An ache that starts like *this* might be a migraine.
Everyone gets headaches once in a while. A mild headache that comes and goes is usually not a big deal, and the exact type of headache you’re having is probably not a huge concern. Riding it out or taking an OTC pain reliever may be the only action steps you need to do.
If headaches are plaguing you monthly, weekly, or daily, or if you’re feeling a pain you’ve never felt before, it may be time to investigate. Different types of headaches cause unique symptoms and may be triggered by different factors. That could be something as simple as hunger or as complex as your DNA.
“It’s important to get the right diagnosis of the type of headache you have,” says Mark Green, MD, neurologist at Mount Sinai Hospital in New York City. “The treatments are all quite different.”
Most headaches are caused by one of these three syndromes:
What Are Tension Headaches?
Tension headaches are one of the most common types of headaches, and it earned its name due to its link to stress, according to the American Migraine Foundation (AMF). However, more recent evidence suggests there are additional causes beyond psychological. Learn more about common headache triggers here.
Tension headaches cause mild to moderate pain across the forehead or around the back of the head. They can last from 30 minutes to a week, and it’s not associated with other symptoms like nausea or aura.
“It’s usually a pressure-like pain,” says Dr. Green. “People [with tension headaches] self-treat and usually are fine.”
What Are Cluster Headaches?
Cluster headaches are more common among men than women, occuring at a ratio of 3:1, according to AMF. They’re considered the most painful of headaches, and patients sometimes describe it “as if a poker was put in my eye,” says Dr. Green.
During a cluster headache, pain is usually on one side of the face only and around one eye. Cluster headaches can build up quickly, in just a few minutes, but they can last up to two hours.
The term “cluster” refers to the repeated headache episodes over a period of weeks or months, separated by headache-free remission periods. To be classified as a cluster headache, however, it must affect the cranial nerve 5 (which triggers the localized pain around the eye) and cause other symptoms, like teary eyes, runny nose, and sweating.
What Are Migraine Headaches?
During a migraine attack, the person may go through multiple stages: prodromes, aura, migraine, and postdromes. This means there may be days or weeks before and after the actual migraine headache during which the person experiences unique, non-headache symptoms. Learn more about the symptoms of migraine at each stage.
Unlike other common types of headaches, migraines are accompanied by nausea and sensitivity to light and sound. In those who experience migraine with aura, they may also suffer from vision problems like blind spots, zig zags, and the appearance of “heat waves.”
It’s not just the symptoms of migraine that distinguish it from other headaches; people having migraines will also behave and react differently than those having a headache.
“In migraine, people want to go to bed. They want to hold still,” says Dr. Green. During a cluster headache, “people can’t hold still. They walk around, they pace, they bang their heads on the wall.”
If you experience migraines, you shouldn’t just muscle through them. “There’s evidence that migraines can be progressive, so the more you have, the more you’re going to get,” says Dr. Green. “People who have a significant amount of disability from migraines should try and seek medical care fairly early, and see if they can be reduced in frequency and in severity.”
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It's important to get right diagnosis
of the type of headache you have,
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because the treatments
are all quite different.
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The tension type headache is
felt throughout the head.
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And it's usually a pressure-like pain, and
it's not associated with nausea, vomiting,
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or any significant light or
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Tension type headaches by
definition are mild, and
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people self-treat and usually are fine.
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Another type of headache we
see are cluster headaches.
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Now, these are headaches which
occur more commonly in men.
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They're always one-sided.
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They build up very quickly, usually over
a few minutes, commonly around an eye.
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And they last up to two hours.
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A short one might be 20 minutes;
a long one may be two hours.
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And you may have more than one a day.
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People say it's as if
a poker was put in my eye.
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And the behavior is completely different.
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In migraine, people want to go
to bed; they want to hold still.
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In cluster, people can't hold still,
they walk around,
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they bang their heads on the wall.
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Migraine's a syndrome, a very, very common
syndrome, usually having headaches, but
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not always having headaches,
associated with light and
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sound sensitivity, nausea,
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Well, migraines often occur over time,
beginning with something called a prodome,
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and prodomes could occur even
the day before the attack.
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Many prodomes include cold hands and feet.
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Yawning is a very common prodrome.
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Then about 20% of people
with migraine get an aura.
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And there many kinds of auras.
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The most common are visual, and people can
see stars or lights, or have blindspots.
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That may last five minutes to an hour.
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And then commonly thereafter one gets
a headache, and the headache classically
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is one-sided, and throbbing, and
it's worse if you move around.
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And then after it's all over and the
migraine attack may last 4 to 72 hours.
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Most of the time people are washed
out; we call that a postdrome.
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Where your headache is largely gone but
you still don't feel well, and
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that can go on for days.
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Well, there's evidence that
migraines can be progressive, so
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the more you have,
the more you're gonna get.
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So people who have a significant amount of
disability from migraines should try and
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seek medical care fairly early,
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and see if they can be reduced
in frequency, and in severity.
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Cluster headache. Mount Royal, NJ: American Migraine Foundation, 2016. (Accessed on August 15, 2018 at https://americanmigrainefoundation.org/understanding-migraine/cluster-headache/.)
Tension headache. Washington, DC: U.S. National Library of Medicine. (Accessed on August 15, 2018 at https://medlineplus.gov/ency/article/000797.htm.)
Tension-type headache. Mount Royal, NJ: American Migraine Foundation, 2016. (Accessed on August 15, 2018 at https://americanmigrainefoundation.org/understanding-migraine/tension-type-headache/.)
Migraine. Washington, DC: U.S. National Library of Medicine. (Accessed on August 15, 2018 at https://medlineplus.gov/migraine.html.)
What type of headache do you have? Cambridge, MA: Harvard Health Publishing. (Accessed on August 15, 2018 at https://www.health.harvard.edu/healthbeat/what-type-of-headache-do-you-have.)
What type of headache do you have? Mount Royal, NJ: American Migraine Foundation, 2017. (Accessed on August 15, 2018 at https://americanmigrainefoundation.org/understanding-migraine/what-type-of-headache-do-you-have/.)