Headaches 101

At one time or another, nearly everyone has had a headache. In fact, 70 percent of people have had at least one in the past year. What's more, roughly 45 million Americans suffer from chronic headaches, a condition that costs U.S. companies billions of dollars in lost productivity annually.

Headaches are so common that it's often easy to dismiss them. However, according to experts, there are several kinds of headaches, each of which can have a different set of causes, risk factors, and severity levels.

Tension Headaches

The most common type of headache is a tension headache, which happens when the muscles in your shoulders, neck, scalp, and jaw tighten. These are often related to stress, depression, or anxiety, and occur mostly in women over 20. You are more likely to get tension headaches if you work long hours, don't get enough sleep, miss meals, or drink alcohol. Tension headaches account for nearly 90 percent of all headaches.

Migraine Headaches

More than 25 million Americans suffer from migraines every year, and they usually experience their first attack before they're 30. But children as young as 3 can also be affected by a migraine. They are generally associated with increased blood flow as a result of the blood vessels in the brain widening. Many sufferers rely on prescription medicines, especially for debilitating migraines that are preceded by flashing lights or spots or are associated with intense throbbing pain, nausea, or vomiting.

Cluster Headaches

Cluster headaches don't throb, but you can feel them on one side of your head, usually behind the eye. They're more common in men, occurring over the course of several days and lasting about 30 to 45 minutes. Cluster headaches generally occur between one and four times a day and, like migraines, are related to increased blood flow as a result of the blood vessels in the brain widening.

Common Culprits

Specific health conditions or lifestyle factors can give you a headache. For example, a sinus infection could be causing your headache if you have pressure around your eyes, a sore throat, or a fever. Even cutting down on coffee or trying to get off some prescription medications, such as anti-depressants, can cause headaches. And if you experience headaches after you read, watch TV, or work on the computer, you may need to get your eyes checked by an optometrist or ophthalmologist.

If you get headaches and feel shaky and weak after missing a meal, you may have hypoglycemia or low blood sugar, in which case you should schedule an appointment to see your doctor. You may also want to eat six small meals during the day rather than three large ones to better regulate your blood sugar.

A headache can also occur when you bite or chew food, or have a tooth that's sensitive to cold food or liquid, which may indicate a dental or sinus problem. Headaches also can be caused by a misalignment of the jaw joints right in front of your ears, called temporomandibular joint dysfunction (TMJ).

In addition, some allergy patients complain of headaches—especially if they're exposed to environmental triggers, such as perfume, cigarette smoke, or certain foods. In some cases, a headache can indicate neuraligia, which refers to pain that occurs when a nerve fires abnormally, producing pain in the area it supplies, such as the face and head.

Getting Treatment

By making lifestyle changes, finding ways to relax, and taking over-the-counter pain relievers, such as aspirin, you can often alleviate many types of headaches. But it's important to note that some causes of headaches are life-threatening and require immediate medical attention.

Seek medical help immediately if you suffer a headache:

  • After you take a blow to the head, which may mean a concussion or internal bleeding
  • With a stiff neck, fever, confusion, loss of consciousness, or pain in the eye or ear, which may indicate meningitis, a serious infection of the fluid surrounding the brain and spinal cord
  • With numbness, tingling, or weakness in the arms and legs, which could signal a stroke
  • With disorientation, unconsciousness, slurred speech, or hallucinations, which may signal a brain tumor

The way doctors treat a headache depends on the causes and the symptoms. For non-emergency headaches, doctors will usually perform a complete physical exam and headache evaluation, taking your medical history into consideration. Doctors may also order a CT scan or MRI—sophisticated medical tests designed to detect neurological disorders. And if your headache doesn't go away, gets worse, or becomes more frequent, your doctor may refer you to a specialist.