Headaches are generally classified according to how and why the body is generating the pain.
Your pain might be anxiety-related or caused by substances that you’ve ingested or been exposed to reacting negatively with your body. On the other hand, your headache may be a more serious side effect of a disease your body is fighting.
How do you know?
Understanding the basic information about headaches can help pain sufferers better navigate the road to healing. Here’s what you need to know to begin to decipher your pain and resolve it.
Primary and Secondary Headaches
Headaches are generally grouped as primary or secondary. A primary headache refers to pain that is not a symptom of a disease, injury, or incident. While the reason for the pain may not be readily understood, overactivity within the head region is the direct source of the pain. According to the Mayo Clinic:
A primary headache is caused by overactivity of or problems with pain-sensitive structures in your head. A primary headache isn’t a symptom of an underlying disease.”
On the other hand, a secondary headache is viewed as a side effect of a disease or a seemingly unrelated factor. It is secondary to the initial cause of the pain. A secondary headache develops due to the presence of a separate issue somewhere in the body.
Tumors, aneurysms, and sinus pain are examples of secondary headaches. Hangovers and ice cream headaches are also considered secondary. A secondary headache can be solved by removing the cause, for example, a tumor or sinus blockage, or perhaps by consuming particular cold items with care.
Primary Headaches and Their Causes
Pain associated with certain headache types remains a medical mystery, but science is rapidly gaining understanding. As technology reveals more and more of how the nervous system and brain send messages throughout the body, headache pain continues to be better understood. Individuals who experience one type of primary headache may often also experience at least one other type of headache.
Since primary headaches are not the result of a particular ailment, narrowing the source of the pain can sometimes prove tricky. An exact reason for pain experienced by a patient may not always be readily identifiable. Yet, we can still take meaningful steps to minimize and alleviate headache pain.
Tension, migraine, and cluster headaches are the most common. Ice pick headaches are a bit less common, but as the name suggests, are no less painful. Each of these is considered primary because they exist as the initial pain problem.
Tension headaches are the most common and can occur at any age. They may be episodic (occurring less than 15 times in 30 days) or chronic (occurring 15 times or more in 30 days). Episodic tension headaches may last 30 minutes or as long as a week. Chronic tension headaches may run the stretch of a few hours and are often continuous or reoccurring in nature.
Possible Triggers: Elevated stress levels may trigger tension headaches in some individuals.
Tension headaches do not cause nausea or vomiting. They are also not caused by intense physical activity. A dull aching pain with a feeling of a band placed tightly around the head is how people have been known to describe tension headache pain.
Migraine headaches are the second most common type of headache. They can be as short as a few hours or as long as a few days and are usually reoccurring in nature.
Possible Triggers: Each person can have a different set of possible triggers for migraine pain. Some typical triggers include hormonal changes, environmental factors including things like weather and lighting, medications, sleep patterns, food and beverage choices, and physical exertion.
Paying attention to warning signs that often precede a migraine is one key to managing migraine pain. Warning signs can include flashes of light, emotional disturbances like depression/anxiety, blind spots, or tingling sensations in the face or arms.
Cluster headaches, also known as neurovascular headaches, happen one after another in a short period of time. This type of headache can last for a few minutes or as long as a few hours. While cluster headaches are not considered life-threatening, they are known to be one of the most painful types of headaches.
Pain may center around one eye, radiating to other parts of the head and through the neck area. The same eye may experience redness, stuffiness, excessive tearing of the duct, and may droop. Sensitivity to light may also only be present on one side. Often cluster headaches aren’t associated with any known triggers. Although, people may notice that pain is intensified by alcohol consumption.
Direct causes are not really known. Smoking is correlated with cluster headaches. Patterns usually form with this type of headache. For example, pain may start about the same time daily (or several times weekly), often shortly after one falls asleep. Pain often diminishes rapidly, leaving the sufferer exhausted — perhaps, in part, due to a repeated loss of sleep.
Ice Pick Headaches
Ice pick headaches may appear and disappear rapidly or last for several days. Occurrences may seem random and unrelated to anything that the person is actively doing at the time. Sufferers describe these as intensely painful, feeling like an ice pick has been shoved into the head or face.
Possible Triggers: Triggers vary by the individual and may be difficult to decipher. Sudden movements, stress, and bright light can be factors for some. Tension and migraine sufferers may also experience ice pick headaches.
It is unclear whether ice pick headaches develop as symptoms of a disease. Here, they are classified as primary because of the manner in which their pain is generated by the body. They are often unexplained by a source outside of the structures of the head. Disease may be the cause of some ice pick headache pain, but the exact source of the pain is often unclear.
Secondary Headaches and Causes
There are many possible causes of secondary headaches. Trauma, disease, dehydration, influenza, stroke, environment, and personal choices can all play a direct role in producing secondary headaches. There are also a wide variety of potential secondary causes – underlying medical conditions, such as high blood pressure, anxiety, depression, PTSD, stress, blood clots, and more.
Sinus headaches are commonly occurring secondary headaches. Your sinus cavities, found inside the forehead, cheekbones, and behind the bridge of the nose, can be a source of pain.
- A sinus headache can occur when proper drainage of the sinus cavities is blocked. Allergies can be to blame.
- You can run a fever if the cavity gets inflamed or infected. Pressure can build up due to inflammation and insufficient mucus drainage. Chiropractic treatments can work to alleviate pressure in the sinus cavities.
Cervicogenic headaches are often difficult to distinguish from migraines. The difference is in the origin of the pain. The primary difference is that a migraine headache is located in the brain, and a cervicogenic headache is rooted in the cervical spine (neck) or base of the skull region. It’s considered referred pain.
Cervicogenic pain can last a few hours or more than a week. This type of headache will often come back until the source of the pain is resolved. Therefore, it’s important to find out the reason for the pain. Clinic HQ explains:
Many people find manipulative therapies such as Chiropractic, Osteopathy or Physiotherapy to be helpful in returning the neck, shoulder and upper back joints back to their healthy state.”
- Injury, whiplash, and arthritis can contribute to a cervical issue that leads to cervicogenic headaches. Placement of the head and neck in a certain position for extended periods of time can also lead to this kind of pain.
- Cervicogenic headaches may or may not include neck pain and a reduced range of motion. Pain is often most associated with one side of the head and neck area and may increase with certain movements.
Thunderclap headaches get their name because they come on rapidly and may even take the sufferer by surprise. After about 60 seconds, a thunderclap will usually peak in its level of pain. Pain may occur anywhere in the head (and possibly in the back) and can last a few minutes or a week.
- Possible Triggers: Intense physical labor, encountering hot or cold water rapidly, and certain drugs may act as triggers for some people. Causes may be related to infection in the brain, aneurysm, issues with arteries or blocked veins, spinal fluid leaking or other dangerous issues that need attention.
- It is also possible to experience nausea, vomiting, and a loss of consciousness with a thunderclap headache. This type of headache can be a sign of a severe and potentially fatal condition. Immediate medical attention must be sought to avoid risky complications.
When Should You See a Doctor?
How do you know if you just need to eat and drink something, get some rest, or if it’s more serious?
Three or more headaches within the span of one week would easily justify the need for medical attention. The following symptoms are considered serious and require immediate medical attention:
- Abrupt severe head pain can be the result of a serious condition. Seek medical attention.
- A loss of control within the body may be the sign of a serious condition. Headache pain may cause or be accompanied by other conditions (dizziness, unable to control feet or limbs, difficulty speaking, vomiting, loss of consciousness, or vision problems). Seek medical attention promptly.
- Head injuries require immediate medical attention. Even if you hit your head and did not lose consciousness or were in an accident a few days prior, headaches may begin sometime after the initial incident. Do not delay in seeking medical attention.
- Extreme, unexplained head pain (especially lasting 72 hours) needs attention. If pain causes you alarm, seek medical care.
Relieving All Types of Headache Pain
As long as your symptoms don’t warrant immediate medical attention, there are many things you can try for headache relief. Of course, what works depends on the type of headache you have. If you can determine a cause, it will be easier for you and/or your health care professional to decide on the most suitable treatment and possible prevention strategies.
Here are some methods of relief:
- Any relaxing or creative activity that reduces stress can often bring relief.
- Acupuncture has been proven to ease headaches.
- Many sources recommend stretching and exercise.
- Minimize exposure to bright lights.
- Massage therapy has been shown to reduce pain.
- The American Migraine Foundation recommends meditation and yoga.
- Review the food and beverages you’ve consumed recently to notice any connection and avoid them.
- Hydrate. Drinking plenty of water or an electrolyte drink can bring relief.
- Minimize muscular and spinal issues that may be related to headache pain with chiropractic adjustments or chiropractic massage.
Dr. Brent Wells is the founder of Better Health Chiropractic & Physical Rehab, a massage therapy center and chiropractic clinic in Anchorage. His practice has treated thousands of patients from different health problems using various services designed to help give you long-lasting relief.
Dr. Wells is also the author of over 700 online health articles that have been featured on sites such as Dr. Axe and Lifehack. He is a proud member of the American Chiropractic Association and the American Academy of Spine Physicians. And he continues his education to remain active and updated in all studies related to neurology, physical rehab, biomechanics, spine conditions, brain injury trauma, and more.