Understanding Headaches and Migraines: Causes, Symptoms, and Treatment

Headaches and migraines are extremely common. While occasional tension headaches are normal, frequent debilitating headaches may indicate an underlying disorder needing evaluation. Understanding the differences between headache types along with causes, symptoms and treatment options will help you find relief.

Primary Headache Disorders

Headaches fall into two main categories – primary and secondary. Primary headaches stem from the headache condition itself instead of another medical issue. Types include:

Tension Headaches

The most common variety caused by tightened muscles pressing on nerves in the neck, head and scalp. Feels like a squeezing band of pressure. Stress, poor posture, grinding teeth and lack of sleep often contribute. 

Migraines 

Recurring moderate to severe headaches with intense pulsing/throbbing pain, often one-sided. Other symptoms like nausea, light and sound sensitivity are common. Exact cause unknown but genetics and neurological factors play a role.

Cluster Headaches  

Sudden, extremely painful headaches on one side of the head, often around an eye. Occur in clusters of weeks or months interspersed with remission periods. Thought to involve the hypothalamus. More common in men.

Secondary Headaches

These result from another medical condition, illness or substance use including:

 

- Medication overuse headaches from overusing pain medication

- Giant cell arteritis - inflammation of blood vessels in the scalp

- Head injury such as concussion

- Sinus infection

- Meningitis or encephalitis  

- Hangovers or substance withdrawal

- Brain tumor

- Blood clots

- Carbon monoxide poisoning

Proper treatment of the underlying issue generally resolves secondary headaches.

Common Migraine Symptoms

While symptoms vary by person, migraines often involve:

- Moderate to severe throbbing head pain, commonly one-sided

- Increased sensitivity to light, sound, and smell

- Nausea and vomiting

- Dizziness or feeling faint

- Temporary visual disturbances like seeing auras or flashing lights

Migraine intensity ranges from somewhat disabling to completely incapacitating. Attacks may last anywhere from 4 hours to 3 days.

Migraine Triggers to Avoid

Factors that may trigger migraines include:

- Stress, anxiety, shock 

- Hormonal changes in women

- Bright or flashing lights

- Loud noises 

- Strong smells like perfume  

- Weather changes

- Altitude changes

- Dehydration and skipped meals

- Certain foods like aged cheese, processed meats, red wine, artificial sweeteners

- Poor or irregular sleep

Identifying and limiting triggers is key to migraine management. Keeping a headache diary helps pinpoint personal triggers.  

 

Seeking a Migraine Diagnosis

To obtain an accurate migraine diagnosis, your doctor will:

- Ask about headache history, frequency, characteristics, location and timing

- Perform a neurological exam testing reflexes, sensation, balance and vision

- Request imaging like an MRI to rule out underlying conditions if needed

- Screen for triggers and risk factors

- Review family history since migraines often run in families

There are no definitive tests to diagnose migraines, but these steps aid in confirming a migraine disorder.

Preventing Migraine Attacks

While not always possible to prevent migraines entirely, these approaches may help lower headache frequency:

- Avoiding known headache triggers 

- Finding healthy ways to manage stress through exercise, meditation, communication, etc.  

- Getting regular exercise which boosts natural painkilling endorphins

- Staying well hydrated by drinking water consistently 

- Limiting caffeine intake to 1-2 caffeinated beverages daily

- Following a nutritious, balanced diet focused on whole foods

- Establishing consistent daily sleep schedules  

- Taking magnesium, riboflavin, CoQ10, or other supplements shown to lessen migraines

- Reducing alcohol, especially red wine and craft beers

Prevention is ideal, but having an effective abortive migraine treatment is also important when attacks occur unexpectedly. 

 Treating Acute Migraine Attacks

When a migraine strikes, the following remedies may provide relief:

- Prescription medications like triptans, ergots, anti-inflammatories

- Over-the-counter pain relievers when taken early like acetaminophen, ibuprofen, or naproxen

- Anti-nausea medications when needed

- Resting in a quiet, dark room applying hot or cold compresses to the head and neck  

- Hydrating with water and electrolyte drinks 

- If applicable, using prescribed acute migraine treatments like lasers, electronic stimulators or nasal sprays

If headaches become more frequent or severe, preventative daily medication may be beneficial to reduce susceptibility to migraines developing.

When to Seek Emergency Care

Seek prompt emergency treatment for:

- Sudden severe headache differently from your normal migraines

- Headache with fever, stiff neck, mental confusion, seizures, double vision 

- New headache pain if older than 50 years old

- Headache after a blow to your head 

- Severe headache during pregnancy or after giving birth  

- Increasing headache frequency and worsening intensity

- Headache causing awakening from sleep

Rapid worsening headaches could signify a more serious cause like stroke, aneurysm, or hemorrhage needing urgent evaluation.

Frequently Asked Questions

What’s the difference between a migraine and a headache?

Migraines differ from regular headaches in severity, specific symptoms like nausea and sound/light sensitivity, tendency to affect one side of the head, and occurrence in cyclical patterns. Migraines are recurring and debilitating while tension headaches are generally milder.

What lifestyle changes help prevent migraines? 

Avoiding migraine triggers, staying hydrated, limiting caffeine, managing stress through relaxation practices, getting regular exercise, following a nutritious diet, and sticking to consistent sleep routines may help lower migraine frequency for some people. Keeping a headache diary also helps identify personal triggers.

When should you see a doctor for headaches?

Schedule an appointment if headaches are worsening, needing medication more than twice weekly, interfering with daily activities, causing awakening from sleep, or exhibiting unusual symptoms like fever or neurological deficits. Sudden severe headaches warrant prompt emergency care.

Can foods trigger migraines?

Yes, certain foods and beverages may precipitate migraines in susceptible people, especially aged/fermented foods, processed meats, chocolate, alcohol, and items with artificial sweeteners or monosodium glutamate (MSG). Because food sensitivities vary, an elimination diet can help identify problematic triggers.