Headaches are one of the most common conditions seen in doctor’s offices across America.

Headaches can be caused by arthritis, caffeine, eye strain, illness, tension or tumors. The associated headache pain can range from a mild, irritating pressure to a debilitating pain that causes people to seek the solace of a dark, quiet room.

Caused by a variety of triggers – ranging from stress to hunger – the intense, throbbing pain of a headache can be hard to stop.

The National Headache Foundation lists 24 different types of headaches in its Complete Headache Chart. But most headache specialists divide headache pain into three broad categories:

  • Migraine
  • Cluster headaches
  • Tension-type headaches

Working with a headache or pain management specialist, a person suffering from headache pain may be able to find the best treatment for relief.

Diagnosis is a challenge

Headaches are difficult to diagnose. Since there is not a medical diagnostic test available, headache specialists often diagnose the type of headache by evaluating the headache sufferer’s symptoms.

Cluster Headaches

Named for the random, frequency of attacks, cluster headaches cause sudden, burning or piercing headache pain, usually on one side of the head. The pain may be located behind the eye or radiate across the face on the affected side. Cluster headaches may cause drooping eyelids, teary eyes, sinus congestion or a runny nose on the side of the face where the pain is located.

Cluster headache attacks may occur frequently over the course of several weeks or months and then disappear completely for a time. When they return, the pain may move to the opposite side of the face.

During a cluster event, headaches start suddenly, last less than an hour, but can reappear up to four times during a 24-hour period. Some cluster headaches occur during sleep, causing pain intense enough to awaken a person. This characteristic has earned cluster headaches the moniker of “alarm-clock headaches.”

Cluster headaches are commonly seen in the spring and fall and are often misdiagnosed as a symptom of allergies. Twenty percent of the people who experience cluster headaches report they have them year-round without the respite of remission.

Since the cause of cluster headaches is unknown, treatment often includes medications to prevent the headaches from occurring. The benefits of using pain relief medications may not outweigh the risks because of the short duration of intense pain.

Migraine Headaches

Migraine headaches are vascular headaches experienced by more than 37 million people. The medical community knows a great deal about migraines, but they still do not know why they happen. Migraines:

-Usually, occur in people who are between 15 and 55 years of age
-Are more common in people who have relatives affected by migraine
-Can be triggered by foods, disruptions in sleep cycles, hunger, hormones, light, noise and smell.
-Can be debilitating and interfere with daily activity

The symptoms of migraine headaches vary from person to person. Attacks can be chronic, happening more than 15 days in a one-month period, or acute, occurring less than 15 days a month.

Migraine headaches are usually diagnosed when a person experiences moderate to intense pain on one side of his or her head severe enough to interrupt physical activity, coupled with one of the symptoms below.

-Sensitivity to light
-Sensitivity to sound

A migraine attack can last four to 72 hours. One in five people will experience an aura before an attack. Auras may cause visual disruptions such as flickering spots or lines, loss of vision, a pins-and-needles feeling in the body, or aphasia, difficulty speaking.

While doctors understand what happens inside the brain and body during a migraine attack, they do not know what causes a migraine headache to be triggered in the first place. As a result, migraine treatment focuses on prevention, pain relief and trigger avoidance. Migraine sufferers may be prescribed preventative and pain relief medications, and may be asked to journal their experience.

Up to half of the population who suffer migraine, have not been diagnosed. The National Headache Foundation estimates 80 percent of people who self-diagnose their headaches as sinus headaches actually suffer from migraines. Since the pain and discomfort of a migraine attack usually resolves itself within 72 hours, the sinus medications appear to work, which perpetuates the misdiagnosis problem.              


Tension Headache

The third category of headache most often experienced is tension headache.

Tension headaches are often described as dull, irritating, non-throbbing pain or vice-like tightness on both sides of the head. Stress or depression often triggers this type of head pain.

Episodic tension headaches may occur randomly in response to stress, anxiety, fatigue or anger. Chronic tension headaches, often caused by anxiety or depression, may be felt daily with continuous pain that fluctuates in intensity. 


Medication Overuse Headache

Medication overuse headaches, though relatively rare, are worth mentioning. This type of rebound headache is caused when some takes too much medication or takes medication too long. During a medication overuse headache, taking more medication does not relieve the symptoms, but instead, makes them worse. Stopping the medication also causes severe headache pain. People often need medical care to stop the pain of a medication overuse headache.

Fortunately, the incidence of medication overuse headache is rare and easy to avoid. If you take headache medication, take it according to your doctor’s orders. If your headache gets worse and you have taken the maximum amount of your prescribed medication, don’t take more, contact your healthcare provider.

When should you see a doctor for a headache?

If headache pain lasts longer than two days without relief, occurs more than 15 days a month, or interferes with your ability to function, you should see a headache or pain management specialist who can assess your condition.

Call your medical provider or go to the nearest emergency room, immediately, if you experience:

  • Sudden and severe pain
  • The worst headache pain of your life
  • Head pain accompanied by a fever or a stiff neck
  • Confusion
  • Dizziness
  • Numbness
  • Slurred speech
  • Vision loss
  • Weakness
  • Persistent vomiting or diarrhea
  • Shortness of breath
  • A blow to the head
  • Chronic pain that gets worse or will not go away after trying OTC medications
  • Your headache feels different than normal

Headache pain occurs for many reasons.They may be symptoms associated with other health conditions. Some of these are serious and life-threatening conditions.

If you experience frequent headaches, headaches that cause intense pain, or headaches that interfere with your daily life, you should visit a headache or a pain management specialist for diagnosis and treatment.