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Headache - What is it?

This fact sheet is intended as a general introduction to the most common types of headaches experienced by adults.

What is headache?
Headache is an almost universal experience; most of us have some kind of headache at some time in our lives. The
classification system of headaches used by the medical profession is one of the longest in medicine, with many types
and causes.

Types of headache

The International Headache Society has two broad categories for headache disorders:
The first is based on symptoms (called primary headache disorders) and includes migraine, tension-type

headache and cluster headaches.


The second is based on their causes (called secondary headache disorders). This would include
headaches associated with a head injury, stroke, substance misuse and/or their withdrawal (including alcohol),
infection, disorders of the neck, eyes, nose, sinuses or teeth.
If you experience recurring (regular) headaches it is helpful to understand the type of headache which you have in
order to manage your condition effectively.

How is a headache different from a migraine?


There is a difference between a headache and a migraine headache. Headaches are not usually accompanied by
other symptoms associated with migraine. However, it is quite likely that if you have migraine you will also experience
other headaches.

Headache
Headaches can vary greatly in their duration, cause and severity. A hangover headache, for example goes within a
few hours and headaches associated with an infectious illness improve when the illness is over.
It is really important to identify the type of headache you have so you can get the right sort of treatment and advice. A
headache can be the result of a whole variety of factors such as head injuries, infections and other medical
conditions.

Migraine
In general terms, migraines are experienced as a headache of at least moderate severity usually on one side of the
head and occurring with other symptoms such as nausea, vomiting, sensitivity to light and noise (though some people
experience migraine without headache). The headache is usually made worse by physical activity. Migraines usually
last from 4 to 72 hours and in most cases there is complete freedom from symptoms between attacks. Certain factors
are involved in triggering an attack in those predisposed to migraine. These are usually called trigger factors and
can include lifestyle, and hormonal changes.

The importance of a diagnosis


If you get regular headaches, it is important to see your GP and get a proper diagnosis. Diagnosis will depend upon
your doctor taking a medical history, possibly referring you for tests and narrowing down the range of possible causes
for your headaches. The correct diagnosis of a headache can help you to manage your headaches and if necessary
embark on a suitable form of treatment.

Headache diary

Keeping a record can be very helpful in assisting your doctor to have a clear picture of your headaches. This may
include information on:
when the head pains started
how often they happen
if there are other symptoms, such as being sick or vision problems
how long the attacks last
whether the pain is the pain is throbbing or piercing
where the pain is
treatment you are using for the attacks
the result of the treatment.
You could record if the headaches seem to be associated with particular events, medication, times of the day.
A headache diary can be especially important if you experience medication overuse or rebound headaches (see chart
below). By being able to distinguish between the types of headaches the right treatment can be selected.
Start recording your headaches now with an online migraine diary or read our Migraine Diaries fact sheet.

Common headaches

The most common types of recurring headache as classified by the International Headache Society are:
Tension-Type Headache (for more information see Tension-Type Headache fact sheet)
Chronic Daily Headache(for more information see Chronic Daily Headache research article)
Medication Overuse/Rebound Headache(for further information see Medication Overuse Headache -

please note this information is written for health professionals)


Sinus Headache
Headache due to Eye Strain

Another well known recurring headache which is less common is:


Cluster Headache (for more information see Cluster Headache fact sheet)
The chart below summarises the symptoms of these recurring headaches. This information is intended as a guide
only.

The Most Common Types of Recurring Headache:


Type

Causes/Comments

Common Symptoms

Tension-Type
Headache

The most common type of headache


usually caused by stress, worry,
depression, lack of sleep, tiredness. These
can occur rarely (which is known as
episodic tension-type headache) or
frequently, even daily (known as chronic
tension-type headache).

A feeling of tightness and pressure


around the head with pain occurring on
both sides of the head (bilateral
location).

Chronic daily headache includes:


chronic tension-type headache
medication overuse / rebound

The type of headache pain can vary


and can change depending on the
individual's situation. It can therefore
consist of a number of different types of

Chronic Daily
Headache
This term is
given to

headache

headaches that
occur 15 or
more days a
month.

chronic migraine.

head pain such as tension-type


headache and medication overuse /
rebound headache.

Medication
Overuse /
Rebound
Headache

Caused by the overuse of "over the


counter" medication or prescribed
headache medication such as the triptans
used for migraine. As the medication wears
off the withdrawal from the medication
triggers the next headache, which in turn
leads to increased drug consumption.

This type of headache pain often occurs


as the medication wears off. It often
occurs in the morning after no tablets
have been taken overnight. It may even
awaken you from your sleep.
The head pain is of mild or moderate
intensity which tends to worsen during
drug overuse.

Sinus
Headache

Sinusitus tends to be over diagnosed as a


cause of headache in adults based on the
belief that pain over the sinuses must be
related to the sinus itself. In fact, pain over
the sinus area is often caused by migraine
and tension-type headache.

Some people describe their headaches


as sinus headaches because the pain is
located over their sinuses in their
forehead. The pain is usually restricted
to the infected sinus and is made worse
by sudden movements or bending over.
Sinusitis can be treated by antibiotics
and decongestant.

Eye Strain

Headaches can be caused by weak eye


muscles. This type of headache gets worse
when the individual reads, uses a computer
screen or any activity which requires their
eyes to work in a focused intense way.

These headaches generally start


around the eyes and then spread to the
forehead and temple. You may
experience blurred vision. Having an
eye test and wearing glasses may help
this condition.

Rarer but well known type of Recurring Headache:


Type

Causes/Comments

Common Symptoms

Cluster
HeadacheThese
have been called
"suicide" headaches
because of their
extreme pain.

This is a relatively rare condition, often


misdiagnosed as migraine or sinus
headache and so can be mistreated. The
cause of cluster headache is not yet fully
understood by the medical profession. The
pattern of pain and the pattern of the
episodes suggests there could be a disorder
in the central nervous system. Further
medical investigation and tests will be
necessary to confirm a diagnosis of cluster
headache. Medication is available which
can be preventive or be used to remove the

Extreme head pain which lasts


from 15 to 180 minutes if
untreated. The headache is
associated with one or more
symptoms including: watering
eyes, nasal congestion, facial
sweating and drooping eyelids. It
is more common in men than
women and usually starts in a
persons 30s. During a cluster
headache the individual cannot
remain still and often paces up and

pain once it starts.

down. They often start in the early


hours of the morning and can even
occur up to 8 times per day. The
pain is described as burning or
piercing.