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​​What is a headache?

A headache is pain or discomfort in the head or face area. Headaches vary greatly in terms of pain location, pain intensity, and how frequently they occur. This results in several categories of headaches. While the actual brain tissue doesn’t have pain-sensitive nerve fibers and doesn’t feel pain, other parts of the head can be responsible for a headache including:

  • A network of nerves that extends over the scalp
  • Certain nerves in the face, mouth, and throat
  • Muscles of the head, neck, and shoulders
  • Blood vessels found along the surface and at the base of the brain (these contain delicate nerve fibers)​​

​​​What causes a headache?​​

Headaches are classified as primary or secondary.

A primary headache means the headache itself is the main medical problem, although other factors, such as muscle tension or exposure to certain foods, may be identified.  Other contributing factors include medications, dehydration, or hormone changes.

A secondary headache is related to an underlying medical condition.  An example of this would be a headache due to neck injury, eye problems, jaw, teeth or sinus infection. 

​​What are the symptoms of a headache?

​Headache symptoms depend on the type of headache.  The frequency of headaches and the intensity of the symptoms may vary as well.  Typical headache symptoms include:

  • ​​Slow onset of the headache
  • Head usually hurts on both sides
  • Pain is dull or feels like a band of vice around the head
  • Pain may involve the back (posteriori) part of the head or neck
  • Pain is mild to moderate, but not severe

 ​​*Tension type headaches typically do not cause nausea, vomiting, or sensitivity to light.  The symptoms of a headache may resemble other conditions or medical problems.  Always consult your physician for a diagnosis.

​​How is a head​ache diagnosed? 

​​​The full extent of the problem may not be understood immediately, but may be revealed with a comprehensive medical evaluation and diagnostic testing.  The diagnosis of a headache is made with a careful history, physical examination and diagnostic tests.

Questions commonly asked during the exam may include, but are not limited to, the following:

  • ​When do headaches occur?
  • What is the location of the headache?
  • What do the headaches feel like?
  • How long do the headaches last?
  • Have there been changes in behavior or personality?
  • Do changes in position or sitting up cause the headache?
  • Do you have trouble sleeping?
  • Do you have a history of stress?
  • Is there a history of head injury?​

​​​If the history is consistent with migraine​ or tension-type headaches and the neurological exam is normal, no further diagnostic testing may be necessary.  However, if it is not a primary type headache, then other tests may be needed to determine the cause which include:

  • ​​Blood tests.  Various blood chemistry and other lab tests may be run to check for underlying conditions.
  • Sinus x-rays.  A diagnostic imaging procedure to evaluate for congestion of other problems that may be corrected.
  • Magnetic resonance imaging (MRI).  A diagnostic procedure that uses a combination of large​​ magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
  • Computed tomography scan (also called a CT or CAT scan).  A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body.  A CT scan shows detailed images of any part of they body, including the bones, muscles, fat, and organs.  CT scans are more detailed than general X-rays. 

​​​How are headaches treated?

Specific treatment for the headaches will be determined by your physician based on:

  • ​Your age, overall health and medical history
  • Type of headaches
  • Severity and frequency​ of the headaches
  • Your tolerance for specific medications, procedures, or therapies
  • Your opinion or preference

 ​​​​The ultimate goal of treatment is to stop headaches from occurring.  Adequate headache management depends on the accurate identification of the type of headache and may include:

  • ​​Avoiding​ known triggers, such as certain foods and beverages, lack of sleep, and fasting
  • Changing eating habits
  • Exercise
  • Resting in a quiet, dark environment
  • Medications, as recommended by your physician
  • Stress management

​​*Some headaches may require immediate medical attention including hospitalization for observation, diagnostic testing, or even surgery.  Treatment is individualized depending on the underlying condition causing the headache.  Full​ recovery depends on the type of headache and other medical problems that may be present.​