Pain or discomfort in the head, scalp, and/or neck has many causes.
Anxiety, stress, caffeine withdrawal, or depression
Lack of sleep. Poor sleep position.
A sensitivity to certain foods and drinks.
Reading a lot, especially in dim light
Missing or delaying a meal
Doing boring work
Being in one position for a long time, like at a computer
Exposure to chemicals and/or pollution
Side effects from some medications
Hormone changes that come with menstruation, while taking birth control pills, etc.
Dirty or polluted air
Airplane travel
Alcohol
Poison
Poor posture
Cigarette smoke
Too much physical activity
Bright lights. This includes watching TV.
Movement, such as riding in a car or elevator
Loud noises
Strong odors
Eating or drinking something very cold, such as ice cream
A headache can be a symptom of many health conditions. Some of these are:
Allergies
Arthritis in the jaw joint
Depression
Fever
Flu
High blood pressure
Low blood sugar
Infections
Pinched nerve in the neck
Shingles
Dental problems
Less often, a headache can be a symptom of a serious health problem that needs emergency medical care. Examples are:
Acute glaucoma
Stroke
Tumor
Blood clot
Ruptured blood vessel (aneurysm) in the brain
Types
Tension or Muscular Headaches
About 90 percent of all headaches are tension or muscular headaches. These headaches respond well to self-care, without causing ongoing problems. Symptoms include:
Dull ache in your forehead, above your ears, or at the back of your head
Pain in your neck and shoulders
Tense or tight muscles in the face, neck, or scalp result in these headaches. Common causes are:
Fever
Poor quality sleep
Stress or worry
Concentrating hard for long periods of time
Physical postures that strain the head or neck, such as working at a computer
Dehydration
Sinus Headaches
Symptoms include:
Pain in your forehead, cheekbones, and nose
Pain is worse in the morning.
It hurts more if you bend over or touch your face.
Stuffy nose
Sinuses are behind your cheeks, around your eyes, and in your nose. You may get a sinus headache from:
A cold or upper respiratory infection
Allergies, like hay fever
Other breathing problems
Swimming in dirty or polluted water
Airplane travel
These things interfere with fluid drainage in the nose, causing a buildup of pressure. Pain results.
Cluster Headaches
This uncommon type of headache usually start at night, can last from 15 minutes to 3 hours, and can interrupt sleep. They can also start during the hours a person is awake. These headaches come once or twice a year, usually in older men, and tend to run in families.
Symptoms include:
Sharp, burning, stabbing or steady pain on one side of your head, often involving the eye
Watery eyes
Your pupils look smaller.
One or both of your eyelids droop.
Runny or stuffy nose on the same side as the neck pain
Red, flushed face with extreme sweating
You get headaches in groups (clusters), everyday for a week or longer.
Migraine Headaches
Migraines happen when blood vessels in your head open too wide or close too tight. At least one in eight adults suffer from migraines. Women have migraines more often than men. Migraines tend to run in families, too. Symptoms include:
One side of your head hurts more than the other.
You feel sick to your stomach or throw up.
You may see spots or zigzag flashes of light.
Light hurts your eyes.
Noise bothers you.
Your ears ring.
Your face is pale.
After the headache, some people have a drained feeling with tired, aching muscles. Others feel great after the headache goes away.
Types of migraine headaches:
Migraines with an aura. Some people experience auras about 10 minutes to 1 hour before the actual headache. Symptoms include vision changes, flashing or bright lights, ringing in the ear, muscle weakness, trouble speaking, and tingling in the hands or face.
Migraines without an aura. They start more slowly and tend to last longer than migraines with an aura. Most migraines are this type.
Prevention
Keep a headache diary. Write down when, where, and why the headaches seem to start. Try to avoid things that trigger headaches.
Try to stop the headache as it begins.
Exercise on a regular basis.
Keep regular sleep hours, even on weekends.
Don’t smoke. If you smoke, quit.
Cut down on salt.
Avoid excess alcohol. Alcohol can lead to a “hangover” headache.
Don’t have foods and drinks known to trigger headaches in sensitive people.
Treatment
Usually, headaches are not linked to serious health problems. Self-care treats most headaches.
Self-Care
Rest in a quiet, dark room with your eyes closed.
Rub the base of your skull with your thumbs. Work from the ears toward the center of the back of your head. Also, rub gently along the sides of your eyes, your shoulders, neck, and jaw.
Take a warm bath or shower.
Place a cold or warm washcloth, whichever feels better, over the area that aches.
Take an over-the-counter (OTC) medicine (that your provider recommends) for pain. Take it right away.
Relax. Imagine a calm scene. Meditate or breathe deeply.
Medication
Over-the-counter (OTC) pain medications. Examples are aspirin, ibuprofen, naproxen sodium and ketoprofen. Most tension and muscular headaches go away with OTC medications. Some OTC medicines (e.g., Excedrin Migraine® and Motrin Migraine Pain®) are FDA approved for migraine headaches.
Prescribed medicines. Examples are:
Triptan drugs, such as sumatriptan
Ergotamines
Antihistamines
Beta-blockers
Calcium channel blockers
Tricyclic antidepressants
Take medicines as prescribed.
Biofeedback
Biofeedback is a process of learning how to control internal functions to relieve pain. These things occur with biofeedback:
A biofeedback therapist explains how the muscles react to stress and cause tension headaches.
A headband, connected to a machine, is fastened across your forehead. The machine emits a steady sound that changes if muscles in the head or neck are tensed.
A small thermometer is attached to one of your fingers. Another machine keeps track of your temperature.
You learn how to use these biofeedback machines.
You learn to control the automatic response of your muscles and blood vessels that cause headaches.
Then you learn to do the same thing without the machines to control headaches on your own.
Reasons to Get emergency Care
A headache due to a serious head injury or a blow to the head causes severe pain, enlarged pupils, vomiting, confusion, or feeling sleepy.
Severe pain occurs in and around one eye.
A severe, persistent headache occurs with a stiff neck or a red or purple rash that doesn’t fade when pressure is applied to the skin.
The headache came on suddenly and hurts much more than any headache you have ever had.
Call 9-1-1 if signs of a stroke occur:
A sudden and severe headache with no known cause
Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Reasons to Call Doctor or Health Care Provider
The headache has lasted more than 2 to 3 days and keeps getting worse.
Migraine headaches (intense, throbbing, one-sided, often with nausea or vomiting) occur often. Flashing lights or spots may precede the pain.
A headache persists or recurs and is present with nausea or vomiting.
A headache started after taking a new medicine (prescribed or over-the-counter).
Your headaches wake you up from sleep, make it difficult to fall asleep, or keep you from working or participating in normal activities.
Work with Your Health Care Provider
For headaches that do not need medical care fast, contact your primary care provider first. Most likely, they will be able to figure out the type of headache you have. If not, they can refer you to a specialist.
Tips on working with your doctor or health care provider:
Make notes before your office visit.
List every symptom, even if it seems minor.
Be honest with your health care provider. The facts you give could be important in finding out why you have headaches.
Follow your doctor’s advice. Let them know if the prescribed treatment helps. Tell your doctor if you have any side effects from treatment.
Answer these questions before your office visit:
When did your headaches begin?
How long does your headache last?
How often do you have these headaches?
Where does it hurt (both sides, one side, etc.)?
Is there a pattern to your headaches?
Are your headaches different from each other?
Are there any symptoms just before the headache begins?
What helps the headache go away (rest, medicine, hot or cold treatment, massage)?
Does anything make the pain worse (moving the head, standing or lying)?
Does an activity or situation bring on headaches (after exercise or eating a certain food)?
