It’s hard enough to get through the work week when you’re feeling your absolute best. But for about half of the adult population worldwide, the daily grind can be complicated by regular headaches that cause everything from nagging, unpleasant tension to overwhelming, debilitating pain. And while so many people suffer from some form of the affliction, many don’t know the specific type of headache they’re dealing with, whether they should be concerned, or if it’s necessary to see a health care provider. Headaches that are severe and have associated neurological changes (weakness in one arm, numbness, etc) require urgent medical attention, but there are far more common types of headaches that do not require a trip to the emergency room. Here’s a guide to three kinds of headaches frequently encountered in our clinics and tips for taming symptoms and getting the right kind of care.
If you’ve ever experienced mild to moderate squeezing pain on both sides of your head, you’ve very likely experienced a tension headache. And it makes sense that you have since about three out of every four adults deals with them once in a while. “These are the most common types of headaches,” says Boston based One Medical provider, Michael Richardson, MD. “They’re bilateral [occur on both sides] and create constant pressure that’s like a band around your head.”
In addition to the signature dull, tight head pain, people who experience tension headaches may also feel aches and pains in their neck and shoulders and/or sensitivity to light and sound. The cause of tension headaches isn’t fully understood, but experts suspect stress can play a big part in triggering the issue. For some people who experience tension headaches, the pain can last for about 30 minutes — for others, it can last a whole week. And if the pain occurs for 15 or more days a month for at least three months, they’re considered chronic.
When it comes to managing the pain of tension headaches, everyone is different. Some people find that over-the-counter pain relievers like aspirin, naproxen, and ibuprofen can do the trick and nip symptoms in the bud. For people with severe and/or chronic tension headaches, prescription pain relievers may be necessary to effectively ease the pain. Medicine isn’t always a necessity, though — tension headaches may be preventable and manageable through lifestyle techniques like stress management and home remedies like heating pads or ice packs.
Unlike the dull, nagging pain of tension headaches, migraines are powerful, pounding, and relentless, often lasting hours or days. “Migraines are intense, unilateral [occurring on one side], and usually in the temple,” Richardson says. “They’re sharp and feels like a hammer hitting your head.”
Another telltale sign of a migraine is an aura — a temporary visual, sensory, or speech symptom that appears gradually and can last up to an hour (think: seeing spots, feeling pins and needles in the limbs, or having a hard time getting words out). “An aura is a funky sensorial event before the headache hits, usually affecting vision but can be presented in other ways such as a change in speech or limb numbness,” Richardson says. “These sensations are temporary and usually resolve in an hour, but the headache can last all day.” The tricky thing is, some people with migraines experience these sensory symptoms while others don’t, so some people have a hard time figuring out whether their headaches are migraines or something else entirely. Some other symptoms that may accompany migraines: nausea, vomiting, lightheadedness, and blurry vision.
If you suspect you’re suffering from migraines, your health care provider may refer you to a neurologist or order imaging tests to rule out other more serious causes of head pain, but imaging is not needed to diagnose migraines specifically. When it comes to treatment, pain relievers and preventive medications are usually the go-to strategies. Over-the-counter pain meds may work for mild migraines, but prescription drugs may be necessary to combat more severe cases. In terms of prevention, migraine sufferers have found relief from a variety of methods like blood pressure-lowering medications, anti-seizure drugs, and even Botox injections. Everyone’s treatment plan is unique, so it’s important to work with a provider who can collaborate with you on an effective strategy.
It’s tough to mistake cluster headaches for the other two types described above — these are severe, recurrent, and are usually characterized by burning or piercing pain behind or around one eye. “Cluster headaches are uncommon,” Richardson says. “They’re intense, constant, usually focally located near the eye and are associated with a tearing eye and unilateral runny nose.”
These types of headaches can come on suddenly without warning and last anywhere from 15 minutes to three hours — but in severe cases, they can strike up to eight times in a single day. For some people, the pain can be so disturbing and agitating, they have a hard time sitting still. Like migraines, imaging is not needed to diagnose cluster headaches but your provider may refer you to a neurologist or order some imaging to rule out more concerning causes of your headache (tumor, intracranial bleed, etc).
While there’s no cure for cluster headaches, it’s possible to decrease their severity and even prevent them from occurring. The same medications used on migraines are also helpful in treating acute symptoms, but there are prescribed medications, such as calcium channel blockers, that may help prevent the headache from occurring.
Have a nagging headache and need some medical advice? Coping with a chronic issue that you finally want to address? Make an appointment with a One Medical provider today and get started on your wellness journey.
The One Medical blog is published by One Medical, an innovative primary care practice with offices in Atlanta, Boston, Chicago, Los Angeles, New York, Orange County,Phoenix, Portland, San Diego, the San Francisco Bay Area, Seattle, and Washington, DC.
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