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What different types of

headaches are there?


Medically reviewed by Deena Kuruvilla, MD — By
Stephen Gill — Updated on January 3, 2023

Migraine Tension-type Cluster Exertional


Hypnic Medication-overuse Sinus
Caffeine-related Head injury Menstrual
Hangover Speaking with a doctor Summary

There are many different types and


causes of headaches, such as
migraine, tension-type, cluster, sinus,
and hypnic headaches. Medication
overuse can also lead to a headache
when a person stops using pain relief
or other drugs after using them for
some time.

Headaches are a common complaint — the World


Health Organization (WHO)  estimates that
almost half of all adults will have experienced at
least one headache within the last year.

While they can sometimes be painful and


debilitating, a person can treat most of them with
simple pain relievers, and they will go away within
several hours. However, repeated attacks or
certain types of headaches could indicate a more
serious health condition.

The International Classification of Headache


Disorders defines more than 150 different types of
headaches, which it divides into two main
categories: primary and secondary.

A primary headache is not due to another


condition — it is the condition itself. Examples
include migraine and tension headaches. In
contrast, a secondary headache has a separate
underlying cause, such as a head injury or sudden
caffeine withdrawal.

This article explores some of the most common


types of headaches, along with their causes,
treatment, prevention, and when to speak with a
doctor.
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1. Migraine
Peter Finch/Getty Images

A headache with migraine often involves intense


throbbing pain on one side of the head.

A person may experience a heightened sensitivity


to light, sound, and smell. Nausea and vomiting
are also common.

Around 25%  of people with migraine experience


an aura before the headache starts. These are
visual and sensory disturbances that typically last
5–60 minutes and include:

seeing zig-zagging lines, flickering lights, or


spots
partial loss of vision
numbness
tingling
muscle weakness
difficulty speaking or finding words

Be aware that aura symptoms could also indicate


stroke or meningitis. Anyone experiencing these
for the first time should seek immediate medical
attention.

Migraine headaches tend to be recurrent, and


each attack can last from a few hours  to several
days. For many, it is a lifelong condition.

Health experts do not understand the causes of


migraine fully. However, it often runs in families
and is more common in people with certain
preexisting conditions, such as depression and
epilepsy.

Triggers of migraine could include:

stress and anxiety


sleep disruption
hormonal changes
skipping meals

dehydration
some foods and medications
bright lights and loud noise

Treatment

Treatment will depend on various factors,


including how severe the symptoms are, how
often they occur, and whether the person
experiences nausea and vomiting.

Treatment options include :

non-steroidal anti-inflammatory drugs


(NSAIDs), such as ibuprofen, naproxen,
aspirin, or acetaminophen
triptans, such as sumatriptan, which need a
prescription
antiemetics, such as metoclopramide, to
manage nausea and vomiting

Neurostimulation techniques, such as transcranial


magnetic stimulation, may also help.

A person can also ease attacks by:

resting in a dark, quiet place


placing an ice pack or a cold cloth on the
forehead
drinking water

People with chronic migraine should speak with a


doctor about preventive treatment. A healthcare
professional may diagnose chronic migraine if a
person has an episode on more than 15 days 
per month or if symptoms occur on at least 8 days
a month for 3 months.

Drug options for migraine prevention include:

topiramate (Topamax)
propranolol
amitriptyline

Other management choices to consider are


dietary changes, stress management, and
acupuncture.

Get some tips on managing migraine through


lifestyle strategies.
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2. Tension-type headache
Tension-type headaches affect most people at
some time. They present as a dull, constant pain
on both sides of the head. Other symptoms can
include:

tenderness of the face, head, neck, and


shoulders
a feeling of pressure behind the eyes
sensitivity to light and sound

These headaches can last from 30 minutes to


several hours.

What causes tension headaches is unclear, but


stress, anxiety, and depression are common
triggers. Other potential triggers include:
dehydration
loud noise
lack of exercise
insufficient quality sleep
posture
skipped meals
eye strain

Treatment

Over-the-counter (OTC) painkillers, such as


ibuprofen, acetaminophen, and aspirin, are
usually very effective in stopping or reducing pain.
Individuals experiencing headaches on more than
15 days per month over 90 days should consult a
doctor.

Lifestyle changes and some treatments may help


prevent tension headaches. These can include:

getting enough sleep


regular exercise and stretching
improving sitting and standing posture
having an eye test
management of stress, anxiety, or
depression
acupuncture

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3. Cluster headache
Cluster headaches are severe and recurrent
headaches. They are six times more likely  to
affect males than females. People describe an
intense burning or piercing pain behind or around
one eye.

Other symptoms can include:

watering eyes
swollen eyelid
a blocked or a runny nose
sensitivity to light and sound
restlessness or agitation

Cluster headaches usually come on suddenly and


without warning and last between 15 minutes and
3 hours. People can experience up to eight
attacks a day.
These attacks tend to occur in daily clusters and
can persist for weeks or months. They also tend
to start at consistent times, often a couple of
hours after falling asleep at night.

Any person experiencing these symptoms, which


can sometimes resemble hay fever, should
consult their doctor.

The cause of cluster headaches is unclear, but


they are more likely to occur in smokers. People
should avoid alcohol during attack periods.

Treatment

Treatment aims to reduce the severity and


frequency of the attacks. Options include:

oxygen therapy
sumatriptan
verapamil
steroids
melatonin
lithium

Deep-brain stimulation and vagus nerve


stimulation also show promise in treating cluster
headaches that do not respond to medication.

4. Exertional headache
Exertional headaches are due to strenuous
physical exercise, with the following triggers:
running
jumping
weight lifting
sexual intercourse
bouts of coughing or sneezing

These headaches are usually very short-lived but


can sometimes last up to 2 days. They present as
a throbbing pain throughout the head and are
more common in those with a family history of
migraine.

Individuals experiencing cluster headaches for the


first time should see speak with a doctor, as they
could be a sign of something serious.

Treatment

Treatment for exertional headaches includes 


using:

OTC pain relief


beta-blockers, such as propanolol
indomethacin

Sometimes, exertional headaches may result from


cardiovascular problems. If so, a doctor may
recommend tests to check a person’s
cardiovascular and cerebrovascular health.

5. Hypnic headaches
A hypnic headache is a rare condition that usually
begins when people are in their 50s, but it can
start sooner. People also refer to them as “alarm
clock” headaches, and they wake individuals
during the night.

A hypnic headache consists of mild-to-moderate


throbbing pain, usually in both sides of the head.
It can last for up to 3 hours, while other symptoms
may include nausea and sensitivity to light and
sound.

People can experience several attacks each


week. The cause of hypnic headaches is not clear,
and there are no known triggers.

Although hypnic headaches are harmless, an


older adult who experiences any unusual
headaches for the first time should seek medical
advice. A doctor may wish to rule out migraine
and cluster headaches.

Treatment

Treatment options for hypnic headaches include 


:

caffeine
indomethacin
lithium

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6. Medication-overuse headache
A medication-overuse headache (MOH) —
sometimes known as a rebound headache — is
the most common type of secondary headache. A
MOH features frequent or daily headaches with
symptoms similar to those of tension headaches
or migraine.

These headaches initially respond to painkillers


but then reoccur sometime later.

A doctor may diagnose MOH if a person has a


headache disorder and has also taken pain relief
medication on at least 15 days in a month.

Drugs that can cause MOH include:

opioids

acetaminophen
triptans, such as sumatriptan

NSAIDs, such as aspirin and ibuprofen


A MOH can still occur despite taking these
medications. However, a MOH mainly seems to
develop in people taking painkillers specifically to
treat a headache.

Treatment

The only treatment for MOH is to stop taking the


medication causing the headaches. However,
anyone stopping medication should only do so
under the supervision of a doctor. The doctor can
help devise a plan and may prescribe alternative
medicines to ease the withdrawal process.

After stopping the drug, a person is likely to


experience:

worsened headaches
nausea and vomiting

increased heart rate


low blood pressure

sleep disturbance
restlessness, anxiety, and nervousness

A doctor may prescribe medication, such as


antiemetics, to help relieve these symptoms to
manage nausea and vomiting. The symptoms
usually last for 2–10 days  but can persist for up
to 4 weeks.

A doctor will advise on suitable pain relief


medication to use after resolving a MOH.
The following steps can help prevent MOH:

avoiding the use of codeine and opioids


limiting the use of pain relief medication for
headaches
using preventive medications for a chronic
migraine

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7. Sinus headaches
Sinus headaches occur with sinusitis — an
inflammation of the sinuses. It usually results from
an infection or an allergy.

The symptoms consist of a dull, throbbing ache


around the eyes, cheeks, and forehead. The pain
may worsen with movement or straining and can
sometimes spread to the teeth and jaw.

Other possible symptoms include :

facial pressure or pain

reduced sense of smell


nasal discharge

a blocked nose
fever

fatigue
ear pain

bad breath
cough

dental pain
a general feeling of being unwell

Sinus headaches are quite rare. If there are no


nasal symptoms, a headache of this nature is
more likely to be a migraine attack.

Treatment

Sinusitis usually goes away within 2–3 weeks.

Treatment options include:

rest

drinking fluids
OTC pain relief

nasal decongestants
saltwater nasal sprays or solutions from the
pharmacy
antihistamines

steroid nasal sprays, available on


prescription

antibiotics, if a doctor finds there is a


bacterial infection

People should speak with a doctor if symptoms


do not improve within a week or become severe.

To diagnose the underlying cause of sinusitis, a


doctor may refer an individual to an ear, nose, and
throat specialist. In some cases, minor surgery
may be necessary to drain the sinuses.

Tips for preventing sinusitis include avoiding


smoking and known triggers.

Read some tips on how to treat a sinus infection.


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8. Caffeine-related headaches
A high caffeine intake — more than 400
milligrams (mg), or around 4 cups of coffee per
day — can sometimes lead to headaches.

In people consuming more than 200 mg of


caffeine daily for over 2 weeks, withdrawal may
result in migraine-like headaches. These typically
develop 12–24 hours after stopping abruptly.
They peak at 20–51 hours and can last 2–9 days.

Other possible symptoms include:

tiredness
difficulty concentrating

reduced mood or irritability


nausea

The effects of caffeine vary from person to


person, but reducing intake could decrease the
risk of getting headaches. Limiting caffeine
consumption may help people who have chronic
migraine.

Is caffeine bad for you?

9. Head-injury headaches
Sometimes, a person develops a headache
immediately or soon after a head injury.

OTC pain relief often resolves this. However, if


symptoms are severe or get worse over time, an
individual should seek immediate medical
attention.

Always call an ambulance for a serious head


injury or if the following symptoms occur after a
head injury:

unconsciousness

seizures
vomiting

memory loss
confusion

vision or hearing problems

Post-traumatic headaches can also develop


months after the original head injury, making them
difficult to diagnose. They can sometimes occur
daily and persist for up to 12 months.

Even a small blow to the head can result in a


traumatic brain injury. Learn more here about how
to recognize it and what to do.
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10. Menstrual headaches


Headaches are often due to changes in hormone
levels. Migraine may occur around menstruation
from changes in estrogen levels.

Hormone-related headaches often develop 2


days before or 3 days after a period or during
ovulation. Symptoms are similar to migraine
without aura, but they can last longer.

Hormone-related headaches can also result from:

oral contraceptives

menopause
pregnancy

Treatment

Treatment for a menstrual headache is the same


as the treatment for migraine without aura.
Doctors can advise about possible preventive
measures, such as:

hormonal therapy
taking a triptan or NSAID around the time of
periods

alternative oral contraception plans, such as


omitting the pill-free break

hormone replacement therapy for those


undergoing menopause

What is a menstrual migraine?

11. Hangover headaches


Consuming excessive alcohol can lead to a
throbbing headache the following day or even
later that day. These migraine-like headaches
usually occur on both sides of the head and can
worsen from movement.

Someone with a hangover headache may also


experience nausea and sensitivity to light.

Treatment

There are no cures for hangovers, but it is


possible to relieve symptoms by drinking plenty of
water and eating sugary foods. OTC painkillers
may help reduce or stop the headache.

Symptoms of hangovers tend to go away within


72 hours.

Ways of reducing the risk of a hangover include:

drinking in moderation

not drinking on an empty stomach


drinking water between alcoholic beverages
and before going to bed

Find some more tips for managing a hangover


headache.

To discover more evidence-based


information and resources for headache
and migraine, visit our dedicated hub.

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When to speak with a doctor
Headaches are a common problem, but most
people can manage them with OTC pain relief,
such as acetaminophen.

However, anyone who experiences severe,


persistent, recurrent, or worsening headaches
should consult a doctor. An individual should seek
immediate medical assistance if they have  a
headache:

that starts suddenly and is extremely painful


following a significant blow to the head

with confusion or disturbed vision,SUBSCRIBE


balance,
or speech

with numbness or weakness


with fever, seizures, or unconsciousness

with a stiff neck or rash


with persistent vomiting

Children who have recurring headaches should


also speak with a doctor as soon as possible.
Summary
Headaches can affect many people. Often, taking
OTC pain relief, such as NSAIDs, will resolve
them. However, in some cases, headaches may
indicate a medical issue.

Cluster, migraine, and medication-overuse


headaches are all types of headaches that may
benefit from medical help and possibly
prescription medication.

Anyone with concerns about persistent


headaches should seek medical advice, as they
can sometimes indicate an underlying disorder.

Read this article in Spanish.

Last medically reviewed on October 29, 2021

Anxiety / Stress Headache / Migraine


Neurology / Neuroscience
Complementary Medicine / Alternative Medicine

How we reviewed this article:


SOURCES

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