symptoms.
Taking paracetamol and aspirin more than twice a week or migraine drugs called triptans for more than ten days a month can put you at risk.
“What seems to happen is that pain receptors, which are blocked on a regular basis by medication, become over-sensitive to pain stimuli,” says Dr. Andy Dowson, director of headache services at King’s College London.
“If you stop taking the medicine, the headache comes back with a vengeance.”
Treatment: If the headaches are particularly bad, your doctor may prescribe anti-depressants and anti-epilepsy drugs, which raise your pain threshold.
“The old school of thought was that you go through the process of withdrawal,” says Dr. Andy Dowson.
“Now, we think it may be better to take preventatives – <<rescue pain medication>> – such as antidepressants and some anti-epilepsy drugs.
“These aren’t habit forming, and you can ease off them gradually.”
2. TOP OF THE SKULL HEAD SQUEEZER
Symptoms: Pain accompanied by sensation that the head is pushed from the top or sides.
Possible cause: Stress or tension headaches are common, with 50 to 70% of the population suffering one every month.
While the cause is unclear, it may be that teeth grinding at night triggers the pain – this leads to the muscles in the jaw becoming permanently taut.
Poor posture – being slumped in front of a screen, for instance – is also thought to be a factor, as it causes tension in the neck and shoulder muscles, which can trap nerves to the head.
Treatment: Teeth grinding can be reduced by wearing a mouth guard at night.
A blast of fresh air and painkillers can provide short-term relief.
A 2007 Indian study also showed yoga can reduce chronic tension headache pain by 71%.
“A relaxing massage or hot bath can help to relieve tension,” says Dr. Andy Dowson.
3. HEAD EXPLODER
Symptoms: Dull throbbing pain in the front of your head, feeling of pressure, watery red eyes and fever.
Possible cause: Blocked or inflamed sinuses behind the eyes, nose and cheeks.
The sinuses can swell as a result of infection with bacteria or virus. This often happens during a cold. The inflamed passages block the drainage of mucus. The pain is compounded if the area becomes infected (sinusitis). It can also cause pain in the top teeth.
Treatment: Many sinus headaches subside on their own within a few days.
Over-the-counter medicines including ibuprofen or paracetamol can help reduce inflammation.
See your GP if symptoms continue beyond ten to 14 days, as you may need antibiotics.
4. LIGHT-HEADED HEADACHE
Symptoms: Pain and light-headedness sometimes accompanied by nausea and nervousness.
Possible cause: Coffee lovers and people who drink lots of cola drinks may suffer caffeine withdrawal headaches if they cut back.
It’s thought caffeine interferes with the chemical messenger that widens blood vessels in the brain. The body can’t compensate when caffeine levels suddenly fall.
Treatment: Have no more than 300 mg of caffeine each day – equivalent to three mugs of instant coffee or four cups of tea.
Typical cola drinks contain less than 50 mg of caffeine per can.
5. HEADACHE BEHIND EYES
Symptoms: Constant dull ache behind the eye sockets.
Possible cause: Eye strain can trigger asthenopia headaches, which can be debilitating.
“It’s important to get an early diagnosis because it can sometimes be caused by more serious conditions such as glaucoma or cancer,” says Dr. Clyde Alexander, an optician at Clyde Kobrin in Potters Bar, Herts.
One of the main causes is not wearing the correct glasses or any glasses at all when you need them.
“The ciliary muscles, responsible for flattening the lens and allowing clear vision far away, struggle to hold the lens in the correct position, which can lead to chronic headaches,” says Dr. Clyde Alexander.
People who spend a lot of time looking at screens, even if they don’t need glasses, can also suffer eye-strain headaches.
Treatment: “If you need to work looking at a screen, take short breaks every 20 minutes to allow the muscles in your eyes to relax,” says Dr. Clyde Alexander.
6. CRIPPLING HEADACHE
Symptoms: Severe pain accompanied by sensitivity to light.
Possible cause: Migraine affects around 15% of the population.
“Some people have a predisposition to migraines, which can then be triggered by factors including diet, changes in temperature and even artificial lighting,” says Dr. Andy Dowson.
“The intense pain is thought to stem from the trigeminal nerve, the main nerve in the face (also active in cluster headaches).
“The pain can last for hours and even days if left untreated.”
Treatment: Lying down in a quiet, dark room can help calm nerve cells. Triptan medication, such as Imigran recovery, can help if taken at the onset of symptoms.
If you’re getting weekly migraines and medication isn’t working, doctors may prescribe a low-antidepressant such as amitriptyline.
This works by increasing levels of feelgood brain chemical serotonin.
A recent Swedish study found people who exercised 40 minutes three times a week had the same pain reduction as those who took prescription migraine drug topiramate – it’s thought it stimulates release of pain-killing endorphins.
7. BENDING DOWN HEADACHE
Symptoms: Pain on bending down or moving head side to side.
Possible cause: Not drinking enough to maintain levels of fluid and electrolytes, such as sodium, chloride and potassium, in the body can lead to dehydration.
Experts believe dehydration may cause blood vessels to narrow, reducing the brain’s supply of blood and oxygen.
The brain has no pain receptors, so it is probably receptors in its lining that trigger the discomfort.
Treatment: “Don’t wait until you feel thirsty, and make sure you drink six to eight glasses of fluid a day,” says personal fitness instructor Kathryn Freeland.
8. MONTHLY HEADACHE
Symptoms: Throbbing pain that strikes once a month.
Possible cause: Women often experience headaches during and around the time of their period when levels of oestrogen are very low. The pain can be accompanied by nausea, vomiting or sensitivity to light and sound.
“There’s some evidence that changes in the oestrogen levels make blood vessels in the brain more sensitive, sending them into spasm,” says gynaecologist Mike Bowen from the Saxon Clinic Milton Keynes.
Women going through the menopause tend to experience more headaches, which may also be due to falling oestrogen levels.
Treatment: Over-the-counter pain relief can help, and anecdotal reports suggest alternative remedies containing feverfew and butterbur may provide relief.
A quick fix is an ice pack, applied to the sore area for ten to 15 minutes every hour, to ease inflammation, says Robert Kaniecki, neurologist at the University of Pittsburgh school of medicine.
9. ORGASM HEADACHE
Symptoms: Throbbing or stabbing pain within seconds of orgasm.
Possible cause: No one knows for sure why some people develop intense headaches at the point of orgasm, but it’s probably due to a change in the blood’s chemical composition when a protein is released by nerve cells.
“The first time it happens, it can feel as if you’ve burst a blood vessel and even lead to hospitalization,” says Dr. Andy Dowson.
Men report more sex headaches than women, possibly due to a surge in male hormones. The pain can last from a few minutes to hours.
Treatment: Low-dose aspirin every day may help, but this should never be taken without consulting your doctor.
Otherwise, certain anti-epilepsy drugs may dampen down hyper-excitable nerve cells in the brain.
10. PERFUME HEADACHE
Symptoms: Throbbing headache after using perfume or air freshener spray.
Possible cause: Many fragrances in multiple consumer products contain chemicals that can trigger headaches in sensitive people, and can even lead to migraine.
Several studies suggest that material commonly found in fragrances affect blood circulation in the brain, triggering pain.
“The chemicals most commonly identified in perfumes and fragrances that can cause problems are benzyl alcohol and anisyl alcohol,” says Dr. Andy Dowson.
“Natural ingredients such as clove or cinnamon oil can also cause headaches.”
Treatment: Opt for fragrance-free beauty products.
11. ALARM CLOCK HEADACHES
Symptoms: Excruciating pain that starts in the eye area and spreads to the temples and cheeks. Lasts from 30 minutes to four hours.
Possible cause: Cluster headaches.
Also known as suicide headaches or alarm clock headaches, these tend to come in clusters over a month or so, and strike at the same time each day.
One eye may go red and water and the lid may droop, possibly due to disruptions in the trigeminal nerve, the main nerve in the face. Men are more commonly affected.
The pain is thought to be triggered by an abnormality in the hypothalamus – the area of the brain that co-ordinates the release of various hormones and chemicals.
Faulty messages cause blood vessels in the brain to widen.
This also helps regulate the body’s biological clock.
Treatment: Your doctor can prescribe a preventative drug such as sumatriptan, which is injected and helps shrink the blood vessels.
If an attack comes on – usually without warning – people can take the steroid prednisolone every day for a week, which also helps narrow the vessels.
