What Causes the Different Types of Headaches and How to Treat Them

Mature woman with head in hands and eyes closed
Getty Images/Christopher Robbins

If you struggle with headaches, you are not alone. In fact, more than half of the world’s adult population has experienced a headache at least once in the past year. Headaches come in all shapes and sizes, ranging from dull throbbing to sharp pain, and lasting from just a few minutes to several days.

Each type of headache has a different cause, but all of them can be very troublesome. Understanding the distribution of pain and characteristics of each headache type will help you properly assess and treat your condition. 

Types of Headaches

There are more than 150 types of headaches, each with different causes and triggers. Experts agree there are two primary classifications for headaches:

  • Primary headaches are stand-alone conditions.
  • Secondary headaches are caused by another medical condition.

Patients who have more than 15 headaches per month are chronic headache sufferers; those with 14 or fewer have what are called episodic headaches.

When to See a Doctor

Even if you regularly experience headaches, sometimes a headache can be a symptom of a potentially serious health condition, such as high blood pressure, severe dehydration, vascular disease, or even stroke. Talk to your doctor if your headaches:

  • Increase in frequency
  • Cause increasing pain
  • Interfere with your regular activities

Always seek immediate medical attention if you have any of the following:

  • Sudden head pain that's the "worst of your life"
  • A headache that lasts more than 72 hours with fewer than four pain-free hours
  • Loss of vision or consciousness
  • Uncontrollable vomiting during a headache

Tension Headache

Experts estimate that as many as two-thirds of American adults suffer from tension headaches, the most common type of primary headache. Tension headaches are caused by stress and strain. Women are more likely than men to have tension headaches.

If a patient has more days with tension headaches than without them, they are said to have chronic tension headaches. Chronic tension headaches aren’t as common as episodic tension headaches, which is when headache-free days outnumber days with tension headaches.

Symptoms of a tension headache include:

  • Mild to moderate pain in the neck, face, or head
  • Constant (not throbbing) pain
  • Pain on both sides of the head

Treatment

Tension headaches can be treated with over-the-counter pain medications, such as aspirin or acetaminophen. Lifestyle changes, such as relaxation techniques and exercise, may also help.

Caffeine Headache

This type of headache comes not from caffeine itself, but from caffeine withdrawal. Symptoms of a caffeine headache are very similar to those of a migraine and can include other symptoms of caffeine withdrawal such as:

  • Irritability
  • Poor concentration
  • Anxiety or depression
  • Drowsiness
  • Nausea and vomiting
  • Stiff or achy muscles

Treatment

If you are suffering from a caffeine headache, the best short-term treatment is to have a caffeinated beverage. If you are trying to reduce your caffeine intake, it is best to do so slowly in order to avoid withdrawal symptoms.

Migraine Headache

Migraine is a specific type of primary headache that can be painful and disabling and last for hours or days. The causes of migraine are not fully understood, but some experts have linked genetics and environmental factors to the condition. In some patients, chemical imbalances or a major pain pathway in the brain–the trigeminal nerve–may be involved. 

There are four stages to a migraine: prodome, aura, headache, and postdrome. Not all patients progress through each stage.

Symptoms of a migraine headache can include:

  • Severe throbbing pain, usually on one side of the head
  • Nausea
  • Vomiting
  • Sensitivity to light and sound

Treatment

Migraine headaches may respond to over-the-counter medications such as acetaminophen or aspirin, but sometimes require prescription drugs. If you are experiencing migraine symptoms, your doctor may prescribe triptans, beta-blockers, or even onabotulinumtoxin A (Botox) injections. Some patients with migraine also respond to alternative therapies such as massage, acupuncture, or biofeedback.

Allergy or Sinus Headache

A sinus headache is a type of secondary headache, meaning it results from a problem with your sinuses, such as an infection (sinusitis). Some people believe they are suffering from sinus headaches when they are in fact experiencing migraine headaches.

Symptoms of a sinus headache can include:

  • Facial pain or pressure around your sinuses (in your forehead, brow, or cheeks)
  • Nasal congestion
  • Tiredness
  • Increased pain/pressure if you bend forward or lie down
  • Discomfort in the upper molars near your lower sinuses

Treatment

Because sinus headaches are caused by sinusitis, the best way to get rid of this type of headache is to treat the underlying sinus issue. Over-the-counter medications may provide some relief, along with nasal decongestants to allow mucus to drain and to reduce swelling. Saline nasal spray and vaporizers can moisten the air and soothe your sinuses. Your doctor can determine the cause of your sinusitis and assess whether it could go away on its own or if you need antibiotics or anti-fungal drugs. 

Rebound Headache

Rebound headaches occur in patients who frequently take pain medications for headaches or even other conditions. This type of headache, also called a medication overuse headache, can occur in patients who suffer from tension, cluster, or migraine headaches and regularly take pain medication for them.

This type of headache can occur if certain medications are stopped suddenly, or in patients who have built up a tolerance for them. Certain drugs, such as narcotics or even barbiturate-containing analgesics, are more likely to cause rebound headaches.

Treatment

The primary treatment for rebound headaches is to stop the medication that is causing them. Depending on the medication, your doctor may incorporate other drugs, non-pharmaceutical treatments, or even behavioral therapies to help you with pain management as you discontinue the medicine.

Cluster Headache

A cluster headache is one of the most painful types of primary headache. The condition gets its name from the frequent bouts—or clusters—of headache episodes a patient can experience. Patients with cluster headaches can go months or years between attacks.

Though cluster headaches are sometimes compared to migraines, they are very different. Each headache in the cluster can last from 30 to 90 minutes, and they often occur at the same time each day. Symptoms of a cluster headache can include:

  • Extreme pain on one side of the head, specifically in or around one eye
  • Excessive watering and redness in the affected eye
  • Stuffy or runny nose on the affected side

Treatment

Cluster headaches do not respond to over-the-counter medications.

Your doctor may prescribe drugs called triptans, which are also used to treat migraine headaches. Other medications, such as calcium channel blockers or corticosteroids, may be helpful in preventing an episode of cluster headaches. Sometimes, alternative therapies such as acupuncture or even chiropractic treatments can provide some relief.

Hormone Headache

Women suffer more headaches than men, and some experts believe that hormone headaches may be one of the reasons. For some women, a drop in estrogen levels can trigger this type of headache. Hormone levels can drop for a number of reasons, including:

  • Menstruation
  • Pregnancy
  • Menopause
  • Taking oral contraceptives
  • Lactation

Sometimes, this type of headache is called a “menstrual migraine.” Symptoms are the same as those of a migraine, and typically appear up to three days before your period. The headache may last throughout your cycle. 

Treatment

Non-steroidal anti-inflammatory medications, known as NSAIDs, are a first-line treatment for hormone headaches. They can be effective when taken in the days prior to menstruation. Your physician may also prescribe oral contraceptives or estrogen replacement therapies, or even drugs such as corticosteroids, beta-blocker drugs, or analgesics.

Frequently Asked Questions

How do you get rid of a headache?

Because different types of headaches respond to different treatments, it is important to know what type of headache you are experiencing and what may be triggering your pain. If you suffer from frequent headache episodes, your doctor can help you determine what type you have and the best treatments. It is helpful to identify the pattern of your pain so you can discuss symptoms accurately with a healthcare professional.

Why do I wake up with a headache?

Morning headaches can be caused by a number of factors, such as insomnia, stress (and tension), alcohol use, nightime tooth grinding, or even sleep apnea. If you frequently wake up with a headache, talk with your doctor about whether a sleep disorder or other concern could be responsible.

When should you worry about a headache?

Sometimes, headaches are a sign of a more serious medical condition. Talk with your doctor if your headache is preventing you from participating in everyday activities, if your pain is sudden or severe, or if you lose consciousness during a headache episode.

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Article Sources
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  1. Cleveland Clinic. Headaches. Reviewed June 3, 2020.

  2. Cleveland Clinic. Tension-type headaches. Reviewed February 4, 2021.

  3. American Migraine Foundation. Medication overuse headache. Published July 9, 2016.

  4. Cleveland Clinic. Cluster headaches. Reviewed February 4, 2021.

  5. Cleveland Clinic. Menstrual migraine (hormone headaches). Reviewed March 3, 2021.

  6. Cleveland Clinic. Are you waking up with a headache? December 13, 2019.