Pain series: Not every headache is a migraine

·Contributor
·5 min read

Most of us have had a headache at least once. And a cup of coffee or tea and some short rest was all that was needed. However, while some headaches are migraine related, not all of them are. So what are the other causes of headaches?

Brain tissue and the skull don't have nerves that register pain. But the blood vessels in the head and neck can signal pain, so can the tissues that surround the brain and some major nerves that originate in the brain. The sinuses, your teeth, and muscles and joints of the neck can also cause head pain.The pain may be a dull ache, or sharp and throbbing, and the frequency may be constant or intermittent. You will be surprised to know that there are over 150 types of headaches!

The pain may be a dull ache, or sharp and throbbing, and the frequency may be constant or intermittent. You will be surprised to know that there are over 150 types of headaches!
The pain may be a dull ache, or sharp and throbbing, and the frequency may be constant or intermittent. You will be surprised to know that there are over 150 types of headaches!

In 1988, the International Headache Society (IHS) first released its classification system for headaches. The IHS hoped that the classification system would help health care professionals make a more specific diagnosis as to the type of headache a patient has, and allow better and more effective options for treatment. The latest edition of the classification released in 2018 has extensive guidelines and the Headache Society recommends that health care professionals consult the guidelines frequently to make the right diagnosis.

Head pain can be classified as being one of three types: 

1) primary headache, 2) secondary headache, and 3) cranial neuralgias, facial pain, and other headaches.

Primary headaches

Primary headache accounts for more than 90% of headache complaints. 

Triggers include certain foods, alcohol, changes in sleep habits, and stress.

Tension Type Headaches (TTH)

Tension headaches are the most common type of headache among adults and teens. They cause mild to moderate pain and come and go over time. They usually have no other symptoms. Studies show that Tension headaches occur more commonly among women than men. According to the World Health Organisation, 1 in 20 people in the developed world suffer with a daily tension headache.

Migraine Headaches

Migraine headaches are often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually happen one to four times a month. 

Migraine headaches are often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually happen one to four times a month
Migraine headaches are often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually happen one to four times a month

Along with the pain, people have other symptoms, such as sensitivity to light, noise, or smells; nausea or vomiting; loss of appetite; and upset stomach or belly pain.

Cluster Headaches

Cluster headaches are a rare type of primary headache. It more commonly affects men in their late 20s, though women and children can also suffer from this type of headache.

Rebound headaches

These days they are called medication overuse headaches. If you use a prescription or over-the-counter pain reliever more than two or three times a week, the headache may improve for a short time after the medication is taken and then recur. When the meds wear off, the pain comes back and you have to take more to stop it. Medication overuse headaches tend to result from taking opiate-based medications, such as those that contain codeine or morphine.

If you use a prescription or over-the-counter pain reliever more than two or three times a week, the headache may improve for a short time after the medication is taken and then recur
If you use a prescription or over-the-counter pain reliever more than two or three times a week, the headache may improve for a short time after the medication is taken and then recur

Most primary headaches go away with a little rest and over-the-counter or prescription pain relief medications. 

Treating migraine has to be under a doctor’s supervision.

Secondary Headaches

Secondary headaches are those that are due to an underlying structural or infectious problem in the head or neck. 

This could range from dental pain from infected teeth or pain from an infected sinus, to life-threatening conditions like bleeding in the brain or infections like encephalitis or meningitis.

Secondary headaches are those that are due to an underlying structural or infectious problem in the head or neck. This could range from dental pain from infected teeth or pain from an infected sinus, to life-threatening conditions like bleeding in the brain or infections like encephalitis or meningitis
Secondary headaches are those that are due to an underlying structural or infectious problem in the head or neck. This could range from dental pain from infected teeth or pain from an infected sinus, to life-threatening conditions like bleeding in the brain or infections like encephalitis or meningitis

Post-concussion/trauma headaches (after a blow to the head) as well as headaches associated with substance abuse and Hangover headaches fall into the category of Secondary headaches. Sinus headaches are also considered a secondary headache due to increased pressure or infection in the sinuses.

Thunderclap headaches come suddenly out of nowhere and peak quickly. Some of the causes of thunderclap headaches include: Blood vessel tear, rupture, or blockage; Head injury; haemorrhagic stroke from a ruptured blood vessel in your brain or blood pressure changes in late pregnancy.

When to see a doctor

The type of headache treatment you need will depend on a lot of things, including the type of headache you get, how often, and its cause. Some people don’t need medical help at all. 

In case of migraines, remember to steer clear of the things you know can trigger your headaches, like foods or smells. Also regular exercise, enough sleep, and a healthy diet can help keep those headaches away.

As secondary headaches can result from serious health issues, it is important to seek medical advice if any headache:

  • is severe or disruptive

  • is persistent

  • occurs regularly

  • does not improve with medication

  • occurs alongside other symptoms, such as confusion, a fever, sensory changes, or stiffness in the neck.

  • occurs after a blow to the head

  • In patients with cancer or impaired immune systems.

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