What is a Headache? While a headache is casually defined as pain in or around the head, there are many different kinds of headaches. Each kind has its own symptoms, causes and remedies depending on the location of the pain, the severity, frequency and longevity.
Diagnosing a Headache
Different kinds of headaches are identified via the location of the pain, the duration of the pain or the trigger for the pain. Common headaches are typically broken into 10 groups:
- Allergy/Sinus
- Caffeine
- Cluster
- Exertion
- Hormonal
- Hypertension
- Migraine
- Post-Traumatic
- Rebound
- Tension
There are also numerous less common types of headache, including:
- Chinese Restaurant Syndrome (MSG) - while the name has stuck, it is something of a misnomer. There is no scientific evidence MSG can cause headaches in anyone not sensitive to it. In addition, many foods, including tomato, miso, anchovies, ham, vegemite and parmesan cheese contain high amounts of naturally occurring MSG and are rarely pointed to as the cause of headaches.
- Dehydration
- Eye Strain (including Computer Vision Syndrome) - Pain in and around the eye.
- Thunderclap - sudden, debilitating, headaches often a symptom of a serious medical condition.
- COVID-19 - According to the World Health Organisation (WHO), around 14% of people who contract COVID-19 suffer a headache in addition to a dry cough and fatigue.
Headache Causes and Symptoms
Depending on the variety of headache you are suffering, the location of the discomfort, intensity and frequency will vary. Headache symptoms include:
- Allergy/Sinus - Pain from allergic or sinus headaches is usually concentrated around the sinuses at the front of the head/face. Migraines are often misdiagnosed as sonic headaches. Exposure to common hay fever allergens can cause allergy headaches in seasonal hay fever sufferers. Likewise, food allergies or intolerances can lead to allergic or sinus headaches.
- Caffeine - Caffeine can trigger a headache either through overuse (including drinking too much coffee, overusing caffeine based stimulants like No Doz, or energy drinks), or through withdrawing from caffeine use cold turkey. Pain from caffeine headaches is usually generalised and not limited to one area of the head.
- Chinese Restaurant Syndrome (MSG Intolerance) - Sufferers of MSG intolerance complain of pressure or tightness in the face, painful banding and pressure around the forehead and temples. Sufferers sometimes also complain of associated chest pains. Some people complain of headaches starting around 20 minutes after eating Chinese food but double blind studies have shown that there is no scientific correlation between MSG and headache.
- Cluster - Cluster headaches are typified by severe piercing or burning pain usually concentrated around one eye or one side of the face. As the name suggests, these headaches appear in clusters. An individual headache normally lasts between 15 minutes to an hour but most sufferers will have 1 to 4 a day. Typically when one cluster headache fades the next soon comes on. There is currently no medical consensus as to the cause of cluster headaches, but men are three times more likely to develop cluster headaches than women.
- Dehydration - The pain from a dehydration headache usually encompasses the whole head and can be caused by a number of factors including excess alcohol consumption, air travel, heat stroke, diarrhea and lack of adequate fluid intake.
- Exertion - Exertion headaches typically occur shortly after periods of intense physical activity. The nature of this activity can be anything from exercise to sex to a severe bout of coughing. An exertion headache typically presents as a throbbing pain in both sides of the head. It is thought to be caused by excess blood flow brought on by exertion.
- Eye Strain - Eye strain and other vision based headaches usually present as heaviness and pain around the eyes. Undiagnosed or uncorrected vision problems (requiring glasses or contact lenses) can cause eye strain, as can intense focus at close distance and excess glare (Computer Vision Syndrome)
- Hormonal - Many women experience headaches that coincide with hormone (estrogen) fluctuation, including menstruation, pregnancy or the use of birth control. Headaches that occur specifically during menstruation are commonly known as menstrual migraines.
- Hypertension - Hypertension headaches are similar to exertion headaches but are caused by ongoing hypertension (high blood pressure) rather than elevated blood pressure after exertion. Hypertension headaches are usually only associated with dangerously high blood pressure and present as a throbbing pain on both sides of the head. Other symptoms that may arise during a hypertension headache include: shortness of breath, tingling or numbness, nose bleed, chest pain and changes in vision.
- Migraine - The pain from migraine headaches is usually debilitating, limiting what the sufferer is capable of. The pain is usually throbbing, intense and seems to originate from deep in the head. It is often localised to one side of the head. People suffering a migraine are frequently light sensitive and may experience nausea and vomiting. Some migraine sufferers experience visual disturbances, such as flashing or shimmering lights and blind spots, before an attack.
There are many potential causes of migraine, including genetic predisposition (having a family history of migraines), Post Traumatic Stress Disorder (PTSD), lack of adequate sleep, dehydration, hormonal fluctuation and exposure to some chemicals. Women are three times more likely than men to suffer migraines.
- Post-Traumatic - Post traumatic headaches can be caused by any kind of head injury and will typically occur frequently for 6-12 months after the injury occurred. Post traumatic headaches range from feeling like a tension headache to being more akin to a migraine.
- Rebound - A rebound headache is caused by overuse of medication used to control pain. They are typically found in people who use over the counter painkillers (including aspirin and ibuprofen) more than 15 days a month. Rebound headaches are more common with medications containing caffeine. A rebound headache can feel like a tension headache or migraine.
- Tension - Tension headaches typically present as a dull ache throughout the head. Tenderness around the neck, scalp and shoulders may also occur. Tension headaches are among the most common of all headaches and can be caused by stress or poor posture.
- Thunderclap - Thunderclap headaches come on very fast, with pain reaching its most intense within about 60 seconds on onset. The pain is intense and debilitating (often described by sufferers as the worst headache of their lives) and is often accompanied by nausea and vomiting or fainting. Thunderclap headaches can be symptomatic of serious medical conditions, such as bleeding in the brain, but can also have benign causes.
Headache Care
Over the counter pain medication is good for many kinds of headache, but depending on the cause you may need to take extra steps to alleviate pain.
Allergy/Sinus - Steroidal nasal sprays, antihistamines and nasal decongestants can alleviate allergy headaches caused by allergies. Some sinus headaches are caused by bacterial or viral sinus infections so may require a doctor to prescribe proper medication.
Caffeine - Reducing caffeine intake to a steady level or quitting caffeine entirely can eliminate caffeine headaches.
Cluster - Doctors may not be sure what causes cluster headaches, but there are a number of treatments commonly used to effectively treat cluster headaches, including oxygen therapy, local or topical anaesthetics. If you suffer cluster headaches you should see a doctor to work out a treatment plan.
Dehydration - Anyone suffering a dehydration headache should endeavour to rehydrate with ample clear liquids. Specialised rehydration drinks like Hydralite are excellent for this purpose.
Exertion - Exertion headaches usually fade shortly after they come on but the pain can be controlled with over the counter medication if necessary. If you regularly experience exertion headaches you should see a doctor as they may be indicative of an underlying illness or cause.
Eye Strain - Anyone suffering from frequent or ongoing eye strain headaches should book an appointment to see an optometrist to see if they have any uncorrected vision problems.
Hormonal - Over the counter pain relief can work to relieve hormonal headaches, but prescription medication may be needed. Some relief may also be found through relaxation techniques such as meditation or yoga, or eating a specialised diet.
Hypertension - If you feel you are suffering hypertension headaches you should see a doctor. Frequency and severity are likely to reduce when your blood pressure is controlled.
Migraine - Over the counter pain medication can work to lessen symptoms but sufferers may require prescribed medication. You should also check with a doctor if there is a preventative medication that may help you lessen the frequency and severity of attacks.
Post-Traumatic - If you suffer a headache after a head injury then you should see a doctor.
Rebound - The only real way to stop rebound headaches is to slowly wean yourself off the pain relief medication that you’ve been taking too frequently. Pain may worsen to begin with but should improve within a few days.
Tension - The pain of tension headaches can be controlled with over the counter pain relief medication (aspirin, ibuprofen, paracetamol and the like), but serious chronic tension headaches may require prescription medication to control.
Thunderclap - Medical help should immediately be sought if you suffer a thunderclap headache.