Headaches are a common health complaint. Some are minor annoyances that resolve quickly. Others are more debilitating and can even be a sign of something more serious.
“Headaches fall into two categories—primary and secondary,” says Atlantic Health System neurologist Minal Patel, DO. “Primary headaches are not caused by an underlying medical condition—they are the condition. Secondary headaches, although rare, are symptoms of something bigger, maybe life-threatening, that require urgent medical attention.”
1. Tension headache
Pressure and tightness in your head and neck can develop from poor sleep, stress, illness, eye strain, and dehydration. You’ll typically feel mild to moderate, dull pain around the entire head, and can have either light or noise sensitivity. Tension headaches last from 30 minutes to several days. Over-the-counter pain relievers with acetaminophen or ibuprofen can bring relief, along with lifestyle modifications to help avoid triggers.
2. Migraine headaches
Stress, weather, menstruation, dehydration, and skipped meals can all trigger a migraine attack. You’ll feel moderate or severe throbbing pain, often on one side of the head, as well as sensitivity to light and sound, and maybe nausea and vomiting. You may experience fatigue, mood changes, dizziness, and brain fog for about four to 72 hours. Treatments include acute migraine medications and NSAIDs (non-steroid anti-inflammatory drugs), as well as preventive meds to help with related symptoms.
3. Cluster headache
These often occur at night during the spring and fall seasons. Excruciating, stabbing pain around one eye or one temple leads to severe restlessness. Other symptoms can include teary eyes, nasal congestion, and a droopy eyelid. Attacks can last anywhere from 15 minutes to three hours and occur in clusters over weeks or months. Cluster headaches are acutely treated with high-flow oxygen therapy, steroids, triptan injections, and nasal sprays. Preventive medications can also help limit attacks.
4. Sinus or allergy headaches
Migraine headaches are often misdiagnosed as sinus headaches. Usually, sinus and allergy headaches are caused by sinus infections and inflammation, which lead to pressure in the forehead, cheeks, and around the eyes. Nasal congestion, facial tenderness, colored nasal discharge, postnasal drip, and even mild fever can all accompany these headaches. Although the length of time varies greatly, antihistamines, decongestants, antibiotics, and saline nasal sprays all help alleviate pain.
5. Trigeminal neuralgia
If you experience a sharp, electric-shock-like pain on one side of your face, it could be tied to a nerve misfiring (primary headache), or more severely, something in the brain pressing on that nerve (secondary headache). Triggered by touch, wind, teeth brushing, or talking, it can last from seconds to minutes and recur throughout the day. Treatment starts with an accurate diagnosis to rule out secondary causes before anticonvulsants, nerve blocks, or surgery is considered.
6. Thunderclap headache
Imagine the sudden onset of the worst headache of your life. It typically reaches peak intensity within 60 seconds and can last minutes to hours, varying in intensity. You might experience fever, visual changes, and physical weakness. A thunderclap headache can be a primary condition—but is more commonly a warning sign of a larger health concern such as a hemorrhage, aneurysm rupture, or blood clot in the brain. An emergency CT scan or MRI is needed to rule out serious causes.
When to seek help
If your headache is sudden, severe, and comes with weakness, vision changes, or confusion, seek medical attention immediately. Also see a doctor if your headaches have been occurring regularly and seem to interfere with your daily life.
“Most headaches are primary and are not dangerous,” says Dr. Patel. “The first step toward effective treatment is to know what type of headache you’re dealing with, so we can help you find the right combination of medication, prevention strategies, and support.”
Related articles
