Why does my head hurt? It is a question most people ask themself. Luckily, I will help you find the answer to that headache.
Virtually everyone in the world at least once has had a headache. It is one of the symptoms with most recognition worldwide.
I did this article to cover the most significant aspects of this symptom. It will surely help you to find accurate information regarding your inquiries.
I am a medical doctor. Therefore, my primary purpose on this would be to guide you through this disorder as if you were a doctor yourself. Just keep reading to obtain critical insights about headaches from a doctor’s perspective.
What is a headache?
Headache is a symptom, and one pretty common actually. However, not every headache pain is the same.
Typically, a headache would have features that allow the doctor to distinguish or classify the headache disorder. Also, it can be classified according to the time, in acute or chronic headache, the former lasts hours to days, whereas the following weeks or months.
The pain distribution in a headache could comprise the whole head or just one side. It could be in the back of the head, or just in the front.
How the patient describes the pain could vary depending on the cause with some describing a sharp or dull ache. The intensity of the pain can range from mild to severe and sometimes unbearable.
The source of the pain could be either inside of the skull, in the brain, or outside of it. For example, high blood pressure could also trigger in specific situations a headache.
The importance of this symptom is evident in the International Headache Society, which is the leading authority in this topic. This society is indispensable because they dictate how doctors should accurately assess and classify headaches worldwide.
What are the types of headaches?
The International Classification of Headache Disorders (ICHD-3-beta) divides headaches into two broad types, primary and secondary headaches. The foundation of this division relies on the cause.
In a primary headache, there is no underlying disease that explains the headache. This definition does not mean that it cannot be very annoying and halt people’s life. However, what it does mean is that it is not going to represent a real and immediate threat to a patient’s life.
On the other hand, secondary headache has a disease, which is causing it. The extended list of sources ranges from infection, traumatic events, and even cancer. Some of them are:
- Sinus headache: affection of the sinus within the face (sinus infection).
- Head injury (concussion or any trauma).
- Infection: Brain (encephalitis) or meninges (meningitis).
- Vascular headache: brain bleeding or autoimmune diseases.
- Headache because of chronic obstructive sleep apnea.
- Brain tumors.
- Cervicogenic headache.
- Substance abuse or removal: caffeine withdrawal, alcohol, etc.
- Nerve swelling: trigeminal, glossopharyngeal, and occipital neuralgia.
- And many others.
Nine of every ten people with a headache would have a primary type. Therefore, most of the time, a patient having this symptom will no carry any actual risk to their life.
However, if the doctor finds some danger signs that I will be explaining further, they talk about the possibility that the patient has a secondary and likely severe cause for the headache. All the secondary headaches require a thorough assessment.
Usually, a doctor assessing a headache would want to discard any possibility of a secondary headache to secure that the patient is without risk. Then, it would start treating one of the possible primary causes of the headache.
What are the different types of primary headaches?
A primary headache very often is identifiable by several questions without further exams. This results great because we have to remember that 90% of the patients would have either one of these diseases.
The most common types of headaches are:
- Tension headache.
- Migraine headache.
- Cluster headache.
They affect more than half of the adult population with 40%, 10%, and 1% in descending order, respectively.
Characteristically, tension headache is a headache of the whole head, of mild or moderate intensity, and no other symptoms. The source here, as you may think, is not only the muscle tension within the neck muscles. It has been found that the nerves of these patients are overreactive to ordinary stimuli. Therefore, they are prone to develop this type of headache.
Migraine headache has way more symptoms. Migraine sufferers could have nausea, vomits, and high sensitivity to light and strong sounds. Also, it gets worse with physical activity. This headache tends to be just from one side of the head, lengths from four to seventy-two hours, and the pain can be very severe.
Moreover, it is possible that patients with migraine have an “aura.” These are symptoms that precede the headache. They could be several, such as visual, speech, motor, or sensorial symptoms.
Cluster headache is relatively rare, and when it comes to pain, a very severe headache. It is usually brief, lasting from fifteen minutes to nearly three hours. This primary headache usually affects people below thirty years and similarly could have other symptoms.
Furthermore, mostly, a cluster headache affects just one side of the head, and it comes with a pain pointedly localized within the eye. Therefore, it causes symptoms in the eye, nose, and the whole face, including lacrimation, nasal discharge, and facial sweating.
Can my headache stay too long?
A chronic headache is the one occurring specifically at least two weeks every month for three consecutive months. It is a significant reason for disability worldwide, affecting, on average the 2% of the population. And, yes, it can stay for a while.
Most of the causes of chronic headaches are the same ones coming from the acute phase. However, these were not controlled. Hence, we would have chronic migraine, chronic tension headache, and chronic cluster headache, among others again.
It is possible that by not avoiding the risk factors that cause many of these headaches. It could arouse a headache to appear and stay. For example, the headache triggers for migraine are:
- Hormonal changes (in females as menstruation or pregnancy)
- Sleep disorders.
- Exposure to bright light.
- Strong odors.
- Very cold food like ice cream.
- Red wine or jumping meals.
- Some types of food or its components (aged cheese, caffeine, citrus fruits, and more)
- Lack of exercise
Interestingly, stress also plays a main role in the tension headache. Therefore, it is core to understand what is triggering the episode to make it stop—besides, the right medication.
These diseases can cause chronic daily headache in a vast proportion of the cases. This term refers to the diseases that have capabilities to affect a patient each day consecutively. Or it could be a recurrent headache when it stops and then recurs over time. It could vary widely.
Furthermore, particularly in chronic headaches, pain killers, and anti-migraine medication overuse can cause a rebound headache. This situation means that people could have a headache from the same drugs that are supposed to take it away. So learning how to use this medication properly is essential for not causing more trouble.
What are other possible symptoms?
The symptom would depend on the cause underneath the headache. And this is true for both primary and secondary types.
For example, one of the primary headache with more symptoms are migraines. A migraine attack right before the head pain could have an extended list of symptoms, such as vertigo, dizziness, confusion, coordination, tingling in extremities, or the inability to articulate words, hence of effectively communicate.
A migraine symptom can present alone like the eye symptoms being the most common the scintillating scotoma (a vision absence with a shimmering border) or successive, or many at the same time. It varies a lot.
Then, in a tension headache, another symptom would be neck pain. It is vital because a differentiation from the neck stiffness is mandatory. After all, the latter is an alarm sign of an underlying severe disease.
Furthermore, facial pain and headache are very known for their relationship and possible causes for it. This pain due to a sinus affection, or sinus infection is typical. Commonly, they develop simultaneously in an acute onset. These patients could also have nose obstruction, nose discharge, and decreased smell.
Digital eye strain is an affection of the eye due to the overuse of digital devices as computers or phones. The most common symptoms of this condition are eye strain, headaches, blurred vision, and neck pain. Another symptom may arise here. For example, patients con have dry eye syndrome, which includes burning eyes, dry eyes, and tired eyes.
How can you tell the difference between an ordinary headache and one that’s dangerous?
Headaches have “red flags” that, if present, the doctor might ask for more exams. Most of the time, it could imply that the patient has a secondary headache that needs assessment because the brain and well-being could be at risk.
- Severe pain and sudden-onset headache or first and worst headache ever.
- A totally new headache.
- Headache with other neurologic symptoms, for example, difficulty moving a body part or losing sensibility to stimulus.
- That the headache appears for the first time in someone over fifty years.
- A headache that is continuously changing how it presents itself, for example, sometimes is of just one side, then, the whole head.
- A headache that gets worse with sudden movements or exercise. Anything that causes the head to increase its pressure.
- A headache with other symptoms: Fever, weight loss, cough, or stiff neck.
- Headache in patients with cancer, diabetes, or HIV infection.
- Headache in a patient with a history of neck or brain injury.
These signs do not necessarily mean that the person is already sentenced or whatsoever. What it does mean is that it would require more exams to discard the possibility of a severe disease underneath.
When is a headache a sign of a brain tumor?
A patient can give certain clues about if what is happening underneath is a brain tumor, and before we talk about this. It is essential to remember that “tumor” does not necessarily mean cancer. It is just a tissue that is abnormally growing.
Typically, doctors refer to the symptoms that brain tumor causes as a mass that is within the brain. This term is used because the signs that it produces are from a large mass that is pushing structures within the skull.
And, this is also true because any mass (including infectious disease, for example) that pushes structures in that location would cause the same symptoms. Therefore, it is not specific to brain tumors. It is accurate for diseases that shove brain structures within the skull.
In light of this, a patient with a brain tumor will have a headache that worsens with sudden movements (as a cough) and with physical activities. A headache in association with changes in personality, mental health, or consciousness, or that is progressing in severeness over time, also talks about a brain tumor to the doctor.
There is an expression of other symptoms, which your doctor calls focal neurologic signs. They could be present in these patients. However, there are many of them. It would mostly depend on the portion of the brain that is compromised, the symptoms that would appear. It could be an eye, motor, sensitive, and more type of symptoms.
What are the most serious symptoms of a headache?
A first and worst headache of a patient’s life could mean brain vessel bleeding or a severe infection. So, every severe headache of sudden appearance means seriousness.
A headache episode just after a significant physical effort should also raise alarms. It could be due to a brain vessel bleeding, severe infection, or a brain tumor. Similarly, if it presents with neck stiffness or change in personalities (overall mental issues), it is also a link to worse diseases.
Furthermore, there are alarming symptoms that can really terrify a person, albeit they are reversible. Not as the ones I just told you about, which could imply a severe threat to the life of a person.
A migraine attack is the expression of the migraine disease. It could yield very severe signs like a speedy heart and breathing rate. And, in complicated migraines, it could even cause half of the body to paralyze its movements or halt the capability to feel or talk properly. However, in this disease, these expressions, although annoying and lasting they are transient in nature.
What I am trying to say is that sometimes what most worries a patient, like a transient paralysis of the body. It will not worry that much your doctor because migraines can be controlled with a good plan. On the other hand, the different types of headaches, which imply a severe disorder underneath, should be of very much to worry about.
Nevertheless, it is essential to remember that paralysis with a headache could also mean that the patient is having a stroke. Therefore, it would also require an assessment to discard that possibility. Then, a diagnosis of migraine or a complicated migraine could raise an explain the scenario, among other options. I wish in medicine everything was as easy as 1 + 1 = 2.
What is the headache medication?
The medication would vary depending on the cause of the headache. So, let us talk about the most common ones and their treatment and some with particular threats.
Tension headache would include in its pain reliever treatment local measures as hot or cold packs, improvement of posture, stretching, relaxation techniques, acupuncture, change in lifestyle habits (as having more sleep or exercise), among others. Then, many over counter pain killers will aid in diminishing pain. However, when this condition is not responding to standard therapy, the last resource is barbiturates medication.
Patients with migraine will benefit from two types of therapy, for alleviating pain in a migraine attack, and preventive treatment for avoiding migraine attacks at all. For the attacks, doctors mostly use these types of medication, NSAIDs (pain killers), triptans, and ergot alkaloids (ergotamine and dihydroergotamine). Besides the opioids and dopamine antagonists for severe cases.
These treatments result very well as a pain reliever. They have all different ways of administration, including skin patches, pills, and more. Then, preventive therapy could be by several medications from a wide array of drug families. This election would finally depend on the patient having another disease, or specific features.
Cervicogenic headache is a secondary headache that involves half of the head and the neck from the same side. It worsens with neck movement because the problem is within the upper segment of the column (cervical column). This type of condition benefits from physical therapy, as many studies show.
Rebound headache appears when the patient is not taking the medication properly. Most of the time is overusing it, causing itself a headache. Generally, these medications for pain should be only two or three days a week. Or, as instructed by the doctor.
When should you see a doctor about a headache?
You should see a doctor when the danger signs we just talked about appear. All those signs that make a doctor think in another underlying and severe condition. Also, if you have another disease, like diabetes or hypertension, or you are above fifty years.
Before going to a doctor, it would be beneficial to have a headache diary. It would help you to keep track of how many times per day, and what duration are you having those episodes of pain.
Remember that most of the time, it would be a primary headache, and their diagnosis is through questions. Mostly, of the particular features as you saw, where is hurting, how is the pain, how severe, are you having other symptoms, and more.
What should I do if my head is hurting?
This tool is a headache symptoms checker. It would help you to determine the specific features of the headache. Besides additional symptoms that could coexist with it, and are in association with other diseases. It is free, and it would only take a few minutes.