Headaches are a common complaint; whether it’s a mild ache in the temples or a literally blinding paroxysm, people experience the familiar pain of headaches for a wide variety of reasons. Anything from caffeine and coming down from a hangover alcohol withdrawal to a head injury can cause a headache, but sometimes headaches are symptoms of a more serious underlying disorder or disease.
According to the World Health Organization (WHO), about 50% of adults worldwide have a headache disorder, meaning they have experienced a headache at least once in the past year. There are many different headache disorders, but they are all characterized by recurrent headaches that can sometimes be disabling for people with the condition; the WHO says that up to 4% of the population suffers from near-constant headaches for more than 15 days each month. Because headaches can be serious, it’s a good idea to have recurrent headaches checked out by a doctor as soon as possible.
How to Know If You Have Migraine
Migraines are one of the more well-known causes of severe, recurring headaches, yet migraines are a chronically under-diagnosed disease. Amaal Starling, a headache specialist and assistant professor of neurology at the Mayo Clinic in Arizona, explains that migraines are a genetic neurologic disease that sadly carry a great deal of stigma, which can make it difficult for migraine patients to be diagnosed early and accurately.
Migraines are more common among women than among men: according to the Migraine Research Foundation (MRF), 38 million people in the United States have migraines, 29 million of whom are women. The MRF describes a migraine headache as “typically a severe throbbing recurring pain, usually on one side of the head. But in about one-third of attacks, both sides are affected.” Migraine headaches can also be experienced with vision problems known as “aura.”
“Aura is basically an episode of reversible neurologic symptoms,” Juliana VanderPluym, a neurologist also of the Mayo Clinic in Arizona, tells Allure. Most commonly, symptoms of aura include “changes in vision,” VanderPluym says, and “there might be a spot of shimmery colors, or black-and-white visual patterns, almost like a lightning bolt, in part of their vision.” As the minutes go on during a migraine headache, the visual patterns can spread and potentially partially block vision. Migraines with aura can also include numbness or tingling sensations in one part of the body, and sometimes a person will have trouble talking during an aura-inducing migraine headache.
Other migraine headache symptoms can include nausea and vomiting. Migraine headaches can be brought on by a number of triggers, such as a drop in estrogen, certain foods, and stress. Treatment options for migraine headaches include pain-relieving medication, including over-the-counter drugs such as Excedrin, anti-nausea medicine, and prescription options like antidepressants and even Botox injections.
Menstrual Headaches 101
For some people with migraines, their headaches are triggered by a drop in estrogen, which occurs before and during a period. Migraine headaches triggered by this drop in estrogen are called menstrual migraines.
Migraine headaches can be even worse for those who take birth control, because the placebo pills taken during the period week cause a sudden drop in estrogen. Some migraine patients opt for a continuous form of the pill, or a progesterone-only option, in order to keep their estrogen levels steady enough to ward off headaches.
The matter of birth control can be particularly problematic for migraine patients who experience migraines with aura. Starling says that people who have migraine headaches with aura are at a slightly higher risk for stroke, and some birth control methods can also increase the risk of stroke. This is one reason why it is imperative for people with migraines to get an accurate diagnosis since it could impact what kind of birth control is safest.
A Guide to Tension Headaches
Tension headaches are the most common type of headache, and, unlike migraine headaches, are not caused by an underlying disease. The Mayo Clinic describes a tension headache as “generally a diffuse, mild to moderate pain in your head that’s often described as feeling like a tight band around your head.” In addition to dull, aching pain and a feeling of tightness, tension-type headaches can also include tenderness on the scalp as well as pain in the neck and shoulder muscles, according to the Mayo Clinic.
Though tension headaches are not caused by a disease and are experienced by many people, there is no clear cause for these headaches. Still, the Mayo Clinic says that stress is the most common trigger for people who report tension headaches.
Cluster Headaches Are a Clusterfuck
“Cluster headache is a very different and unique headache compared to migraine,” says VanderPluym, but both types are still incredibly painful.
Unlike migraine headaches, cluster headaches are more common in men than women, and occur in periods that can last weeks to months, according to information from the Mayo Clinic. VanderPluym says that people who experience cluster headaches will typically experience them for a few days to a few weeks, then the headaches will go away and not return for up to another year before they come back.
These headaches usually come on quickly and without any warning, and VanderPluym tells Allure the pain can be “excruciating.” The pain is sharply focused on one side of the head or felt most in one eye. Cluster headaches can also be accompanied by “autonomic symptoms” such as tearing up in the affected eye or getting a runny nostril on the side of the head where the pain is located. Sometimes the pain is so intense that people will need to move around in order to distract from the pain, and in other cases, the pain is severe enough that sufferers are driven to bang their heads against other objects, according to VanderPluym.
There are treatment options for cluster headaches. VanderPluym says that the treatments for cluster headaches include the administration of oxygen during the cluster headache, preventative therapies including medication such as Verapamil, and the use of steroid injections or oral steroids.
How to Tell If It’s a Sinus Headache
Sinus headaches are caused by inflammation of the sinus cavities, which are located in the forehead between the eyebrows, behind the cheeks, and the bridge of the nose. An allergic reaction to something in the air or a sinus infection can cause the sinuses to swell, which prevents the mucus that sinuses create from draining like normal. The sinuses, which are typically just filled with air, then become filled with mucus and can cause pain that feels just like a headache, according to the Cleveland Clinic.
This type of headache can be prevented by treating the underlying cause of the inflammation, whether it’s something mundane like allergies or a more severe cause such as a tumor. When experiencing a sinus headache, over-the-counter pain relievers and decongestants can help; if the headache is the result of an infection, a doctor will need to diagnose it and prescribe medication. The Cleveland Clinic also notes that symptoms of chronic sinus headaches can be alleviated with a warm air vaporizer, a warm compress, and saline nose drops.
What to Do About Caffeine-Withdrawal Headaches
Most people who have had a few too many cups of coffee will attest to the fact that consuming a lot of caffeine can be followed by a headache. Starling says that people with migraines “are very prone to having caffeine-withdrawal headaches,” but adds that not everyone who experiences headaches due to caffeine withdrawal gets a migraine.
Varying levels of caffeine may bring on headaches for different people, but the Mayo Clinic advises that it’s usually fine to drink up to 400 milligrams of caffeine per day (that’s about four 8-ounce cups of coffee) for healthy adults. But coffee lovers who suffer from migraines might want to exercise caution; the caffeine withdrawal could trigger an attack.
“Caffeine can change the size of blood vessels, and caffeine itself will cause blood vessels to constrict and it slows blood flow in those areas,” Starling explains. When caffeine levels in the body drop, the blood vessels widen, causing head pain. Consuming more caffeine can relieve the headache, but the cycle of withdrawal will continue. According to the American Migraine Foundation, doctors recommend that migraine sufferers limit their coffee intake to one or two cups a day — but even then, they recommend tracking the relationship between headaches and caffeine to see if patterns arise.
Decreasing caffeine intake is one way to relieve this type of headache, according to the National Headache Foundation. Otherwise, using pain relievers such as ibuprofen, drinking plenty of water, and massaging painful spots on the head can help as well, according to Healthline, a mental and physical health outlet.
Some Headaches Are Resultant From Injuries
Injuries to the head can cause a lot of pain and a number of issues, one of them being headaches. It is common for people who are suffering from a concussion to have headaches, and sometimes the headaches can last a long time after. According to the Mayo Clinic, post-concussion syndrome consists of dizziness and headaches that may feel like tension headaches or migraine headaches. These symptoms will usually manifest between a week and 10 days after a concussion and will go away within a few months. However, in some cases, the syndrome can last for longer than a year.
Beyond concussions that are caused by a mild head injury, traumatic brain injuries are also likely to cause headaches. Brain injury and surgeries related to a brain injury will cause head pain, but sometimes headaches last long after the initial injury. “These headaches can be caused by a variety of conditions, including a change in the brain caused by the injury, neck and skull injuries that have not yet fully healed, tension and stress, or side effects from medication,” according to BrainLine, an online resource for information about traumatic brain injury and PTSD.
Here’s When You Should See a Doctor
VanderPluym and Starling both say that it’s important for patients to see a doctor right away if they have new headache symptoms or ongoing headache symptoms. “A primary headache disorder, where a headache itself is the problem, can cause someone quite a bit of disability,” says VanderPluym. “There’s no point having to live with or suffer through a headache.”
Migraines, in particular, have “been under-recognized for decades. It is highly stigmatized and under-diagnosed,” according to Starling, who herself has migraine headaches. She says that migraine headaches can get worse over time if they are not treated early on, making it all the more vital for patients to get an accurate diagnosis as soon as possible. Because patients with migraine are not always taken seriously by primary care doctors, Starling says, patients may have to self-educate and should arm themselves with information about migraines and their own symptoms.
Not all headaches are indicative of a serious problem, but if headaches get in the way of normal life, are a new problem, or come with other symptoms like impaired vision and nausea, going to the doctor is the right call.