Are you a chronic headache sufferer? Or know someone who is always popping pain killers for their headaches? Listen up! There are several different types of headaches and they all mean different things. It can be hard to know why you have one, what to do about it and when to worry. Let’s see if we can take some of the guesswork out of it for you.
If you’ve hit up a search engine to find the answer to your question, you will find lists with all sorts of numbers. The International Classification of Headache Disorders has more than 150 of them. Let’s not bog you down with every one of them, but we may have some answers for you. To get to the bottom of the mystery, you need to think about where the pain is, what type of pain it is, and when you usually get it. All three factors matter when figuring out the headache mystery.
Broadly speaking, there are three categories of headache:
- Primary headaches
- Secondary headaches
- Cranial neuralgias, facial pain and other headaches
The most common headaches are primary headaches: the tension type headache, migraine headache and cluster headache. Some of them resolve quickly while others can leave you in a dark room, hovered over a chuck bucket and hanging on for dear life.
Secondary headaches are those that occur because of another problem or overindulgence. Think sinus headaches, concussions, infections, hangovers, or substance abuse-related headaches. Overuse of certain medications may cause a withdrawal headache. Dehydration or dental pain may cause secondary headaches too. They can also signal a life threatening condition like meningitis, encephalitis or yes, a brain tumour.
Can we just say though – it’s rare that your headache is because of a brain tumour. Just breathe!
The third type is cranial neuralgias and other headaches. You have 12 cranial nerves that come from the brain carrying pain and muscle signals. Cranial nerve V can cause intense facial pain when its inflamed.
Now! This article is going to be a longish one, because we have to talk about a lot of specifics. You’ll probably skim read to the bits you are interested in. Here’s the bit you can’t skim read:
“If you experience – a stiff neck, a rash, vomiting, confusion, slurred speech, a fever higher than 38 degrees Celsius, paralysis in any part of your body, or vision loss along with your headache, or if your headache is nothing like you’ve had before or is the worst you’ve ever had – get your arse to the doctor or emergency room please. Get checked.
Okay now: Let’s talk primary headaches
- The Migraine Headache. The migraine headache is intense, throbbing and almost always hemispheric (occurring only on one side of the head). Common symptoms involve hypersensitivity to light, noise or smell, nausea or vomiting, vision problems (like the ‘migraine halo’ or aura that can occur before or during the migraine.) Pain tends to radiate towards the eyes, forehead and temple.
Sufferers may find it almost impossible to carrying on daily life during an episode. There is often a pre and post migraine stage (pro-drome and post-drome). Migraines do have triggers, but these are varied and individual. You might have to work out what yours is by working with your primary healthcare provider, but we can tell you studies have shown magnesium is your friend.
How to manage: The best time to combat these suckers is as soon as you start to get symptoms. When this happens, put your hands and feet in warm-hot water. Why? this tricks your body into thinking you’re hot and shunts the blood away from your brain and into your extremities to cool down. This will reduce the pounding in your head that results from your blood vessels dilating and your brain getting engorged with blood. Getting yourself into a dark, quiet room and rest is probably all you’ll feel like doing too. This helps any over stimulation of your nervous system. Sometimes over the counter drugs and sleep might be your only friend here, and if you are a migraine-vomiter, you might need anti-nausea drugs. An icepack on your forehead or the back of your neck might help too.
When to seek help: If you are experiencing the “aura” (or visual/sensory disturbances like flickering lights, spots, partial loss of vision, or a halo effect) for the first time, get to a doctor straight away as this symptom can also indicate more sinister causes. If you have recurrent episodes, chat to your primary healthcare provider to figure out your trigger. It will be a physical, chemical or emotional stressor. You just have to figure out which one.
Remember: take note when they come on. Is it in the morning, at night after work, after you’ve eaten something, or at the same time of your menstrual cycle. Hormones and food triggers can be the main culprit in these circumstances.
Prevention: The only way to prevent these is to figure out your triggers and avoid them. You may benefit from a high-quality magnesium supplement (I recommend liquid magnesium). I also recommend getting checked and adjusted by a chiropractor regularly, but don’t go during a migraine episode. Just go to bed!
- The Tension Headache. This is a very common type of headache and most people will experience one on the odd occasion. They are dull, felt on both sides of the head and will vary in severity and length. You can usually get on with your day if you have a tension headache. Symptoms, apart from the head pain itself, may (but doesn’t always) include tenderness in the face, head, neck or shoulders, a sense of pressure behind your eyes, and sensitivity to light or sound. The triggers for a tension headache can be many and varied. They include lack of exercise, poor sleep, dehydration, eye-strain, skipped meals and bad posture. So some lifestyle changes can make a big difference here.
How to manage: Have yourself a big glass of water, and lie down on your posture pole, this is the best thing to relieve the strain on your body and muscles that are the cause of your headaches in this case.
When to seek help: These headaches normally last from half an hour to several hours. If its gone on for days, and you aren’t getting relief, then you may need to chat to your healthcare provider. A typical sign of these headaches is they go away or ease when you lie down.
Prevention: Lifestyle changes are recommended to prevent these suckers. Improve your posture! This is the biggy, and will help dramatically if it is a true tension headache. Get yourself good sleep. Exercise regularly… (check out the exercises to avoid in our eBook) Make sure you don’t need glasses. Get some if you do. But here’s the kicker for me – manage any stress, anxiety or depression that might be feeding into this tension type headache. A chiropractor can also help make sure there isn’t anything causing that wind-up in your upper back and shoulders and contributing to your headaches.
- The Cluster Headache. If a tension headache is a pain in the bum, and a migraine headache is a bitch, a cluster headache is an absolute psycho (plus a whole lot of other swear words). They usually hit without warning, last between 15 minutes and 3 hours, and come with intense burning, piercing pain (usually behind or around one eye).
Why are they called cluster headaches? Because people can experience clusters of attacks lasting from weeks to months and typically it’s a pattern – (i.e. they hit at the same time of day). They’re nicknamed the alarm clock headache.
How to manage: Whatever works in the moment! Deep breathing exercises are thought to help, as is magnesium. Pain relief can be a bit of a mystery, as researchers are still trying to understand them. Don’t use alcohol during a cluster headache. Note: some people have found that the only thing that helps them is Oxygen Therapy, in extreme cases a hyperbaric chamber may be your best bet. Speak to your healthcare practitioner about this.
When to seek help: If you are having trouble managing your cluster headache, you might need to head on in to your healthcare provider or even the emergency room for a bit of help. These headaches are the stuff of nightmares and can be very difficult to manage. Symptoms should disappear within a few days, but if you identify your triggers (which will take a bit of work with your healthcare provider) you might be able to decrease the attacks. Note: triggers in cluster headaches are sometimes very hard to track down. The medical profession is still confused about what causes them, although they do tend to affect men more than women, so hormones are hypothesised to play a role.
Prevention: Quit smoking, taking up yoga, do daily exercise, and take a magnesium supplement.
Common secondary headaches
- Vascular (or hypertensive) headaches. This type of a headache is usually caused by high blood pressure, and it’s dangerous. It will usually occur usually on the top (vertex) of your head, usually towards the top of your head in a pulsating pattern. It usually gets worse with activity, and can also be made worse when lying down (all that blood pools in your head).
When to seek help: If you think you are experiencing one of these, or if you experience any changes of vision, numbness, tingling, blood noses, chest pain, shortness of breath or have had blood pressure issues in the past – get to the emergency room. Don’t mess around with these guys.
Prevention: Get that blood pressure down and keep it down. Chat to your healthcare provider about how to do this.
- Exertion headaches. These headaches happen quickly after periods of intense physical activity. If you’ve gone for a run, lifted some weights, or had a little sexy time, you might get one of these. They won’t last too long, usually resolving within a few minutes (which can seriously ruin the buzz of the endorphins – from your exercise session, of course). If you get these regularly, chat to your health-care provider to make sure there’s not some underlying condition causing it.
- The Sympathetic Dominance Headache: This one is one you’ll probably only hear about here for a while, but its one I see a lot. Does your headache get worse toward the end of the day, start at the back of the neck and radiate over the top of your skull towards your forehead? Is it more common during periods of high stress? Are you sensitive to light, and noise? Do your shoulders feel like concrete? Then we might need to talk about some lifestyle changes and supplements that can help calm your nervous system.
How to manage: Pop in some earplugs, and get some red-lens glasses. Have a glass of water and lie down on your posture pole (don’t drink the water at the same time though!).
Prevention: A magnesium supplement is excellent, as is some time on a posture pole. But have a chat to an SD certified practitioner to get the full picture here, as you’ll need to identify the physical, chemical or emotional stressor that is keeping your system on high alert.
- The ones that get worse when you bend forward: This is usually a sinus headache, which causes pain in the front of the face, in the sinus passages, behind the cheeks, nose and eyes. When you bend over, the pain tends to spike. You might get this type of headache if you have a cold or flu. These are the ones that come on with hayfever season and may be accompanied with teeth or jaw pain.
How to manage: You’ll need to look at the underlying cause, not just the headache.
- Other secondary headaches: Some secondary headaches are hormonal (affecting women in menopause, or at certain times in their monthly cycle for example). These are things you’ll have to work through with your healthcare provider. Some are traumatic (concussions or head injuries for example). Don’t muck around with these. You’ll need to get checked to make sure that spine of yours is okay, and that there’s no brain trauma involved. Get to a hospital. and at the very least after a concussion (no loss of consciousness) make sure you have someone checking on you every 15 minutes for the first couple of hours and stretching to 30mins for the rest of the day. Some headaches may be allergy related, in which case you’ll need to look at that. The list here can be endless really.
In the case of hay fever headaches, it’s wise to make sure its actually hay fever. Sometimes cluster headaches can be misdiagnosed as hay fever headaches as they can cause swelling or weeping eyes.
There are rare types of headaches like thunderclap headaches, spinal headaches or ice pick headaches. But we’d be keeping you here all day if we were to list and talk about all of them.
The take home lesson is this: your lifestyle and stress load matters. Headaches happen to the vast majority of us, and it’s what we do outside of the headache episode that can have the greatest bearing on how often we suffer them.
My top recommendations for a healthy lifestyle that reduces the likelihood of severe headaches are:
- Stay hydrated
- Eat well
- Take a magnesium supplement
- Use a posture pole at least once daily for 15 minutes to help correct posture
- Meditate and reduce your stress load
- Check in with your health provider to make sure there’s no underlying cause if you suffer from regular debilitating headaches.
Above all if this is a new headache, the headache is the worst you’ve ever had, one that wakes you up at night or you get any visual changes or paralysis/tingling go seek medical advice straight away.
Live life on your terms