Headache is defined as a symptom of pain or discomfort anywhere in the region of the head or neck. The World Health Organization (WHO) reports that almost half of all adults worldwide experience a headache in any given year. They can affect anyone regardless of age, race and gender.

The interesting fact is that the brain itself can’t feel pain. So, the pain signal is triggered by the surrounding tissues, brain chemicals, blood vessels and nerves.

35 different types of headaches are being differentiated so it is important to know about the differences, because different types of headaches require different types of treatment regimes.

If you suffer regular from headaches keep a diary regarding your symptoms noting the time of onset, any triggers, the duration of the headaches, the severity of headaches, any associated symptoms, medications taken to relieve headache symptoms, possible triggers and the relationship to menstruation.

Taking regular pain relievers more than twice a week should motivate you to investigate about the underlying reason.


During the initial diagnosis of headaches maybe further tests are suggested to exclude differential diagnosis. These can include Electroencephalography (EEG), laboratory tests, x-ray, CT or MRi scans of brain and neck or a spinal tap.

Classification of headaches are done by underlying reason:

Primary headaches

A primary headache is a stand-alone illness caused directly by a problem of chemical activity in the brain, the nerves or blood vessels surrounding the skull, or the muscles of the head and neck or some combination of these factors. The most common primary headaches include:

  • Cluster headache
  • Migraine
  • Tension type headache
  • Trigeminal autonomic cephalgia
  • Other primary headache disorders as primary cough headache, primary exercise headache, primary headache associated with sexual activity, primary thunderclap headache, cold stimulus headache (brain freeze), external pressure headache, primary stabbing headache, nummular headache, hypnic headache, new daily persistent headache.

Secondary headaches

A secondary headache is a symptom of a different disease that stimulate the pain-sensitive nerves of the head. Possible causes of secondary headaches include:

  • Monosodium glutamate (MSG)- a flavour enhancer commonly added to Chinese food, canned vegetables, soups and processed meats.
  • External compression headaches (a result of pressure-causing headgear, helmet or goggles)
  • Rebound headaches (caused by overuse of pain medication)
  • Medications to treat other disorders
  • Sinus headaches (caused by inflammation and congestion in sinus cavities)
  • Ear infection (middle ear) trauma or Injury to head
  • Influenza (flu) and other febrile (fever) illnesses
  • Spinal headaches (caused by low pressure or volume of cerebrospinal fluid, possibly the result of spontaneous cerebrospinal fluid leak, spinal tap or spinal anaesthesia)
  • Thunderclap headaches (a group of disorders that involves sudden, severe headaches with multiple causes)
  • Vascular headaches (carotid or vertebral dissections, venous thrombosis within the brain, vasculitis – inflammation of the lining of the arteries)
  • Glaucoma
  • Hangovers
  • High blood pressure (hypertension)
  • Dental problems
  • Dehydration
  • Panic attacks and panic disorder

Treatment includes rest, pain relief medication, preventative medication like beta blockers, serotonin receptor agonists and anti-epileptic drugs.

It is important to follow the doctor's advice because overusing pain relief medication can lead to rebound headaches. The treatment of rebound headaches involves the reducing or stopping pain relief medication. In extreme cases, a short hospital stay may be needed to manage withdrawal safely and effectively. As well alternative treatments as acupuncture, cognitive behaviour therapy, herbal and nutritional health products, meditation, nutrients, especially magnesium and certain B vitamins, application of heat or ice packs to head or neck can improve the headaches.

Red flags - See your doctor immediately or go to the emergency room if you have any of the following signs:

  • An abrupt, severe headache like a thunderclap
  • Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
  • Headache after a head injury, especially if the headache gets worse
  • A chronic headache that is worse after coughing, exertion, straining or a sudden movement
  • New headache pain if you're older than 50