Identifying the cause of your headache is the key to getting rid of your pain and getting on with your day.
by Featured Provider April Kolb on Tuesday, June 18, 2019
Everyone gets headaches. They are so common and occur as symptoms of so many illnesses that there's an entire classification system devoted to headaches.
Typically, a headache isn't anything that a dose of Tylenol can't cure. It might even go away on its own. But then the pain comes back and you aren't sure what to do. If you can pinpoint the cause, you can find relief faster and prevent the pounding the next time.
There are so many types of headaches, it'll make your head hurt.
Seriously. There are more than 150 different types! They are classified into two categories: primary headaches that are health conditions all their own and secondary headaches, which are a symptom of something else.
It doesn't matter what your headache stems from, the result is the same — your head hurts. Of the 150-plus types of primary and secondary headaches, these three are the most likely reasons you're rubbing your forehead.
1. Tension Headaches
When you have dull, constant pain on both sides of your head, it's a tension headache. Sometimes the pain can spread across your forehead or to the back of your head. Tension headaches are the most common form of headache. They are milder than the other types and don't usually come with other symptoms, but the pain can last for hours.
There are many possible causes for that tension building in your head. Stress, anxiety and depression are common triggers. It could also be the result of a lack of exercise or sleep, eye strain, loud noises, dehydration, hunger or poor posture.
To ease the tension, take a pain reliever, says April Kolb, DO, Family Medicine physician at The Iowa Clinic's Waukee Alice's Road location.
"Usually acetaminophen doesn't work very well for tension headaches. I usually recommend ibuprofen or naproxen for that," she says.
If you get tension headaches repeatedly, you may need to look beyond short-term pain relief and make lifestyle changes that get to the root of your problem, like:
- Getting better sleep.
- Managing your stress, anxiety or depression.
- Drinking more water.
- Improving your posture.
- Getting regular exercise.
2. Sinus Headaches
Sinus headaches are similar to tension headaches in that the pain is dull and constant. Because the pain originates from your sinuses, you may be able to feel it deeper in your forehead, cheeks or bridge of your nose. Your sinus pain may worsen and spread to your teeth and jaw, which you'll notice when you walk, run, jump or exercise.
Sinus headaches are caused by sinusitis, which is inflammation resulting from a sinus infection or allergies. They typically come with other signs of allergies or infection, like nasal congestion, runny nose and thick green or yellow mucus.
If you have a sinus headache, reach for a bottle of ibuprofen or naproxen instead of acetaminophen. They are both anti-inflammatory drugs that can help ease the inflammation in your sinuses. A nasal decongestant can provide relief for your other symptoms.
"If you use ibuprofen, it would help temporarily. But you really need to figure out what the cause of the sinus issues are so you can address them — whether that's allergies, an upper respiratory infection or a bacterial sinus infection," Dr. Kolb says. "You can do symptomatic treatments too. I recommend saline nasal rinses as a good place to start."
If your headache is only in one temple on the right or left side or behind an eye, it could be a migraine. A migraine is a severe headache disorder that, believe it or not, is the third most common disease in the world. The intense, throbbing pain can last for a day or more. Along with the pounding head, migraines cause a number of other issues, including nausea and sensitivity to light or sound.
Migraines are a chronic, lifelong issue that can cause attacks multiple times a week. And it feels like nothing can provide relief. They can leave you immobile in a dark, quiet room with an ice pack on your head, hoping that the pain reliever kicks in and the migraine runs its course quickly.
"Start with ibuprofen or naproxen. I like Excedrin Migraine as well because it has acetaminophen, aspirin and caffeine in it," says Dr. Kolb. "The caffeine can help with your migraines because there's a strong vascular component to it."
Migraines are genetic, but for most people, they have a specific trigger. Many of the same things that cause tension headaches can trigger migraines. Bright lights, loud noises or hormonal changes can do it too.
If you have chronic migraines, you need a more effective remedy than you have at home. Your primary care provider can help. Headaches that occur on more than 15 days in the month over a three month period with at least eight having tell-tale migraine symptoms are probably chronic migraines. Your doctor can prescribe medications like sumatriptan or rizatriptan or other treatments to help prevent migraines.
What causes your headache may not be so clear.
Tension, sinus and migraine headaches are the most common types but there are so many more rare headache disorders or illnesses that bring them on. And your headache doesn't always fit neatly into one classification. You can have a headache on top of your head, on both sides, behind the eyes, in the back of your head or all of the above. A dull, constant headache can turn into a throbbing one, or the reverse can happen. It's hard to tell if these mixed symptoms are the signs of a tension headache, migraine or something else.
Headache Location and Relief Chart
View the following chart as a PDF.
When over-the-counter pills and other at-home treatments aren't enough, or if your pain is severe or recurring, schedule an appointment with your doctor.
If you experience any of these issues, don't wait for an appointment — get medical help right away, Dr. Kolb says:
- A headache is more severe or different than your typical headache.
- An extremely painful headache or migraine comes on suddenly.
- You have a headache following a blow to the head, which might be the sign of a concussion.
- You are confused or are having trouble with your vision, balance or speech.
- Your head hurts even worse after strenuous physical activity.
- You have weakness, tingling and numbness along with an aching head.
But most of the time, you'll be fine. You'll follow the classic advice by taking two pain relievers and not even have to call your doctor in the morning.
Meet This Featured Provider
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April Kolb, DO joined The Iowa Clinic because of its reputation for excellent patient care. She comes to the clinic from the Family Medicine Residency program at Broadlawns in Des Moines.
Dr. Kolb chose Family Medicine because of the ability to care for patients of all ages. She conside... Read More
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