Headache: Understanding pain

  • September 12, 2020

We all experience headaches. And most of us do not pay much attention to them, either suffering them till they subside or taking a pain killer and going on with our lives. While in most cases this approach would be perfectly okay, in some instances the reason for the headache can be serious and need medical attention. Hence it is important to understand the different kinds of headache and avoid self medicating if it is a chronic or acute problem.

Common Types of Headaches

Tension Headaches – This is most common type of headache among adults and teens. They cause mild pain that comes and goes.

Migraine Headaches – Migraine headaches are often a pounding, throbbing pain that can last from 4 hours to 3 days and may occur one to four times a month. Migraine triggers can be exposure to light, noise, or some smells, and they can cause nausea or vomiting, loss of appetite, upset stomach or pain.

Cluster Headaches – These headaches are the most severe and cause a constant throbbing or burning pain behind or around the eye.

Chronic Daily Headaches – These are usually short stay headaches (rare ones lasting more than 4 hours) which can remain a daily constant for 15 days to 3 months.

Sinus Headaches – With sinus headaches, you feel a deep and constant pain in your cheekbones, forehead, or on the bridge of your nose. These occur when sinuses get inflamed and are usually accompanied by a runny nose, fever, and swollen face.

Post-traumatic Headaches – Known to start 2-3 days after a head injury, they require immediate visit to a doctor.

Other headaches

Exercise Headaches – During an intense activity the muscles in your head, neck, and scalp require more blood. The blood vessels swell to supply them. This can cause a pulsing pain on both sides of your head that can last from 5 minutes to 48 hours.

Hemicrania Continua – is a chronic headache that affects the same side of your face and head. Other symptoms may include red or teary eyes, runny or stuffy nose, droopy eyelids, contracted iris etc. Medications help in controlling the symptoms.

Hormone Headaches – You can get headaches from the change in hormone levels during your periods, pregnancy, and menopause. The hormone changes due to the use of birth control pills and hormone replacement therapy can also trigger such headaches.

Ice Pick Headaches – As the name suggests, these are short, stabbing, intense headaches that last only for a few seconds. It is advisable to see a doctor if you have one as they can be a symptom of an underlying serious condition.

Spinal Headaches – Headache after a spinal tap, a spinal block, or an epidural may require a doctor’s care. While piercing a spinal cord if spinal fluid leaks through the puncture site, it can cause a headache.

Thunderclap Headaches – Probably the worst headache of all, it comes suddenly and peaks quickly. Such headaches may be caused by a blood vessel tear, rupture, or blockage, head injury, haemorrhagic stroke from a ruptured blood vessel or Ischemic stroke from a blocked blood vessel in the brain. They may also be caused due to narrowed blood vessels surrounding the brain, inflamed blood vessels, blood pressure changes in late pregnancy and need immediate medical care.

What Causes Headaches?

Though it is often difficult to identify a specific cause of a headache, the reasons may include:

Illness – Headaches are common with infections, colds, and fevers. They are also common with conditions like sinusitis (inflammation of the sinuses), throat infection, or ear infection. A headache resulting from an injury or a more serious medical problem would require immediate medical care.

Stress and lifestyle – Headaches can be caused due to stress or depression, alcohol use, skipped meals, changes in sleep patterns, and taking too many medications.

Posture – Neck or back strain due to poor posture may also cause aches.

Environmental factors – Pollution, noise, lighting, and weather changes are possible triggers of headache.

Genetics – Headaches, especially migraine headaches are usually hereditary. If both parents have a history of migraines, then there is a 70% chance their child will also have them.


For persistent, chronic or sudden severe headaches, the doctor would study your family history and pattern of pain to understand the underlying cause. The doctor will need a list of things that cause your headaches, things that make them worse, and what helps you feel better. Most people don’t need any diagnostic tests. But in some cases the doctors may suggest a CT scan or MRI to diagnose a problem inside the brain that may be causing your headaches. An EEG is usually suggested only if a severe headache is accompanied with a fainting spell.

How Are Headaches Treated?

The treatment would depend on the symptoms and the diagnosis. For chronic headaches you may be referred to a headache specialist. In most cases people don’t need any medical help. Medications, electronic medical devices for relieving pain, counselling for stress management may be suggested as per requirement.

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