HEAD PAIN - MIGRAINES AND HEADACHES
Important Body Signals
What Is Head Pain?
Headaches and migraines are common causes of head pain. Most are primary headaches, not caused by another disease, while some are secondary, due to an underlying condition. Migraine is a specific neurological disorder, not just a bad headache.
Main Types Of Primary Headaches
| Type | Pain Characteristics | Location & Duration | Other Features |
|---|---|---|---|
| Tension‑type (most common) | Dull, pressing, or band‑like tightness; mild to moderate | Both sides; 30 min to 7 days | Rarely nausea; usually not worsened by activity; neck/shoulder tension common |
| Migraine | Throbbing or pulsing; moderate to severe | Often one side (can be both); 4–72 hours untreated | Nausea/vomiting, sensitivity to light/sound/smells; worsened by activity; possible aura |
| Cluster | Extremely severe, sharp/stabbing | One side, around/behind the eye; 15–180 min (often 30–45 min), multiple attacks/day in clusters | Autonomic symptoms on same side (tearing, red eye, stuffy/runny nose, droopy eyelid); restlessness/agitation |
Secondary headaches have many causes, such as infection, injury, high blood pressure, sinus issues, and medication overuse.
Migraine In More Detail
Migraines affect roughly 12 percent of people, and more women than men. They often have a genetic component and involve changes in brain chemicals and nerve pathways, including serotonin and CGRP.
Typical phases, though not everyone experiences all of them:
- Prodrome, up to 24 hours before: Mood changes, fatigue, food cravings, frequent urination, neck stiffness, yawning.
- Aura, in about 25 to 30 percent of people, usually lasting 5 to 60 minutes: Reversible neurological symptoms, most often visual, such as flashing lights, zigzags, or blind spots, plus possible tingling, weakness, or speech difficulty.
- Headache attack: Throbbing pain, often on one side, nausea or vomiting, and sensitivity to light, sound, or smell. It lasts 4 to 72 hours if untreated.
- Postdrome: Fatigue, difficulty concentrating, and neck stiffness, sometimes called a "migraine hangover".
Other types include chronic migraine, with headaches on 15 or more days a month, menstrual migraine, hemiplegic migraine, and silent migraine, which is aura without headache.
Common Triggers
Triggers vary by person but often include:
- Stress or hormonal changes, especially estrogen fluctuations
- Sleep changes, too much or too little
- Skipping meals, or certain foods and drinks such as aged cheese, processed meats, chocolate, MSG, and alcohol, especially red wine
- Sensory stimuli such as bright or flashing lights, strong smells, or loud noise
- Weather or barometric pressure changes
- Caffeine, too much or its withdrawal, or certain medications
Keeping a headache diary helps identify personal triggers.
Treatment Approaches
There is no cure, but management combines acute relief, prevention, and lifestyle steps.
The right treatment for each person is decided with their clinician.
Acute treatment, to stop an attack:
- Over‑the‑counter options for milder cases, such as NSAIDs, or combinations with caffeine.
- Prescription triptans, gepants, or other migraine‑specific drugs.
- For cluster headaches, high‑flow oxygen and injectable or nasal triptans are first‑line.
Preventive treatment, for frequent or severe attacks: Daily or periodic medications, such as beta‑blockers, certain antidepressants, anticonvulsants, and CGRP monoclonal antibodies, plus lifestyle measures. Mayo Clinic highlights the SEEDS approach: consistent Sleep, Exercise, healthy Eating, Diary tracking, and Stress management.
Avoid overusing pain medications, as this can cause medication‑overuse headaches, also called rebound headaches.
When To Seek Medical Care Immediately
Go to the emergency room or call emergency services for:
- A sudden, severe "thunderclap" headache, the worst of your life, peaking in seconds to minutes
- Headache with fever, stiff neck, confusion, seizures, or rash
- New neurological symptoms, such as weakness or numbness on one side, trouble speaking, vision loss, or double vision
- Headache after a head injury
- A new or changing headache pattern, especially after age 50, during pregnancy or after birth, or with other symptoms throughout the body
See a doctor promptly for frequent, severe, or changing headaches, or if attacks interfere with daily life. Diagnosis is usually clinical, based on history; imaging or tests rule out secondary causes when indicated.
Lifestyle consistency, with regular sleep, meals, hydration, and stress management, helps many people reduce frequency and severity. A healthcare provider can tailor evaluation and treatment.
If you are in crisis, call or text 988. In an emergency, call 911.
This is general information from sources such as Mayo Clinic, Cleveland Clinic, and NIH. It is not medical advice. See a doctor for personal symptoms, diagnosis, or treatment.
Who Do We Help?
Teenagers and adults whose headaches or migraines come with stress, poor sleep, anxiety or low mood.
How Can We Help?
Psychiatry and Psychotherapy help with the stress, mood and anxiety that can trigger headaches or follow them, and Sleep Disorders care helps when sleep plays a part, alongside the care of your doctor.
What Are My Options?
If you are wondering if we could be a good fit for you or have questions about how we can craft your own specialized treatment plan, please reach out to learn more.
For individuals with urgent needs we may be able to offer same-day or next-day appointments to ensure that you get the care you need as quickly as possible.
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