Headache

A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are very rare. Most people with headaches can feel much better by making lifestyle changes, learning ways to relax, and sometimes by taking medications.

Common causes

The most common type of headaches are likely caused by tight muscles in your shoulders, neck, scalp and jaw. These are called tension headaches.

• They may be related to stress, depression, anxiety, a head injury or holding your head and neck in an abnormal position.
• Tension headaches tend to be on both sides of your head. They often start at the back of your head and spread forward. The pain may feel dull or squeezing, like a tight band or vice. Your shoulders, neck or jaw may feel tight or sore.

Migraine headaches are severe headaches that usually occur with other symptoms, such as vision changes or nausea.

• The pain may be throbbing, pounding or pulsating. It tends to begin on one side of your head, although it may spread to both sides.
• You may have an "aura" (a group of warning symptoms that start before your headache). The pain usually gets worse as you try to move around.
• These headaches may be triggered by foods such as chocolate, certain cheeses, or monosodium glutamate. Caffeine withdrawal, lack of sleep and alcohol may also trigger them.

Rebound headaches (headaches that keep coming back) may occur from overuse of painkillers. These may also be called medication overuse headaches. Patients who take pain medication more than three days a week on a regular basis can develop this type of headache.

Other types of headaches:

• Cluster headaches are sharp, very painful headaches that tend to occur several times a day for months, then go away for a similar period of time.
• Sinus headaches cause pain in the front of your head and face. They are due to swelling in the sinus passages behind the cheeks, nose, and eyes. The pain tends to be worse when you bend forward and when you first wake up in the morning.

• Headaches may occur if you have a cold, the flu, a fever or premenstrual syndrome.
• A swollen, inflamed artery (which supplies blood to part of the head, temple, and neck area) can occur with a disorder called temporal arteritis.

Rarely, a headache may be a sign of a more serious cause, such as:

• Brain infection like meningitis or encephalitis, or abscess
• Brain tumor
• Problems with the blood vessels and bleeding in the brain, such as arteriovenous malformation (AVM), brain aneurysm, or stroke
• Subdural hematoma
• Very high blood pressure

Home care

There may be things you can do to relieve the symptoms of a headache. Try to treat the symptoms right away.

When migraine symptoms begin:

• Drink water to avoid getting dehydrated, especially if you have vomited
• Rest in a quiet, dark room
• Place a cool cloth on your head
• Use any relaxation techniques you have learned

If your doctor has already told you what type of headaches you have, you can do many things to manage migraines or tension headaches at home. Your doctor may have already prescribed medicines to treat your type of headache.

Keep a headache diary to help find the source or trigger of your symptoms. Then change your environment or habits to avoid future headaches. When a headache occurs, write down:

• The date and time the headache began
• What you ate for the past 24 hours
• How long you slept the night before
• What you were doing and thinking about just before the headache started
• Any stress in your life
• How long the headache lasted
• What you did to make it stop

Try acetaminophen, aspirin or ibuprofen for tension headaches. Do not take aspirin, ibuprofen, or any other blood thinners if there is a chance that you might have bleeding in your head (from a subdural hematoma, aneurysm, or other injury). Talk to your doctor if you are taking pain medicines three or more days a week.

When to call your health care provider

Some headaches may be a sign of a more serious illness. Anyone who has these danger signs should seek medical help immediately:

• This is the first headache you have ever had in your life and it interferes with your daily activities
• Your headache comes on suddenly and is explosive or violent
• You would describe your headache as "your worst ever," even if you regularly get headaches
• You also have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion or memory loss with your headache
• Your headache gets worse over a 24-hour period
• You also have a fever, stiff neck, nausea and vomiting with your headache
• Your headache occurs with a head injury
• Your headache is severe and just in one eye, with redness in that eye
• You are over age 50 and your headaches just began, especially if you also have vision problems and pain while chewing