Headaches

Overview

Headaches are a relatively common issue. Worldwide, almost half of all adults experience a headache in any given year, according to the World Health Association. 

A headache is a painful throbbing or sharp sensation in any part of the head. Headaches are often triggered by lifestyle or environmental factors but can also be symptoms of an underlying medical condition. 

Migraines are a severe type of headache that is recurring. They often begin in puberty and can be lifelong. 

Most headaches can be treated with rest and over-the-counter pain relief medicines. Your doctor may treat severe headaches and migraines with medication. 

Headache causes

The direct causes of most headaches are not understood. Possible causes of headaches range from harmless to serious, and include:

• Consuming alcohol or processed foods
• Stress
• Lack of sleep
• Incorrect eyeglass or contact lens prescription
• Loud noises
• Tight headwear

Migraines are caused by a deep-brain mechanism that, when activated, releases inflammatory substances that induce pain in the nerves and blood vessels in the head. Migraines can be triggered by: 

• Bright or flashing lights
• Loud noises
• Stress
• Certain foods, such as chocolate and processed meats
• Alcohol and caffeine
• Changes in weather and air pressure

Headache risk factors

Being affected by any of the causes listed above can increase your risk of experiencing a headache. 

Risk factors for migraines include:

• Having a family history of migraines
• Being between ages 35 and 45
• Being female
• Hormonal changes, such as before menstruation or menopause, or during pregnancy

Headache symptoms

Headaches can feel acute or throbbing and can affect the entire head or just one region. 

Migraines tend to:

• Be moderate to severe in intensity
• Feel pulsating
• Be localized to one side
• Worsen with physical activity
• Last for a few hours to several days
• Occur with a frequency of between once yearly and once weekly

Migraines are often accompanied by:

• Nausea
• Sensitivity to light and sound
• Dizziness

Headache prevention

Some headaches can be prevented by:

• Avoiding stress
• Eating regular meals to maintain consistent blood sugar levels
• Exercising regularly

Migraines can be prevented by avoiding common migraine triggers, such as:

• Bright or flashing lights
• Loud noises
• Stress
• Certain foods, such as chocolate, red wine, and processed meats

Your doctor may recommend medications to help prevent recurrent migraines. These may include:

• Medications to lower blood pressure, such as beta blockers and calcium channel blockers
• Antidepressants, which have been shown to prevent migraines in some people
• Anti-seizure drugs such as valproate and topiramate
• Botox injections
• Calcitonin gene-related peptide (CGRP) monoclonal antibodies

Headache diagnosis

Your doctor will attempt to diagnose the type of headache you are experiencing by assessing the severity, type, and pattern of pain. 

You may also be given tests to identify the nature and cause of your headaches, such as:

• Blood tests
• X-rays
• MRI or CT scans

Headache treatment

Headaches are most often treated with rest and over-the-counter pain relief medicines. You may also try to ease pain by taking a hot shower, or by applying a heat or ice pack to your head. 

Your doctor may prescribe the following medications to alleviate severe pain from headaches:

• Analgesics
• Anti-emetics
• Medications specific to treating migraines
• Prophylactic medications

When to seek care

Consult a doctor if:

• Your headaches develop after age 50
• The pattern and severity of your headaches change
• Your pain increases with coughing or movement
• You experience changes in behavior or personality
• You experienced trauma to the head
• Your headaches interfere with your daily functioning
• Your headaches are accompanied by neurological symptoms

Next Steps

Headache and migraine triggers vary from person to person. Your doctor may recommend that you keep a journal to document any foods, activities, environments, and situations that trigger your symptoms. Consult your doctor to set up a plan for preventing and treating recurring headaches.