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Types of Headaches

The International Headache Society classifies headaches into three categories: primary headaches, secondary headaches and cranial neuralgias, facial pain and other headaches.

Primary Headaches

More than 90% of all headaches fall into this category, which includes tension, migraine, cluster and hormone headaches. Primary headaches can have many causes but are not a result of an underlying disease or brain abnormality.

Tension Headaches

Tension headache is by far the most common type of primary headache and many of us have experienced at least one at some point in our lives. A typical tension headache only lasts several hours and is episodic in nature; however, some people can have a headache for a few days and get more than two a month, even daily.

During a tension headache, you will likely feel mild to moderate pain in your forehead, temples or in the back of your head and upper neck. Most people describe the pain as pressure or a tight feeling around the head. Pressure can also be felt behind the eyes or over the eyebrows. Tension headaches usually start in the morning and can progressively worsen throughout the day. Tension headaches that develop almost everyday for longer periods of time are considered chronic.

Many factors contribute to the cause of tension headaches but most scientists believe that pain is caused by chronic inflammation of specific myofascial trigger points located at the base of the skull, the temple and the forehead most often combined with activated trigger points in the trapezius muscle. Many things can put stress on scalp and neck muscles that leads to spasms and pain including:

• Emotional stress, anxiety and depression
• Physical stress, such as poor posture from sitting in front of a computer for extended periods
• Deficiency of basic anti-inflammatory nutrients
• Eye strain, for example, squinting to read
• Certain foods (excessive alcohol, caffeine) or food allergies
• Certain smells or noises
• Lack of sleep
• Teeth or jaws that are not aligned correctly
• Teeth grinding or clenching

Migraine Headaches

Read more about migraine headaches here

Cluster Headaches

These are rare series or clusters of headaches that mostly affect men between the ages of 20 and 45. Cluster headaches strike in groups; they typically occur daily (often more than twice a day) for weeks or months and then disappear for months, even years before coming back.

A cluster headache attack tends to develop at the same time every day, generally in the morning or late night. When they hit at night they do so about one or two hours after the individual has fallen asleep resulting in disrupted sleep. Attacks can last from 30 minutes to over an hour but most of the time they last less than an hour.

Cluster headaches are characterised by extremely severe pain that starts abruptly on one side of the head around the eye. This can be experienced with an inflamed, red and teary eye as well as a congested and runny nose on the affected side of the head. People describe the pain as burning, piercing and throbbing. Cluster headaches are so excruciatingly painful that sufferers are often restless and even resort to banging their heads against a wall in an attempt to stop the pain.

Studies have shown that during a cluster headache attack the hypothalamus (part of the brain responsible for, among other things, certain hormones, hunger, thirst and body temperature) shows increased activity. However, the cause of cluster headaches remains unclear; what is known is that several factors seem to trigger cluster headaches. These include:

• Alcohol
• Smoking
• Strong smells, such as perfumes, cleaning agents etc
• Changes in sleep patterns
• Certain medications
• Exercising in extremely hot weather

Hormone Headaches

Hormone headaches include menstrual migraines (read about migraines here) Please link to migraine health concern or headaches and premenstrual syndrome (PMS) headaches. Birth control pills and hormone replacement therapy (HRT) can also lead to hormone headaches.

PMS headache affects a number of women days or even more than a week before menstruation. Symptoms typically disappear when the period begins and other than headache include:

• Acne
• Joint pain
• Fatigue
• Decreased urination
• Constipation
• Lack of coordination
• Cravings for sugar, salt or alcohol

Secondary Headaches

Secondary headaches result from an underlying disease or abnormality in brain structure or function. The International Headache Society devised a system of eight categories into which secondary headaches can fall. Some examples from each category have been listed:

1. Headache attributed to head and/or neck trauma
   • Concussions
   • Injuries that cause brain haemorrhage
   • Neck injury and whiplash
2. Headache attributed to ear or neck vascular disorder
   • Stroke
   • Aneurism
3. Headache attributed to non-vascular brain disorders
   • Seizures
   • Tumours
   • High cerebrospinal fluid pressure
4. Headache attributed to Medications and Drugs & their overuse & withdrawal (rebound headache)
5. Headache attributed to infection
   
   • Encephalitis
   • Meningitis
   • HIV/AIDS
   • Influenza
   • Pneumonia
6. Headache attributed to disorder of homeostasis (body environment and regulation)
   • Kidney dialysis
   • Hypertension (high blood pressure)
   • Hypothyroidism
7. Headache attributed to neck, eye, ears, nose, throat and teeth disorders
   • Temporomandibular joint (TMJ) disorder (TMD)
   • Glaucoma
8. Headache attributed to psychiatric disorders

Cranial Neuralgias, Facial Pain and Other Headaches

Cranial neuralgias occur when nerves in the head and neck become inflamed and cause pain, such as trigeminal neuralgia. Facial pain that causes headache includes neck-tongue syndrome and herpes zoster.

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