Lancet Neurol. PMID: pubmed. Jensen RH. Tension-type headache - the normal and most prevalent headache. Rozental JM. Tension-type headache, chronic tension-type headache, and other chronic headache types. Essentials of Pain Medicine. Editorial team. A tension headache : May be related to stress, depression, anxiety, a head injury, or holding your head and neck in an abnormal position. Tends to be on both sides of your head. It often starts at the back of the head and spreads forward.
The pain may feel dull or squeezing, like a tight band or vice. Your shoulders, neck, or jaw may feel tight or sore. With a migraine: The pain may be throbbing, pounding, or pulsating. It tends to begin on one side of your head. It may spread to both sides. The headache may be associated with an aura. This is a group of warning symptoms that start before your headache. The pain usually gets worse as you try to move around. Migraines may be triggered by foods, such as chocolate, certain cheeses, or monosodium glutamate MSG.
Caffeine withdrawal, lack of sleep, and alcohol may also be triggers. Other types of headaches: Cluster headache is a sharp, very painful headache that occurs daily, sometimes up to several times a day for months. It then goes away for weeks to months. In some people, the headaches never come back. These nerves send a rush of pain messages to the brain, and this brings on a headache. The most common type of headache is a tension headache also called a muscle-contraction headache.
Tension headaches happen when stressed-out head or neck muscles squeeze too hard. This causes pain often described as:. Pain that's especially sharp and throbbing can be a sign of a migraine headache. Migraine headaches aren't as common as tension headaches. But for teens who do get them, the pain can be strong enough to make them miss school or other activities if the headaches aren't treated.
One big difference between tension headaches and migraines is that migraines sometimes cause people to feel sick or even to throw up. Tension headaches typically don't cause nausea or vomiting. Most migraines last anywhere from 30 minutes to 6 hours. Some can last as long as a couple of days. They can feel worse when someone is doing physical activity or is around light, smells, or loud sounds.
For some teens, hormonal changes can also cause headaches. If you need more help, your doctor may prescribe a stronger pain medication or a muscle relaxant to control headache pain. Many people with recurrent tension-type headaches can prevent attacks by taking a tricyclic antidepressant such as amitriptyline Elavil, generic. Fortunately, most people with tension-type headaches will do very well with simpler programs.
Migraines occur less often than tension headaches, but they are usually much more severe. Neurologists believe that migraines are caused by changes in the brain's blood flow and nerve cell activity. Migraine triggers. Although a migraine can come on without warning, it is often set off by a trigger.
The things that set off a migraine vary from person to person, but a migraine sufferer usually remains sensitive to the same triggers. The table lists some of the most common ones. Migraine symptoms. Migraines often begin in the evening or during sleep. In some people, the attacks are preceded by several hours of fatigue, depression , and sluggishness or by irritability and restlessness. Because migraine symptoms vary widely, at least half of all migraine sufferers think they have sinus or tension headaches, not migraines.
Visual complaints are most common. They may include halos, sparkles or flashing lights, wavy lines, and even temporary loss of vision. The aura may also produce numbness or tingling on one side of the body, especially the face or hand.
Some patients develop aura symptoms without getting headaches; they often think they are having a stroke, not a migraine. The majority of migraines develop without an aura. In typical cases, the pain is on one side of the head, often beginning around the eye and temple before spreading to the back of the head.
The pain is frequently severe and is described as throbbing or pulsating. Nausea is common, and many migraine patients have a watering eye, a running nose, or congestion. If these symptoms are prominent, they may lead to a misdiagnosis of sinus headaches.
P is for pulsating pain O for one-day duration of severe untreated attacks U for unilateral one-sided pain N for nausea and vomiting D for disabling intensity. Without effective treatment, migraine attacks usually last for four to 24 hours.
When you're suffering a migraine, even four hours is far too long — and that's why early treatment for a migraine is so important. Migraine treatment. If you spot a migraine in its very earliest stages, you may be able to control it with nonprescription pain relievers. Acetaminophen, aspirin, ibuprofen, naproxen, and a combination of pain medications and caffeine are all effective — if you take a full dose very early in the attack.
When prescription drugs are needed, most doctors turn to the triptans, which are available as tablets, nasal sprays, or as injections that patients can learn to give to themselves. Examples include sumatriptan Imitrex , zolmitriptan Zomig , and rizatriptan Maxalt. Some patients require a second dose within 12 to 24 hours. Patients with cardiovascular disease and those who take a high dose of certain antidepressants need to discuss the risks of using them with their doctor.
Work with your doctor to find the migraine treatment that works best for you. Remember, though, that overuse can lead to rebound headaches and a vicious cycle of drugs and headaches. So, if you need treatment more than two or three times a week, consider preventive medications.
Migraine prevention. Some people can prevent migraines simply by avoiding triggers. A stroke is preventable and treatable. Prompt medical attention is important for successful treatment. Call if you have stroke symptoms. Do not drive. If you have a head injury, you may have a concussion or a mild brain injury. Get immediate medical help if you have symptoms of a concussion after a fall or a blow to the head. These include:. If you overheat in warm weather or during excess exercise, you may have heatstroke.
If you suspect heatstroke, move into the shade or an air-conditioned space. Cool down by drinking cool water, putting on wet clothes, or getting into cool water. Headaches in the third trimester of pregnancy can be a symptom of preeclampsia.
This health complication causes high blood pressure. It can lead to liver and kidney damage, brain injury, and other serious problems.
Preeclampsia usually begins after week 20 of pregnancy. This blood pressure condition happens to up to 8 percent of pregnant women who may be otherwise healthy. It is a leading cause of death and illness in mothers and newborn babies. Treatment for serious headache pain depends on the underlying cause.
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