Close to half the world’s adult population gets a headache every year. Additionally, data show that more than 7.2 billion people across the world will deal with a headache at least once in their lifetime. Though usually not serious, headaches should also not be taken too lightly.
To quote the World Health Organization fact sheet on headache disorders: “Headache disorders, which are characterized by recurrent headache, are associated with personal and societal burdens of pain, disability, damaged quality of life, and financial cost… Worldwide, a minority of people with headache disorders are diagnosed appropriately by a health-care provider… Headache has been underestimated, under-recognized and under-treated throughout the world.”
Of course, not all headaches are the same. Here’s a quick look at headaches, by type and prevalence:
A headache without another underlying cause — for example, a medical condition such as hypertension or pregnancy — is called a primary headache. Doctors don’t yet know the exact cause of primary headaches, but they believe that a series of chemical activities in the brain, nerves and blood vessels of the head signal pain. Other parts of the body that often contribute to a headache are the scalp, sinuses, teeth and muscles and joints of the neck.
Primary headaches are of at least seven different types. Here are the top 3:
According to the Global Burden of Disease Survey 2010, the latest such survey to include headaches, migraines are the sixth-biggest cause of years lost to disability in the world. (Headache disorders as a whole, were the third-largest contributor.)
Typically, a migraine involves one side of the head. The pain can be debilitating, and it can last for 4 hours to three days. Usually, the pain gets worse when the patient moves or is exposed to sounds and bright lights. A patient with migraine may feel nauseated when the pain is at its peak, and they may sometimes vomit.
Contrary to popular belief, only 20% of migraine patients present with an aura – in which patients may have visual symptoms like sensitivity to bright lights or flashing and sensory symptoms like a tingling sensation in the face, arms or legs, which is followed by an active episode of migraine.
If the disease progresses, migraine pain is treated with prescribed painkillers like sumatriptan or zolmitriptan. Overuse of medication is linked to rebound migraine headaches, which patients say can be worse.
Patients usually describe the pain sensation like a tight band across the forehead. The pain usually lasts for several days. Tension headaches make one uncomfortable and tired all the time, but they usually don’t disturb the patient’s sleep.
This variation of headache is also known as a pressure headache. It can be caused by tightness in the muscles of the neck (especially the back of the neck) and scalp. Stress, tiredness and unusual sleeping positions may aggravate the pain. Sometimes vision problems can also lead to tension headaches.
Tension headaches are usually treated with over-the-counter painkillers like aspirin. They have a lifetime prevalence of 88% in women and 69% in men, according to a chapter on tension headache in Clinician’s Guide to Chronic Headache and Facial Pain, edited by Gary W. Jay.
This type of headache is quite severe and is often referred to as suicidal headaches. Patients can have up to eight episodes of headaches in a single day. The pain characteristically involves just one side of the head. More often than not, the eye on the side that is in pain appears red and watery.
A cluster headache comes in waves of pain lasting 30 minutes to 60 minutes. During this short period, it leaves the patient restless and unable to sit still.
Restoring oxygen flow to the brain provides some relief from pain. As do drugs like sumatriptan when given in an injectable form. The most effective medication for preventing cluster headache attacks is verapamil, a calcium-channel blocker.
A headache arising from an underlying disease such as infection, psychiatric disorder, high blood pressure, head injury, stroke or tumour is known as secondary headaches. Comprehensive management of the underlying condition usually helps to relieve the headache to a large extent.