The 4 Most Common Kinds of Headaches

Rosemary Black

Reviewed by QualityHealth's Medical Advisory Board

Whether mild or severe, a headache certainly can put a damper on your day. The good news is that most headaches respond well to treatments—and these don’t necessarily require medications.

Headaches can be broken down into two subtypes, explains Noah Rosen, MD, director of North Shore-LIJ's Headache Center in Great Neck, NY. Primary headaches, as the name suggests, are those in which the headache is the primary problem. Included in this group are migraine, tension-type, and cluster headaches. "Primary headaches are far more common than secondary headaches," Rosen says. In secondary headaches, he explains, the headache is caused by anything from sinusitis to some kind of trauma or even a stroke.

The 4 Most Common Kinds of Headaches

Tension-type. The most common of the primary headaches, tension-type headaches may be caused by a wide variety of factors, says Brian M. Grosberg, MD, director of Montefiore Headache Center and an associate professor of clinical neurology at Albert Einstein College of Medicine in New York City. "It’s thought that abnormalities in certain pain systems in the brain, along with environmental factors, are the underlying cause for tension-type headaches," he says.

Environmental factors include weather changes like high humidity or low barometric pressure. Depression, anxiety, and even holding your head and neck in an abnormal position can be responsible for a tension headache. Nonetheless, "Probably the most common factor in a tension-type headache is stress," Rosen adds.

Migraines. These send more people to the doctor than any other kind of headache, Grosberg says, and with good reason: A migraine can cause moderate to severe pulsating pain, sensitivity to light and sounds, and sometimes even nausea and vomiting. "With a migraine, pain-sensitive information is relayed along the trigeminal nerve, which supplies sensation to the head and face," Grosberg explains.

Like tension headaches, migraine headaches can be related to weather changes, and, in women, to hormonal changes, says Emad Estemalik, MD, of the Headache and Facial Pain Center for Neurological Restoration at the Cleveland Clinic. "Dehydration and certain foods also can cause migraines," he says. "Foods that can cause a migraine are Chinese food that contains monosodium glutamate [MSG], dairy products, chocolate, and aged cheeses."

Cluster headaches. With this type of headache, which can come on several times daily for months, the pain is very sharp and typically lasts less than an hour. It also can occur at the same time each day.

Sinus headaches. These cause pain in the front of the head and the face due to the swelling of the sinus passages behind the cheeks, eyes, and nose. If your pain is worse when you first wake up in the morning and when you bend forward, suspect a sinus headache.

Other less common reasons for a headache? High blood pressure, carbon monoxide poisoning, cerebral hemorrhage (bleeding in the brain), and sleep apnea.

What You Can Do to Treat a Headache

Luckily, you don’t have to suffer. Here are some ways to soothe your aching head:

Know your personal triggers. "Some triggers may not be avoidable, but knowing what they are may let you be more prepared for a headache," Rosen says.
Try the following: Drink a caffeinated beverage (don’t overdo!), lie down in a dark, quiet room, apply an ice pack to the affected area, or learn some relaxation techniques. "You may also get relief from acupuncture or from massage," Grosberg says.
Be pro-active. "Keep a diary," advises Matthew S. Robbins, MD, FAHS, director of inpatient services at Montefiore Headache Center and chief of Neurology, Einstein Division, Montefiore Medical Center. "It can help if you write down as much as possible about when the pain began." Also include in the diary how much you slept over the past 24 hours, what you ate and drank, what you were doing when the pain started, and how long the headache lasted. Reviewing this diary with your health care provider will not only help you identify triggers, but can help you and your health care provider work out an individual treatment plan.
Stick to a healthy routine. "Don’t miss meals, keep your sleep schedule the same, even on weekends, and stay well hydrated," says Mark Green, MD, director of the Mount Sinai Center for Headache and Pain Medicine and professor of neurology and anesthesiology at the Icahn School of Medicine at Mount Sinai Medical Center in New York City. "It is also very important to manage stress."

Emad Estemalik, MD, reviewed this article.