Headache is a general term used to describe pain in the head, face or neck. Most people will experience an occasional headache during their lifetime. But for some, headaches can be chronic and severe, making day-to-day activities difficult.
Headaches are generally categorized into two types – primary headaches and secondary headaches.
Primary headaches are headaches that do not result from another medical condition. They include tension, migraine and cluster headaches.
Migraines are severe headaches that tend to last for several hours or even days and can be precipitated by triggers that vary widely between individuals.
Migraine symptoms: Generally, migraines cause an intense pulsing, usually on one side of the head, and can interfere with routine activities. They are more commonly associated with other symptoms such as sensitivity to light, sound or odor or nausea and vomiting.
Migraine treatment: Migraine treatments focus on managing headaches with migraine medication. Our doctors may also recommend physical therapy to address any tightness in your shoulder and neck muscles. We may also inject Botox (botulinum toxin), a long-acting muscle relaxant.
Cluster headaches are very severe, attacks of pain which tend to strike quickly and without warning.
Attacks can last 15 minutes to 3 hours, can occur multiple times a day and a “cycle” of attacks can last weeks to months before the patient spontaneously reverts to a pain-free state. These headaches can be episodic (individuals find relief from attacks for at least a month in a year) or chronic (meaning there is little to no respite from the headaches over a year).
Cluster headache symptoms: Cluster headaches typically involve severe burning or piercing pain on one side of the head and may also be associated with teary eyes, redness of the eye, drooping of the eyelid, or a stuffy or runny nostril on the same side as the pain.
Cluster headache treatment: We often treat cluster headaches with a course of steroids along with medication to help prevent future attacks. Nerve blocks are often employed to help break a cycle.
Tension headaches are the most common kind of headache and are slightly more prevalent in women than in men. They are often episodic (occurring less than 15 days a month) but can evolve into a chronic condition (occurring 15 or more days a month).
These headaches can be triggered by stress, lack of sleep, hunger, or activities that require staying in one position for too long, such as using a computer or reading.
Tension headache symptoms: Tension headaches may produce a dull, aching sensation all over your head, as well as tenderness or sensitivity around your neck, forehead, scalp, or shoulder muscles. Pain is usually mild to moderate and does not typically cause nausea, vomiting, or sensitivity to light.
Tension headache treatment: To treat tension headaches, we use a holistic approach. Over-the-counter or prescription medications may be recommended but stress reduction techniques and biofeedback, a method that allows one to modulate their heart rate, breathing and learn to induce a relaxed state, are central components of treatment.
Secondary headaches are less common than primary headaches and are caused by another condition that triggers pain-sensitive areas in the neck and head. Secondary headaches can be related to sinus problems, hormone imbalances, injury, or more severe conditions such as aneurysm, or tumor.
Secondary headaches typically start out of nowhere and are excruciating.
Correctly identifying a secondary headache as a symptom of a potentially life-threatening condition is critical. To identify the causes of a secondary headache, physicians may use detailed neurological exams (including examinations of the optic nerve), blood tests, CT scans and MRIs of the brain or neck and other tests.
The Rochester Regional Health Headache Center offers expert care in secondary headaches.