What your headache locations tell you
Headaches are due to pain-sensitive structures in the head being stimulated by the factor that triggers headaches, either by over-activity or by disease, internal or external to the skull. There are a variety of factors that cause headaches. The location of the headache plays a crucial role as a starting point for diagnosing the cause of various types of headaches, leading to the appropriate treatments, the ability to cope with pain, and the decision when to see a doctor.
What are the most common types of headaches and locations?
The common types of headaches and locations that are not caused by disease or abnormalities within the structure of the head are as follows:
Tension-type headache
Tension-type headaches are both-sided headaches or bands of pain around the head caused by stress, anxiety, fatigue, sleep deprivation, or anger. Tension-type headaches are the most common, with symptoms ranging from mild to moderate, beginning in the forehead, temples, back of the head, or neck, feeling like a squeeze or tightening band around the head.
Typically, those with tension-type headaches can perform daily activities such as bending over, walking up and down stairs or lying down. The duration of the pain ranges from 30 minutes or more to several days, and you may also have migraine headaches. Tension-type headaches can be relieved with over-the-counter pain relievers, as recommended by a pharmacist.
Migraine headache
Migraine headache is the second most common type after tension-type headaches, more common in women than men; it is typically one-sided and may be associated with visual or auditory aura in a quarter of the patients. Characteristics of migraine headaches are a throbbing headache on either side of the head (a pulse-like rhythmic pain), sensitivity to light or sound, and moderate to severe pain associated with dizziness, nausea, and vomiting. Migraine headaches typically last from 4 hours to several days if not treated.
Migraine headaches are due to several factors, including changes in brain chemistry and blood vessel function, heredity, female hormones, particularly during pregnancy or menstruation, temperature change, such as hot weather, certain foods containing preservatives, certain medications, such as vasodilators, fasting with low blood sugar, or insufficient rest.
Mild migraine headaches can be relieved with prescription medication, biofeedback therapy with a hospital specialist to practice mind-body control and create balance, acupuncture, or even Botox injections.
Cluster headache
Cluster headaches are severe one-sided headaches with pain in an eye socket or the temple. Cluster headache sufferers experience a periodic sharp, stabbing pain to the point they become agitated or restless. Other symptoms include tearing, conjunctival injection, eyelid swelling, a runny nose, sweating, ptosis, or constricted pupils. Cluster headaches are more intense than migraine headaches and more common in men than women.
Cluster headaches are due to abnormal brain hypothalamic activation with secondary activation of the fifth cranial nerves-autonomic reflexes and the adjacent blood vessels. After bouts of headaches 1-3 times a day for two weeks to 3 months, they can suddenly go into remission. Cluster headaches can be relieved with prescription medications or 100% oxygen administration in the hospital for aborting the headache.
Sinus headache
Sinus headaches are diffuse headaches, spanning the face along the sinus cavities, including the eye sockets, cheekbones, forehead, and bridge of the nose, with nasal congestion, mucus, runny nose, fever, or facial swelling. The pain is intense when bending the head or trunk forward.
The underlying cause of sinus headaches must be identified and treated. If a bacterial or fungal infection of the sinus cavities is the cause of the symptoms, the neurologist will prescribe an appropriate antibiotic or antifungal medication. If the sinus pain is due to allergies, a doctor may prescribe antihistamines. If the pain is due to flu, the doctor may prescribe nasal decongestants to help reduce sinus swelling.
Hormonal headache
Hormonal headaches are one-sided and experienced early in or during menstruation due to hormonal fluctuations. Sleep deprivation, stress, and side effects of birth control pills or hormone replacement therapy can also cause changes in estrogen levels and hormonal headaches. A hormonal headache is a throbbing headache (a pulse-like rhythmic pain) with associated symptoms such as dizziness, nausea, vomiting, fatigue, and acne, accentuated when stimulated by light, color, or sound, like the pain of migraine headaches.
Headache from hormonal fluctuation can be relieved with non-steroidal anti-inflammatory drugs (NSAIDs), which should begin 2-3 days before menstruation and continue throughout the menstrual cycle. Prescription medications, triptans, can also help relieve headaches from hormonal changes.
Dehydration headache
Dehydration headaches are diffuse headaches caused by dehydration from insufficient fluid intake or severe diarrhea. Dehydration headaches can range from mild to severe, causing a dull headache or a sharp, thumping headache all over the head. Pain may occur in only one location, such as the back of the head, an anterior headache, or side headaches; pain may be aggravated when moving the body; and there may be other associated symptoms such as dizziness, dry mouth, thirst, dark urine, blurred vision, and numbness throughout the body.
Headaches caused by dehydration can be relieved by drinking water, sipping on ORS (oral rehydration salt) solution, resting, and applying a cold compress to the head. Symptoms can also be relieved by nonsteroidal anti-inflammatory drugs (NSAIDs), as instructed by the pharmacist.
New daily persistent headache (NDPH)
New daily persistent headache (NDPH) is a chronic daily headache that has sudden onset one day and does not remit. They are diffuse, non-specific location headaches that last for months to years and have no known cause. NDPH has symptoms with migrainous features. The headaches can be due to inflammation in the structures around the head, infection, brain tumor, or vascular issues, which require a thorough evaluation by a neurologist to make the correct diagnosis. There have been reports of new daily persistent headaches after influenza infection or in patients with Long COVID.
Incurable chronic headache, a warning sign in need of diagnosis
Headaches have a significant impact on daily life. Identifying the location and type of headache is critical to receiving accurate and efficient headache treatment.
Although most headaches are harmless and respond well to pain medication, if the headache worsens, or the person has previously been in an accident with head trauma, or if they are experiencing a sudden, severe headache with accompanying symptoms such as a fever that won't go away, a stiff neck, numbness, feeling confused, having trouble speaking, or blurred vision, it is critical to see a doctor who specializes in neurology for a detailed diagnosis and receive appropriate treatment to eliminate or mitigate headaches and restore the ability to carry on daily life.
