When a headache strikes, it can bring your life to a halt. It's hard to concentrate when your head is pounding, and in some cases there are other symptoms that can be disabling.
"People can get concerned about headaches, thinking that it's something serious," says Henry Ford Neurologist Ashhar Ali, D.O. "The vast majority of time, headaches are normal, but it helps to know the different types so you can determine if you need to see a specialist, or even get emergency care."
There are two major categories of headache: primary and secondary. Primary headaches are those where the headache is the main issue, while secondary headaches have other medical causes that are causing the headache.
The most common type of primary headache is known as a tension, or stress headache, which can affect your forehead, temples or neck. Muscles in these areas contract, leading to the pain. Lifestyle factors are often the cause of this type of headache, and may include stress, fatigue, alcohol, certain foods or staring at a digital screen for too long.
While over the counter (OTC) medications such as acetaminophen or ibuprofen may be a temporary fix for a tension headache, taking them too often can cause what's known as a rebound headache. For this reason, it's best take OTC medications only when you need them, and to find other ways to address tension headaches. This can include working on resolving whatever lifestyle factors are causing them, and also looking into healthy activities to relieve tension such as exercise, meditation and massage.
Tension headaches are often temporary, but migraines can recur periodically or frequently. When a migraine "attack" occurs, it can be completely disabling and affect virtually every aspect of a person's life, from work and family to social life. Depending on the person and the severity, migraines can include nausea and vomiting, light or sound sensitivity, and other symptoms. While certain OTC or specialty medications may help, migraine sufferers also should work to identify the specific factors that trigger their migraines and try to avoid these.
"Keeping a migraine diary to monitor your lifestyle can help to zero in on the likely triggers for your headaches," Dr. Ali says.
Some common triggers include specific kinds of food or drinks, sleep habits, changes in routine, caffeine, too much screen time or even hormonal changes. Women are more likely to experience a migraine than men.
However, men are more likely to experience the third major type of primary headache, known as a cluster headache. This rare type strikes suddenly and features intense pain behind or around one eye that can be worse than a migraine. Cluster headaches may disappear just as suddenly, but can return frequently during one group, or cluster, period, before going away for a period of remission. People can experience them around seasonal changes, so they may be mistaken for something else, and diagnosis from a headache specialist may be needed to determine the best way to treat them.
When to consider your headache an emergency
If you have a secondary headache, it could be caused by an existing chronic condition, such as sinusitis. In these cases, especially if the headaches are affecting your quality of life, you may want to see a specialist to address the underlying condition. However, if you experience certain symptoms, you should go to your nearest emergency room, as these could be a sign of a serious condition such as a stroke, aneurysm or brain tumor.
"If you have a sudden onset, worst headache of your life, or if you have numbness or weakness on one side of the body, you should get checked out emergently," Dr. Ali says.
Other symptoms that could indicate a need for emergency care include a headache that is accompanied by fever or shortness of breath, or severe nausea or vomiting, or headaches that occur following a head injury.