Woman sitting at desk with head on face, in pain

Understanding the Different Types of Headaches

Types of Headaches

Most people will experience headaches during their lives. Knowing which type of headache you have is important for you to get the correct treatment.

You’ve probably had a headache in the past — or perhaps you even have a headache now and are wondering how to treat it. It goes without saying that headaches are awful to live with, but sometimes they are extremely easy to treat.

Although there are over 150 types of headaches according to the International Classification of Headache Disorders, the most common headaches can be divided into primary and secondary headaches.

Primary and Secondary Headaches

Primary headaches are those headaches that are not caused by another condition. For example, tension headaches and migraines are common primary headaches.

Secondary headaches are headaches that you get as a symptom of another condition. These secondary headaches can be because of a head injury, caffeine withdrawal or the overuse of medication.

Types of Primary Headaches

Tension Headaches

Tension headaches triggers include:

  • Stress
  • Fatigue
  • Lack of sleep

The pain of a tension headache is felt on both sides of the head and it’s often described as a “vice gripping your head.” The pain can also include your neck and shoulders, with your shoulders feeling stiff and tense.

A tension headache can last for anywhere from 30 minutes to a week.


A migraine is a type of headache that is severe and can be debilitating. They also last anything from four  to 72 hours.

Migraine pain is often only on one side of the head and begins at the eye or temple. The pain can spread to the back of the head.

Many people who suffer from migraines get an “aura” before the migraine strikes. These “auras” may include seeing “spots” or smelling things that aren’t present (like onions or nail polish remover).

Dr. Elizabeth Loder, chief of the division of headache in the department of neurology at Harvard-affiliated Brigham and Women’s Hospital, has put together an easy way to remember the features of a migraine by using the acronym “POUND”:

P: pulsating pain
O: one-day duration of severe untreated attacks
U: unilateral (one-sided) pain
N: nausea and vomiting
D: disabling intensity

Migraine Triggers

Migraines can start after you’ve been exposed to certain triggers, including:

  • Foods like chocolate, peanut butter, dairy and citrus
  • Lack of sleep
  • Certain smells
  • Weather changes
  • Bright lights or loud noises
  • Gluten may also be a trigger if you have Celiac disease
  • Hormonal swings, for instance with pregnancy or menstruation

The Difference between a Headache and a Migraine

Even though some people call their headache a migraine, it may not be a true migraine.

One difference between migraines and tension headaches, is that a migraine can last anywhere from a few hours to three days, while a tension headache can last anywhere from 30 minutes to a week.

Headaches are usually also not focused on one side of the head like migraines are.

Another difference between migraines and headaches is the type of pain; migraine pain tends to be throbbing while a headache’s pain can be described as steady and chronic.

Current research on migraines show that genetic mutations are partly responsible for this type of headache. It must be remembered that the causes of migraines are varied and not yet well understood. Instead of one cause, migraines have multiple causes.

Cluster Headaches

A third type of headache that is quite common, is cluster headaches. This headache gets its name from the way in which it appears in clusters. A few headaches will occur during a single day for the stretch of a number of days.

Cluster headaches start abruptly and last for half an hour to an hour on average.

Another symptom of cluster headaches is the eye on the affected side of the head becomes red and watery. Your eyelid may also droop and your nose run.

Nausea and sensitivity to light are also possible symptoms of cluster headaches.

While OTC medication doesn't really help for cluster headaches, there are some new medicines being tested that show great promise of treating cluster headaches.

While these are some of the most common primary headaches, there are also secondary headaches to consider when you are struggling with a headache.

Secondary Headaches

Secondary headaches include headaches that are a symptom of another illness or injury.

Looking at these a bit closer, we see they can be divided into seven different types according to the The International Classification of Headache Disorders 3rd edition.

The most common secondary headaches include headaches because of head injury, sinus headaches, and headaches due to the overuse of medication.

Headaches because of a Head Injury

Minor bumps to the head or neck are usually not something you should worry about. However, more severe injuries — for example sustained while taking part in sport or during a vehicle accident — need medical attention as soon as possible.

A headache may develop immediately or soon after a head injury and feel similar to a migraine or tension headache.

Should your headache worsen or be persistent you shouldn’t wait, but see a doctor immediately. You should see a doctor if any of these symptoms are present:

  • Unconsciousness
  • Seizures
  • Vomiting
  • Memory loss
  • Confusion
  • Vision or hearing problems

Sinus Headaches

Usually caused by sinusitis, during which the sinuses swell because of an infection or allergy, sinus headaches have a dull, throbbing ache around the eyes, cheeks and forehead where the sinuses are located.

If the infection is acute, the pain may also spread to include the jaw and teeth.

Other symptoms of sinusitis include:

  • A blocked nose
  • Fever
  • Nausea
  • Light and/or sound sensitivity

It’s important to note that if you do not have a blocked nose, etc. it is much more likely to be a migraine.

Headaches Due to the Overuse of Medication

Did you know that using too much of certain medications can actually cause headaches?

These rebound headaches may turn into a vicious cycle where you take painkillers to help the pain that is actually caused by painkillers.

Drugs that cause rebound headaches include:

  • Opioids
  • Paracetamol (Acetaminophen)
  • Triptans
  • NSAIDs, including aspirin and ibuprofen

When to See a Doctor Immediately

Because a headache may be a sign of an infection, stroke or other severe disease it is of the utmost importance to seek medical help immediately if:

  • Your headache is unusually severe or it steadily gets worse
  • Follows a blow to the head
  • Is accompanied by fever, a stiff neck, confusion, decreased alertness, visual disturbances, slurred speech, weakness, numbness or seizures

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