Headaches

A headache is pain or discomfort in the head, scalp, or neck.

The most common type of headache is tension headache. It is likely caused by tight muscles in your shoulders, neck, scalp, and jaw.

 

A tension headache may be related to stress, depression, anxiety, a head injury, or holding your head and neck in an abnormal position. It tends to be on both sides of your head and often starts at the back of the head and spreads forward. The pain may feel dull or squeezing, like a tight band or vice. Your shoulders, neck, or jaw may feel tight or sore.

 

A migraine headache involves severe pain. It usually occurs with other symptoms, such as vision changes, sensitivity to sound or light, or nausea. With a migraine the pain may be throbbing, pounding, or pulsating. It tends to begin on one side of your head. Migraines may be triggered by foods, such as chocolate, certain cheeses, or monosodium glutamate (MSG). Caffeine withdrawal, lack of sleep, and alcohol may also be triggers.


Rebound headaches are headaches that keep coming back. They often occur from overuse of pain medicines. For this reason, these headaches are also called medicine overuse headaches. People who take pain medicine more than 3 days a week on a regular basis can develop this type of headache.

Clinicians typically use a person's description of their headache, in combination with an examination, to determine the type of headache. Some people have more than one type of headache.

Most people do not need x-rays or imaging tests. A CT scan (or MRI) may be recommended in some circumstances, for example, if symptoms are unusual, if there are any danger signs or if there are any abnormalities seen during the examination.

Other possible reasons for brain imaging include:

●Headaches that steadily worsen despite treatment

●A sudden change in the pattern of headaches

●Signs or symptoms that suggest that another medical condition may be causing symptoms

 

Most intermittent tension-type headaches are easily treated with over-the-counter medications, including:

  • Aspirin
  • Ibuprofen (Advil, Motrin IB, others)
  • Acetaminophen (Tylenol, others)

Daily prescription medications, including tricyclic antidepressants, may manage tension-type headaches. Medications combined with behavior therapies may be more effective.

In addition, alternative therapies aimed at stress reduction may help. They include:
  • Meditation
  • Relaxation training
  • Cognitive behavioral therapy
  • Biofeedback
  • Massage and gentle neck stretches
  • Heat therapy (warm compress or shower)