Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 23, 2015

Headaches are something that most everyone has experienced. Some people only experience occasional headaches, and some experience chronic or severe pain. For those with the occasional ones, it may not be a big problem; they come and go easily. But for some people, daily headaches or migraines can be very painful and also disruptive to work, home or school life. Even though there are many causes for headaches, there are also many ways to either prevent or treat them to keep pain at a minimum.


Definition & Facts

The term "headache" is a pretty broad term; it means any pain that occurs on any part of the head. It can occur on the top of the head, the sides, even the neck. A headache can be mild, and could also be severe, with painful throbbing in the head. They may occur for just a short period of time, or they may last for hours or even days.

A headache could either be triggered by something or a manifestation of symptoms of an underlying problem. There are several types of headaches, as well. Migraines, tension headache, and cluster headaches are all considered primary headaches. Secondary headaches are the ones that are usually caused by something else. Migraines can be accompanied by nausea, sensitivity to light and sound, and auras (visual, sensory, or verbal disturbances).

Cluster headaches occur in patterns or clusters, and can be as painful and debilitation as a migraine. Other headaches include things like rebound headaches or headaches from brain freeze.


Some people may have certain genes that make them more sensitive to the frequency and severity of headaches. Besides this, headaches can be brought on by many different things. Primary headaches, such as migraines or cluster headaches, occur because of problems with pain-sensitive structures that are in the brain; they are not a result of some underlying condition or disease.

These can occur because of problems with nerves or blood vessels, muscles in the neck, or disturbances in the chemicals of the brain. These types of headaches could be caused by anything, including emotional distress. Secondary headaches are usually symptoms of some other underlying disease or condition, which stimulate the nerves in the head and cause pain. There are many conditions which can cause headaches; influenza, concussion, brain tumors or aneurysms, meningitis, pseudotumor cerebri, panic attacks, and dehydration.

Headaches can also be triggered by medications, such as with rebound headaches. A headache could also be the result of skipping meals, drinking alcohol, or certain food items. Some people can get headaches from things like monosodium glutamate (MSG) and nitrates used for food preservatives, or from not drinking enough water. There is also the risk of headaches associated with most any household or industrial cleaners or chemicals; exposure to certain toxins can cause headaches.

When to see a doctor

Most headaches don't pose a real threat. With minor treatment or rest, they will go away fairly quickly. However, there is always the chance that a headache is a sign of something more serious, something that should not be ignored. There are certain “red flags” to look out for that will identify something worse may be happening besides a simple headache.

Of course, if the pain is sudden, severe, or accompanied by other neurological symptoms such as dizziness, blurred vision, decreased motor skills, or slurred speech, a visit to the emergency room is necessary. This could be a signal of a stroke or other dangerous issue which need to be addressed as soon as possible. Positional headaches, such as those that change when lying down or standing up, could also signal something dangerous, as well as exertion headaches.

It's a good idea to get any unusual or rare headache checked out; especially for someone who may have never had one before, or if they began having chronic headaches. Getting a proper diagnosis and developing an individually tailored treatment plan is important, so symptoms can be stopped, minimized, or even prevented.

Treatment & Therapy

Treatment for headaches obviously depends on what is causing it. There are many tests to determine exactly what is causing the pain. If there is something like a tumor or injury, headaches may go away after surgeries or other treatments for those issues. Other health issues need to be addressed, and proper medication given to treat whatever condition or illness is causing the headache.

Sometimes it's as simple as drinking water when dehydrated, or eating after skipping meals to make a headache go away. The most common treatment is over-the-counter medication, such as aspirin, ibuprofen, and acetaminophen; these can be found in most any store. Tension and other mild headaches respond well to over-the-counter medication and rest. For the more severe types, such as migraines, this may not work well. Some people who have migraines may have to take prescription medications, such as sumatriptan and zolmitriptan.

However, even with treatment, some people can still get migraines. To help ease the pain, it's best to rest in a quiet, dark room and use hold or cold compresses. Some take an alternative route to treating headaches, including biofeedback, relaxation techniques, or transcranial magnetic stimulation. Everyone is different, so treatment will vary; it's best to plan with a medical professional to find the right treatment plan.

Prevention & Prophylaxis

Once a diagnosis has been received, or a trigger has been identified, it is wise to build a plan for preventative measures. Not all headaches can be prevented, but chances of them occurring can be minimized, in most cases.

Identifying and avoiding triggers is important; a healthy diet, regular exercise, the right amount of sleep, and proper hydration can help decrease chances of most mild headaches. For those prone to stress-related headaches, adopting some relaxation practices can help reduce the amount or severity of headaches.

For the more serious, migraine types, it may be necessary to take medication that has been shown to help prevent migraines, such as tricyclic anti-depressants. Many people also take a more holistic approach to headache prevention and management by practicing yoga and meditation, breathing techniques, massages, and heat and cold therapy.