You feel it creeping in… Whether it’s a dull throb on the left side of your head, a tight band squeezing behind your eyes or maybe a sudden stabbing pain that stops you in your tracks. Nearly everyone has experienced at least one type of headache. Headaches are so common that most people brush them off as a part of life, but they’re much more complex than a simple nuisance. They can signal anything from dehydration to a life-threatening stroke. And when you know what type of headache you’re dealing with, you’re in a better position to treat it and prevent it from coming back.
Whether you’re trying to decode a left-sided headache or want the clear science behind “what is a headache?” read on to learn more about headaches, their diagnoses, treatment and the reasons behind them.
[READ: Cluster Headaches: 10 Things You Should Know]
Types of Headaches
Headaches are a type of pain located in the head or face, ranging from mild to severe. Headaches can be caused by a variety of factors or underlying conditions. Not all headaches are created equal. Medical providers break down headaches into two major categories, called the hierarchy of headaches:
— Primary headaches. With a primary headache, the headache is not tied to an underlying condition. Rather, it’s a stand-alone condition that requires identifying triggers and making lifestyle adjustments. “Most headaches are primary headaches, meaning they are not caused by a serious medical problem, such as infection, brain tumor, aneurysm, stroke and so on, says Dr. Ella Akkerman, a board-certified neurologist at VSI, formerly Virginia Spine Institute, in Reston, Virginia.
— Secondary headaches. Think of a secondary headache as a headache that has another root cause. It can range from a minor condition, such as tooth pain, to a medical emergency, like a brain bleed.
A headache is considered chronic if it occurs 15 or more days per month. From there, health care providers further classify headaches based on their patterns, triggers and symptoms. The chart below explains some of the most common headaches and what sets them apart.
| Headache type | Symptoms | Distinctive feature | Common locations |
| Tension headache | Pressure or tightness | Often triggered by stress or poor posture | Both sides of the head |
| Migraine | Throbbing pain, sensitivity to light and sound, may include an aura, may be accompanied by nausea or vomiting | Attacks can last hours, up to days, and usually migraines are worse with activity | Usually stays a right-sided or left-sided headache, but it can shift sides |
| Cluster headache | Intense burning or stabbing “icepick” pain | Can be accompanied by red or watery eyes and nasal congestion. Occurs in “clusters,” usually at the same time each day for weeks | Around or behind one eye |
| Sinus headache | Facial pressure, congestion | Worsens when leaning forward | Forehead, cheeks or bridge of nose |
| Occipital neuralgia | Sharp, electric or burning pain | Triggered by neck movement or touch | Base of skull or nape of neck that radiates up to the eye, often involving the cheek or forehead |
| Cervicogenic headache | Neck stiffness | Pain worsens with neck movement | Back of head, radiating to the front of the head |
| Rebound or medication overuse headache | Could be dull or throbbing pain | Often in the morning, daily or nearly daily and improves with stopping the offending medication | Diffused across the head |
| Thunderclap headache | Sudden, intense “worst headache ever” pain | Often signaling a medical emergency, pain peaks at 30 to 60 seconds but can last up to hours. Seek emergency medical care to rule out a life-threatening cause, such as a brain hemorrhage or stroke | Diffused across the head, can radiate |
[READ Pain and the Mind-Body Connection]
Causes and Triggers
Some headaches are harmless, but identifying the reason for your headache can give you insight into whether there could be an underlying concern and which steps to take to prevent the headache from recurring.
Common headache triggers include:
— Demographics. Headaches tend to occur in some populations more than others. “In general, headaches are more frequent in women of childbearing age,” Akkerman says. Headaches peak between the ages of 25 and 40 and decrease with age in both men and women, notes literature from StatPearls.
— Genetics. Some headache conditions run in families, according to the National Institute of Neurological Disorders and Stroke (NINDS). Researchers are even investigating how genes play a role in headaches related to sleep-wake cycles.
— Lifestyle factors. Daily habits can make an impact on headache occurrence. “In general, headaches tend to occur more in those with a sedentary lifestyle and less in those who exercise regularly,” Akkerman says. Inadequate sleep and smoking are also linked to an increased chance of headaches.
— Hormonal changes. Hormonal headaches start in puberty and peak in perimenopause due to significant hormonal fluctuations. These headaches often improve after menopause or age 65, Akkerman says.
— Dietary triggers. What you eat or drink also plays a role in headache frequency. “Unhealthy diet, excessive caffeine use and excessive alcohol use may also cause increased headache risk,” Akkerman says. The NINDS warns against common headache and migraine trigger foods, such as aged cheeses, wine, chocolate, cured meats, nuts and aspartame, a type of artificial sweetener.
— Environmental factors. External conditions can set off headaches or make them worse. Bright lights, loud noises, strong odors or changes in air pressure can be triggers.
— Medications. Using analgesics, such as ibuprofen or acetaminophen, more than two to three days of the week on a regular basis is linked to an increased chance of headaches, Akkerman says. Some prescription drugs, such as vasodilators or hormone therapy, can also increase risk.
— Medical conditions. There are medical conditions that tend to co-occur or be comorbid in patients with headaches or an increased risk of headaches, Akkerman says. These include sleep disorders, mental health conditions, high blood pressure, asthma, diabetes, anemia, nutritional deficiency, a history of concussion and many other health conditions that may influence headache occurrence.
[SEE: Ranking the Most Painful Medical Conditions]
Diagnosis
For occasional or mild headaches, home management is often enough. Researchers suggest that around 96% of headaches are benign. But when headaches are frequent, severe or unusual to you, it’s worth discussing with a medical professional to investigate the underlying cause or to help with pain management. Primary care providers can treat many types of headaches, but there are also providers who specialize in headache diagnosis and treatment.
How to keep a headache journal
To make the most of your appointment with a general practitioner or a headache specialist, consider keeping a headache journal.
Here is an example of a headache journal setup, with a sample row:
| Date and time | Pain location | Pain severity (1-10) | Duration | Other symptoms | Observations and possible triggers | Relief tried and outcome |
| Wednesday, Sept. 3, noon | Left side of head | 8 | Four hours | Aura, nausea | Occurred around menstrual cycle | Took medication, rested in a dark, quiet space |
Medical professionals diagnose headaches in three key steps:
— Medical history. Your health care provider will ask you about past medical conditions and surgery, medications you are currently taking and your family history of health conditions. This information can sometimes point to a diagnosis. For example, if you had a recent ear infection, your health care provider may consider a sinus headache diagnosis.
— Physical and focused neurological and head, ear, eyes, nose and throat (HEENT) exam. Your provider will ask you specific headache questions, such as what type of pain it is, when it occurs and what you have tried for pain relief. This is why keeping a headache journal can be very helpful. As part of the neurological exam, a provider will check your balance, coordination and reflexes to rule out possible neurological causes. During the HEENT exam, the provider will inspect your ear, eyes, nose and throat for any infection or inflammation that could be causing headaches.
— Occasional labs or imaging. It’s unusual to have lab testing for routine headaches, but for certain types of headaches, lab tests are necessary. For example, if a pregnant woman is having frequent headaches, a provider will order lab tests to check if preeclampsia is the culprit. Imaging, such as a CT or MRI, for every headache is also non-standard but is ordered in some cases. For example, headaches that are accompanied by a concerning neurological exam or headaches associated with nausea or vomiting.
Should you see a headache specialist?
“It’s not uncommon for me to see patients who have exhausted at-home treatment options and then eventually pursue evaluation in the headache clinic,” says Dr. Melissa Ann Moore, a neurologist at Tampa General Hospital and USF Health in Tampa, Florida. “Often, the main issue is finding the right diagnosis to help guide treatment. This includes the proper headache diagnosis, as well as identifying other comorbidities that will affect treatment.”
Dr. Jessica Kiarashi, a neurologist and headache expert at UT Southwestern Medical Center in Dallas, adds that “the unfortunate thing is that many patients will start using over-the-counter medications like acetaminophen or ibuprofen to treat the pain, and by the time they are able to see a headache medicine specialist, they are using these medicines daily.”
However, this kind of approach can lead to medical overuse headaches, which will only compound the issue.
A headache specialist can help get to the bottom of your headache diagnosis and treatment.
Red flag headache symptoms
If you experience any of these symptoms accompanied by a headache, don’t wait for a headache appointment; seek immediate care by visiting your local emergency department or calling 911.
You can use the mnemonic “SNOOP” to help you remember red flag headache symptoms:
— S: Systemic illness or condition, such as a fever, pregnancy or cancer
— N: Neurologic signs or symptoms, such as confusion, difficulty with speech, seizures or weakness
— O: Onset is new or sudden
— O: Other associated features, which could include head trauma, drug use or when a headache causes you to wake up from sleeping
— P: Previous headache history that has now progressed or has new characteristics
Treatment
Most headaches are episodic, meaning they are infrequent and don’t require medical attention. Others are considered chronic, meaning they occur more than a few times a month. So, how can you tell whether a headache is severe enough to warrant medical attention?
“Unfortunately, primary headache disorders are not fixable,” Kiarashi says. “Migraine, for example, is a neurologic disease for which there is no cure. All the treatments we have available are aimed at decreasing the burden of the disease.”
This means the goal of treatment is to decrease your pain and associated symptoms.
At-home headache treatment
At-home treatment options include:
— Cold or warm compress
— Relaxation techniques, such as meditation or deep breathing
— Over-the-counter pain relievers, such as ibuprofen or acetaminophen. However, don’t use these for headache treatment long-term without consulting a health care provider. You risk developing a rebound headache.
Headache pressure point therapies
Commonly tried headache pressure point therapies include:
— Acupuncture. “This targets specific pressure points and has moderate evidence supporting its effectiveness for conditions like chronic pain and migraines, with studies showing it may outperform placebo in some cases,” says Dr. Reuben Chen, a Fort Worth, Texas-based board-certified sports medicine physician, longevity expert and the chief medical advisor at Sunrider International, a global health and wellness company that combines traditional Chinese medicine with modern science. Common pressure points treated for headaches include the back of the head, the shoulders and the hands.
— Acupressure. “This is a noninvasive cousin where the practitioner places controlled pressure over specific pressure points; (it) shows promise for nausea and pain relief but lacks robust, large-scale trials to confirm its efficacy,” Chen says.
— Reflexology. “Reflexology is often claimed to influence organs through foot pressure points, but it has little scientific backing, with most studies showing no significant benefits beyond placebo,” Chen says.
— Aromatherapy. “Aromatherapy and essential oil massages, sometimes combined with pressure point techniques, have limited evidence, mainly supporting mild relaxation effects but not specific health claims,” Chen says.
Overall, acupuncture has the strongest evidence among alternative pressure point therapies, Chen says.
Prescription headache treatment
Prescription headache treatment options include:
— Triptans. Triptans, such as sumatriptan, are oral medications that provide long-term headache relief and may be used to prevent or stop migraines.
— Botox injections. Botox injections are used for those with chronic migraines. Botox interrupts pain signals in the head and neck pathways. For insurance to cover Botox injections for headaches, you need to submit medical records demonstrating that you have 15 or more headache days per month, you have typical migraine symptoms, such as a unilateral headache, and you have tried other options without significant relief.
— Corticosteroids. Steroids, such as dexamethasone, can decrease headache recurrence, including migraine recurrence.
— Calcitonin gene-related peptide inhibitors (CGRP). CGRP is a protein involved in migraine pain. CGRP inhibitors, such as Aimovig, are injectable therapies designed to reduce migraines by binding to the CGRP molecule directly to prevent it from activating its receptor.
— CGRP receptor antagonists. CGRP antagonists, such as Ubrelvy, are oral medications for acute migraine attacks. They work by blocking the CGRP receptor.
If you end up seeking inpatient or emergency care for headaches, a provider may also administer fluid rehydration or oxygen therapy to help alleviate your headache. Treatment for secondary headaches should always focus on treating the underlying cause of the headache.
Prevention
Even though not all headaches are avoidable, some lifestyle changes can make a big difference.
Sleep, hydration and exercise, for instance, can have a huge impact on many headache disorders, Moore says. In addition to lifestyle changes, keeping a headache journal and avoiding your triggers can help prevent headaches.
“I think these are sometimes difficult to do because of work and life, causing challenges with time management, but it is very important to make time for our health,” Moore says.
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A Patient’s Guide to Headaches originally appeared on usnews.com
Update 09/03/25: This story was published at an earlier date and has been updated with new information.
