Headache Headache Basics

What Kind of Headache Do You Have?

Some people say the pain is like a band slowly tightening around their head. Others describe pain that worsens when someone turns on a light. Both are descriptions of headaches, but they are symptoms of very different types of headaches that are generally treated quite differently.

While nearly everyone gets an occasional headache, people with chronic headaches live in fear of when the next headache will strike, and they suffer when it does. Headache specialists say the key in treating a headache successfully is uncovering what kind of headache you have. And you don't have to be a neurologist to begin classifying your headache. Below, Richard Lipton, MD, a professor of neurology, epidemiology and social medicine at Albert Einstein College of Medicine in Bronx, describes the symptoms of the most common types of headaches to help you distinguish the type of headache you tend to get.

How common are headaches?
Headache is a nearly universal human experience. In any given year, 90 percent of Americans say they've had at least one headache not caused by a cold, the flu, a hangover or a head injury. But even though headache is a nearly universal human experience, there are headache-prone individuals who have frequent attacks, where headache becomes a significant medical symptom and not just a problem of everyday life.

What are the main types of headaches?
There are two categories of headaches, primary headaches, where the headache problem is the disorder, and secondary headaches, where the headache is a symptom of an underlying condition like a stroke, a brain tumor or an infection. If we look at the primary headaches, there are four major kinds, migraine, tension-type headache, cluster headache and then the fourth group is a miscellaneous group of other, usually uncommon headache types.

How can the type of pain you have help doctors make a diagnosis?
One issue is the quality of the pain. Is it throbbing? Is it a steady ache? Another feature is the location of the pain. Is it in the eye? On one side of the head? On both sides of the head? Another feature of the pain is the frequency and duration. Do attacks last 10 minutes? Do they last 10 days? Do they occur every day? Do they occur only occasionally?

What is a cluster headache?
Cluster headache derives its name from the fact that the attacks tend to occur in clusters. So a person with cluster will have a long period where they don't have any headaches at all, and then they'll have what what's called cluster phase; where they will begin having attacks on a daily or near-daily basis for weeks or months. The cluster attacks tend to be short, they last 15 to 90 minutes.

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