Headache – Types, Causes, Symptoms, And Prevention

Overview

Headache is a common illness that everyone experiences at some point in their lives. They can range from a minor pain to a emergency health condition. Numerous factors, including lifestyle, underlying health issues, and environmental triggers, contribute to the development of headaches. Though most headaches are harmless, it is best to understand what type of headache one must determine the complexity and necessity for medical attention.

Types of Headaches

There are more than 200 types of headaches which feel quite different in terms of signs and symptoms. Headaches are categorised into primary and secondary headaches.

Primary Headaches

Primary headaches happen on their own due to dietary factors, lifestyle, excessive screen time and more, and not due to an underlying health condition. The most common types of primary headaches are:

• Tension headaches: These are the most common form of headache, usually felt as a mild, persistent ache on both sides of the head. This headache is commonly associated with stress and tensed muscles. They are generally caused by stress, anxiety, hunger, eyestrain, or poor posture. This can last for 30 minutes or days together depending on the situation causing the headache. Tension headache affects over one third of men and over one half of women in developed countries.
• Migraine: Intense, throbbing pain along with other symptoms including nausea, vomiting and sensitivity to light/noise. The pain is usually on one side of the head and can last for hours or days. Migraine affects 1 in 7 adults in the world.
• Cluster headaches: These are severe headaches, usually very painful and occur in clusters, hence the name. Extreme pain occurs in clusters of attacks during the same time, every day. The pain is usually behind the eye and feels like a burn or someone stabbing. They are marked by intense pain around one eye or one side of the head and often occur daily at the same time or multiple times a day over a period of weeks or months. They are a consequence of the dilation of the blood vessels of the brain due to the release of serotonin and histamines. It can also cause runny eyes with watery discharge, red eye, and runny nose. Cluster headaches can affect up to 0.1% of the population.
• Sinus headaches: These headaches are associated with sinus infections or when you feel congested. A 2018 survey found that sinus infections affect about 11.6% of adults. They are often caused by the swelling of the sinus passage and have symptoms such as cough, fever, stuffy nose, and pain in the forehead, cheeks and nose.
• Thunderclap headache: These are sudden and severe headaches that ramp up quickly within seconds. Thunderclap headaches are a rare type of headache and can be a sign of a serious medical condition. It is usually described by the patient that it's the worst headache that they have ever had.
• Cervicogenic headaches: These headaches originate from problems in the neck, cervical spine such as neck injury or arthritis. These issues extend the pain to the head.

Secondary Headaches

Secondary headaches have an underlying health condition associated with them. The most common types of secondary headaches are:

• Headaches caused due to infections.
• Headaches caused due to injury to the head or due to a concussion.
• Vascular Disorders: Conditions affecting blood vessels, such as a stroke or aneurysm, can cause headaches.
• Issues with the eyes.
• Neck or Cranial Nerve Disorders: Issues with the neck or cranial nerves may result in secondary headaches.
• In extreme cases, a tumour.

IMPORTANT: If you experience a sudden 'thunderclap' headache, or a headache accompanied by weakness, speech difficulties, or confusion, call 000 or visit your nearest Emergency Department immediately.

What is a Migraine?

Migraine is a chronic headache disorder characterised by recurring episodes of severe and throbbing headaches, usually only on one side of the head. The prevalence of migraine in Australia may be one of the highest in the world at 28%, about one in four people get it. It is often accompanied by symptoms such as vomiting, nausea, pain in the neck, shoulder, or behind one eye or ear, sensitivity to light, and sensitivity to sound. Some individuals also experience visual disturbances known as auras, which includes blind spots, flashing lights, or zigzag lines. A migraine may occur in four distinct phases although not everyone experiences all of them. These phases include:

• Prodrome or preheadache phase: This phase is characterised by symptoms that are not painful and may occur hours or even days before the headache begins. Symptoms often include fatigue, mood swings, food cravings, neck stiffness, frequent yawning, constipation, or increased sensitivity to light and sound.
• Aura phase: Auras refer to sensory changes, such as tingling in the limbs, visual disturbances like flashing lights or blind spots, and speech difficulties. This phase generally lasts between a few minutes and an hour prior to the headache.
• Headache phase: This phase is the core of migraine marked by intense, throbbing pain, usually on one side of the head. It may be accompanied by increased sensitivity to sound, smell, and light, vomiting, and nausea. It can last from hours to several days.
• Postdrome or post headache phase: After the headache fades, some people may experience a period of fatigue, confusion, or mood swings. This phase lasts for a few hours to a couple of days.

Not all people with migraine go through every stage and the severity and duration of each phase can differ from person to person.

Causes of Headaches

Primary Headache Causes

Primary headaches could be caused due to dietary or lifestyle factors such as:

• Alcohol consumption
• Allergies
• Large amounts of caffeine
• Excessive screen time
• Skipping meals
• Stress and Sedentary lifestyle
• Too much or too little sleep
• Bright lights, strong smells, and loud noises

Secondary Headache Causes

Secondary headaches are commonly caused by an underlying condition such as:

• Infections (Sinusitis or cold)
• Ear infections
• Dental issues
• Side effects or overuse of certain medicines
• Dehydration
• High Blood Pressure
• Potentially serious reasons include stroke, tumour, aneurysms, head injuries, meningitis.

It is important to differentiate between primary and secondary headache causes, especially in identifying potentially life-threatening conditions like stroke, tumour, or aneurysms. Symptoms such as sudden onset of severe headache, headache following a head injury, or headaches accompanied by neurological symptoms require immediate medical attention.

Causes of Migraine

Migraine has a range of probable causes and triggers, which varies between individuals. Common causes and influencing factors include:

• Genetics: A family history of migraine can heighten susceptibility.
• Neurovascular changes: Neurochemical disturbances and changes in blood flow may provoke a migraine.
• Environmental factors: Changes in weather, strong smell, bright lights, or lack of sleep can trigger migraines.
• Hormonal changes: Hormonal fluctuations such as menstrual cycle or menopause may start a migraine.
• Dietary triggers: Certain foods and beverages such as caffeine, alcohol, or cheese can initiate a migraine.
• Stress: Sometimes emotional or physical stress may also cause a migraine.

Migraine vs Headache

Headaches and migraines are common yet distinctly different conditions that can significantly impact daily life. A headache might lightly tap on your skull, a mild inconvenience you can brush aside with a glass of water or a short rest, whilst a migraine may feel like it barges like a thunderclap accompanied by its procession of nausea, light sensitivity, and a throbbing beat that can take over your entire day. Understanding whether you are experiencing a headache, or a migraine is crucial for choosing the appropriate treatment strategy. A headache is generally recognised as a migraine when it meets the following criteria:

• Duration: Migraines often last anywhere from 4 hours to 72 hours (about 3 days) if untreated.
• Intensity: Migraine are usually characterised by throbbing or pulsating pain. The pain is intense and severe and can affect daily activities.
• Location: Migraine is known to usually affect one side of the head but can also be bilateral. It may start on one side and spread or switch sides.
• Associated symptoms: Migraines are generally accompanied by symptoms such as nausea, vomiting, and heightened sensitivity to light and sound. Some people may also experience aura symptoms like visual disruptions or sensory changes before the headache.
• Impact on everyday activities: The intensity of the pain and associated symptoms often make it difficult to perform day-to-day chores and activities, differentiating migraines from minor headaches.

Tension Headache vs. Migraine

Tension headaches and migraines are two forms of headaches with distinct features. Tension headaches often produce mild to moderate, dull discomfort that feels like a tight band around the head and can last anywhere from 30 minutes to several days. They usually affect both sides and are often caused by stress or bad posture. Tension headaches are often treated with over-the-counter pain medicines and stress management. Migraines, on the other hand, are characterised by moderate to severe throbbing pain, usually on one side, that lasts between 4 and 72 hours (about 3 days). They are typically accompanied by nausea, vomiting, and a strong sensitivity to light and sound. Migraines may also have an aura, which causes visual abnormalities. Migraines may require specific prescription medications and lifestyle changes to avoid triggers. Consulting a healthcare professional is recommended for severe or uncertain symptoms.

Sinus Headache vs. Migraine

Sinus headaches and migraines are frequently misunderstood due to similar symptoms, yet they have unique features. Sinus headaches are often caused by sinusitis or nasal congestion and are distinguished by a deep, continuous pain in the forehead, cheekbones, or around the eyes. The discomfort typically intensifies with movement or leaning forward and is accompanied by sinus symptoms such as nasal discharge and face pressure. Conversely, migraines are severe, throbbing headaches that typically occur on one side of the head. They can last anywhere from 4 to 72 hours (about 3 days) and are often accompanied by nausea, vomiting, and sensitivity to light or sound. While sinus headaches typically resolve with decongestants or sinus treatments, migraines may require specific medications such as triptans, and lifestyle modifications to manage triggers. Understanding these differences can help in seeking proper treatment.

Cluster Headache vs. Migraine

Cluster headaches and migraines are both severe types of headaches, although they have distinct features and patterns. Cluster headaches occur in cyclical patterns or clusters, generally at the same time every day, and last between 15 minutes and three hours. The pain is intense and generally limited to one side of the head, commonly around the eye, and may be accompanied by nasal congestion, watery eyes, and restlessness. Migraines, on the other hand, are characterised by moderate to severe throbbing pain that can affect one or both sides of the head and persist between 4 and 72 hours (about 3 days). Migraines are frequently accompanied by nausea, vomiting, and sensitivity to light and sound, and they can appear with or without an aura. Cluster headaches often require treatments such as high-flow oxygen therapy or injectable medications while migraines may be managed with triptans and preventive medications, and lifestyle modifications to avoid triggers. Please note: Certain treatments mentioned above, such as high-flow oxygen therapy, are not provided by Hola Health and are included for informational purposes only.

Management and Prevention

Majority of the primary headaches can be managed with lifestyle modification and dietary adjustments whereas for recurrent primary headaches or secondary headaches medical intervention would be needed.

1. Lifestyle Modifications: Stress reduction techniques, regular exercise, and sufficient sleep can significantly reduce the frequency and intensity of headaches.
2. Dietary Adjustments: Identifying and avoiding trigger foods (eg. aged cheeses, processed meats, alcohol, and foods containing MSG), maintaining consistent meal schedules, and staying hydrated can contribute to headache prevention.

Sometimes stressful conditions at the workplace or home can lead to headaches. It is important to take a break and give time for your body to relax with stress reduction techniques such as meditation, yoga, or cognitive-behavioural therapy. Note: This information is for educational purposes only. You should consult a medical practitioner before attempting new wellness programs or lifestyle changes to ensure they are safe for your specific condition.

When Should I Seek Medical Help?

It is crucial to consult with a healthcare professional for a proper diagnosis if someone experiences persistent or severe headaches. You can now get immediate attention to your headache and consult a online medical practitioner within 15 minutes* with Hola Health. Approach a doctor right away if you have any of these following symptoms:

• Taking pain medication to alleviate headaches at least thrice a week.
• Severe and recurrent headaches that come on suddenly.
• Headache in the morning along with nausea.
• Pain that wakes you up from sleep.
• New onset headaches in adults over 50.
• Headache after an injury to the head even if the injury is healed.
• Severe or sudden headaches that feel different from usual.
• Frequent headaches occurring more than twice a week.
• Noticeable changes in headache pattern or intensity.
• Headache accompanied with fever, vomiting, stiffness in the neck, confusion, blurred or double vision, seizure, or a loss of balance.

It's important to seek medical attention for any concerning symptoms to rule out underlying issues and receive appropriate management. Book a telehealth appointment in minutes to get the care you need, now!

How Hola Health may be able to help

Hola Health is an Australian telehealth platform that connects you with registered doctors and nurse practitioners — from the comfort of your home, at a time that suits you. Depending on your situation, a Hola Health clinician may be able to help with:

• 24/7 General medical advice via telehealth doctor consult — talk through symptoms or health concerns with a registered doctor or medical practitioner
• Medical certificate online  — for work or personal leave, when clinically appropriate
• Referrals to specialists - or in-person services when needed
• Online prescriptions — at a clinician's discretion and where clinically suitable
• Pathology or imaging requests — when assessed as appropriate by your treating clinician
• Mental health Care Plan — Mental Health Treatment Plans (referral to your regular GP may be recommended for ongoing care)

Hola Health clinicians are AHPRA-registered Doctors and medical practitioners in Australia. They will always recommend an in-person consultation, specialist referral, or emergency care if that is in your best interest. Note: Telehealth is not suitable for all conditions. Hola Health does not replace your regular GP, specialist, or emergency services. If you are unsure whether telehealth is right for your situation, we recommend speaking with your usual healthcare provider. In emergencies, call 000.

Conclusion

It is important to note that numerous factors can contribute to headaches, and individuals may experience more than one type. Understanding the difference between headaches and migraines is crucial for effective management and management. Keeping a headache diary and identifying triggers can help in managing symptoms. Lifestyle modifications, stress management, and, in some cases, medical intervention can help alleviate and manage headache symptoms. If someone experiences severe or persistent headaches, it is advisable to consult with a healthcare professional for proper diagnosis and management.