Headaches: the different types
Headache is one of the most common ailments. But not all headaches are the same — the location of the pain, how severe it is, how long it lasts and how often it occurs, and sometimes what brings on the pain, are some of the variables that doctors use to define different types of headache.
Knowing what type of headache you have can help you and your doctor to manage and treat your headaches.
This is the most common type of headache — most adults will have experienced a tension headache.
- Steady, non-throbbing mild to moderate pain usually on both sides of the head, and sometimes extending to the neck and shoulders.
- Feels like a tight band of pressure around the head.
- Can occur often.
- Can last for 30 minutes up to a few days, but most attacks are short-lived.
- Can be brought on by several triggers, including stress, lack of sleep and poor posture.
About 15 per cent of adults have migraines. Women are affected 2-3 times more often than men, and hormones are thought to play a role.
- Throbbing pain usually on one side of the head.
- May be preceded by an ‘aura’ of symptoms such as seeing a moving pattern or blinking lights in front of you.
- Often debilitating and accompanied by nausea and, sometimes, vomiting.
- Can last from 4 hours to a few days.
- Can cause sensitivity to bright lights or noise during the headache.
- Often runs in your family.
- Can be brought on by stress, certain foods, changes in the weather, lack of food, lack of sleep, as well as a range of other factors.
This is a relatively rare, severe headache that is much more common in men than women. Cluster headaches can affect people of all ages, but onset is most common between the ages of 20 and 40.
- Occurs once (or several times) every day for weeks to months — a so-called ‘cluster’.
- Usually occurs at the same time every day during a cluster.
- Very severe stabbing pain on one side of the head that typically lasts from 15 minutes to 3 hours.
- Pain is usually centred on one eye, which often becomes watery and red.
Chronic daily headache
- Can occur on and off, every day.
- Often tension headache or migraine symptoms; can be a mixture of both.
- Sometimes causes nausea, and aversion to light, noise and smells.
- Can be associated with anxiety or depression.
- Can be due to ‘rebound’ headache, which results from overuse of pain medications.
Some women experience severe headaches including migraines at times when their hormones fluctuate, for example, around the time of their period each month or around the time of ovulation.
Exertional headache including ‘sexual’ headache
Some people get a headache associated with exercise, sport or sexual activity. A ‘sexual headache’ can occur before or after orgasm; it can be severe and last for several minutes to several hours. Some people experience a sudden, severe headache at the point of orgasm.
Eye strain headache
If you have visual problems that have not been addressed by prescription glasses or contact lenses, you can get an eye strain headache, which typically causes pain and a heavy feeling around the eyes.
Temporo-mandibular joint headache
Some people may get muscle tension and pain related to a disorder of the temporo-mandibular joint (TMJ), the joint just in front of each ear, where your jaw bone connects to your skull.
Eating something very cold can cause a sharp pain in the middle of your forehead or over one temple. People who get migraines may be more likely to get an ice-cream headache — so-named because the pain comes on immediately after eating ice-cream.
Many other headaches are a secondary effect of another disorder, such as:
- a neck problem;
- irritation of nerve fibres, e.g. trigeminal nerve neuralgia;
- eye, ear, sinus, tooth and jaw problems;
- inflammation of an artery in the head (temporal arteritis);
- a head injury;
- a hangover from drinking excessive alcohol; or
- withdrawing from drugs such as caffeine or narcotics.
People may worry that their headaches may be due to a serious brain problem, like a brain tumour, a brain haemorrhage or a brain infection such as meningitis. This is rarely the case, as most headaches do not reflect an underlying brain disorder. If a brain disorder is present, other symptoms apart from headache also tend to occur.
Seek medical attention when you have:
- a headache that is ‘the worst I’ve ever had’;
- a change in the pattern of your headaches, for example, from mild and occasional headaches to severe and frequent headaches;
- a new type of headache for you;
- a sudden-onset headache;
- a progressively worsening headache over days or weeks;
- a headache that is accompanied by neck pain and fever (which can indicate meningitis), or by co-ordination problems, fits (convulsions), changes in personality, and weakness on one side of the body (which can indicate a serious brain disorder).
Drowsiness, visual symptoms, vomiting and dislike of bright light may all be symptoms associated with migraine. However, in other situations, particularly after head injury, they may indicate an underlying brain disorder. If you are experiencing these symptoms for the first time or are in any doubt, seek medical attention.
2. The International Classification of Headache Disorders. 3rd edition. 2018: ICHD-3. https://www.ichd-3.org/