Headache: The most common causes and how to get rid of it (types of pain)

Headache: The most common causes and how to get rid of it (types of pain)
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Headaches are among the most common health problems people seek professional help for. Most cases are non-serious forms that may sometimes be a manifestation of a more serious condition.

A headache is an unpleasant subjectively perceived sensation. It is commonly described as being sharp, stabbing or dull. It can be localised on the forehead, around the eyes, behind the ear, at the top of the temple or the back of the neck. 

A headache may originate from the neck, teeth or other structures close to the head. It almost always accompanies febrile illnesses or upper respiratory tract infections and various viruses as well as influenza and sinusitis. 

Headache = cephalea / cephalalgia. 

Cephalea is divided into different types, which are distinguished from each other by different characteristics. 

An example of a common and frequently occurring pain is migraine or tension headache. The cluster form represents a less frequent type.

However, we also know a group of acute and severe pain. It accompanies high blood pressure, but also other serious, health and life-threatening conditions and diseases.

Not only in adults, but also children experience headache. This unpleasant sensation is usually nothing to worry about, but it may also be a cause for concern.

The headache takes the form of dull little bothersome attacks. But, people also experience intense discomfort that prevents them from carrying out normal daily activities.

It occurs on its own or in association with a range of complaints such as increased sensitivity to light and noise, lack of appetite, vomiting or fatigue and weakness.

In addition to the subjective perception, headache has a significant economic impact, as it can be responsible for being unable to work for days on end.

What's behind a headache?
Is it a serious illness or do I have a migraine?
What for a headache and how to get rid of it?
Read on.

Headache takes different forms
Risk factors and triggers +and important questions

The headache can be benign or severe. It occurs frequently, repeatedly and in attacks. But, there are cases when a person has never had it all his life, and suddenly intense and the worst pain in life sets in.

These are only some of the characteristics that are evaluated for this health problem.

From a crude point of view, headache is divided into primary and secondary. A third, not always mentioned form is cranial neuralgia.

Classification of headaches into types:

  1. primary cephalea - idiopática, causa desconocida y sin daños en la estructura cerebral
  2. secondary cephalea - manifestación de otra enfermedad, puede haber daños estructurales
  3. cranial neuralgia - el dolor proviene de los nervios craneales
    • trigeminal neuralgia
    • neuralgia n. glossopharyngei
    • optic neuritis

With this health problem, some questions and answers are important. This information provides a comprehensive view of the possible cause. However, the diagnosis is not always clear-cut and is supplemented by a special examination, for example by a neurologist.

The relevant questions are:

  • What is the character of the pain? Is it dull, sharp, stabbing, throbbing?
  • What is the localization of the pain? Is it in one place, or is it shifting, radiating somewhere, from somewhere?
    • pain in the front, such as forehead and temples (temples), around the eye, behind/above the eye, around the eyebrow, between the eyebrows, behind/above the ear, on the temple, in the back of the head, radiating from the neck?
  • How often does it occur or recur?
    • the pain is episodic and recurs regularly
    • it's the initial pain
    • rapid onset
    • acute onset
    • how often during the day, month, year it repeats
  • What is the intensity?
    • low
    • high
    • the worst pain ever
  • How long does it last?
    • seconds to minutes
    • hours
    • days or daily
  • How does it progress?
    • as usual, as always
    • or the course, character, intensity of the pain has changed
  • What caused the pain? Is it a provoking factor, physical or psychological stress, sexual intercourse, fatigue, menstruation, food or medication?
  • Are other difficulties also associated? Such as fatigue, sleepiness, sensitivity to light, sound, smell, inappetence, vomiting, tingling in the face, trembling of the hands, limbs, dry mouth?
  • How does the treatment work? Do conventional analgesics help?  

The first headache after the age of 40 is described as risky.

Also important is a personal history, during which information regarding other diseases (respiratory viral disease, high blood pressure, diabetes mellitus, etc.), injuries is obtained. Plus, the family history and the occurrence of diseases in the parents are also extracted.

Risk factors for developing difficulties and red flags

Sometimes it's good to sense the connection. 

What does it mean? 

The human body reacts to a number of environmental but also internal signals, for example a change in the weather or stress.

Risk factors, pain triggers:

  • stress and mental strain
  • fatigue and exhaustion
  • sleep disturbances, sleep deprivation, excess sleep, headache at night waking from sleep, which again disturbs sleep and induces fatigue
  • physical activity, sexual intercourse
  • hormonal changes - especially in women during menstruation, ovulation and pregnancy
  • too low or too high liquid intake
  • hunger, low sugar, or too high
  • diet and fluids such as alcohol, caffeine
  • medications

Mind the red flags. What are they? 

These are warning signs that no one should neglect and seek medical attention when they occur.

The medical literature also talks about yellow flags. The essence is the same, and a person is definitely advised to seek examination when spotting them.

Yellow and red flags = warning signs that point to a professional medical examination.

Table: Red flags and yellow flags

Red Flags Yellow flags
Serious warning signs Suspicions = necessary to look for a secondary form
  1. first pain experienced after 40 to 50 years of age
  2. first intense and severe pain
  3. described as: never experienced before - the worst pain ever
  4. change of pain character
    • emergence of new pain
    • significant increase in intensity
    • worsening headache
  5. increasing intensity of pain with vomiting
  6. sharp onset of pain
  7. sudden onset of pain after physical exertion
    • after coughing
    • after a sneeze
    • after pressure on the rectum, induced by the Valsalva manoeuvre
  8. visual impairment
  9. association of symptoms
    • drowsiness, impaired consciousness, behavioural changes, confusion, disorientation
    • collapse
    • meningeal symptoms
    • Fever
    • skin changes, petechiae, rashes
    • other neurological symptoms, impaired mobility, weakness and paralysis of the limb
    • body cramps
  10. headache after head and cervical spine injury
  11. tumour disease present
  12. blood medications, anticoagulation therapy, warfarin and others
  13. HIV
  1. headache that wakes from sleep
  2. pain appears in the same location
  3. shifting body position has a significant effect on pain intensity

Primary headaches

The group of primary headaches is represented by migraine, which is often mentioned among people. Tension headache may co-occur. 

Less common and well known is cluster headache and other rare primary headaches

Primary pains is divided into:

  1. migraine, with and without aura
  2. tension headache
  3. cluster headache
  4. other rare primary headaches

Table: different types of primary form

Type Description
  • occurs frequently
  • does not have a precisely known cause
  • neuro-vascular cause and abnormal brain response
  • recurrent attacks of pain - attacks or seizures
  • unilateral throbbing pain (may alternate from right to left between attacks)
  • sensitivity to light, noise, odours, nausea to vomiting
  • may have a family history
  • no brain damage present
  • significant triggers: 
    • weather
    • stress
    • physical exertion
    • intense and flashing light
    • fatigue and sleep changes
    • hormonal changes - menstrual migraine
  • with or without aura
    • aura - the headache is overtaken by other symptoms in a few minutes to hours, there may also be prodromes (precursors of the disease)
      • visual, visual - flashes, scotomas
      • sensory - sensitivity to touch, odours, reduced skin sensitivity
      • motor - hemiparesis, monoparesis - impaired limb mobility
      • speech - aphasia, dysphasia - speech disorder
      • stem symptoms - impaired consciousness, double vision, tinnitus
    • bez aury - bez predchádzajúcich ťažkostí
  • chronic migraine - more than 15 days per month for more than 3 months
  • Status migrenosus - attack lasts more than 72 hours
Learn more: Migraine and How to treat and prevent migraine? + 9 natural pain relief tips
Tension headache
  • the most common form
  • has its basis in muscle tension, i.e. tension-vascular 
  • is dull and bilateral, even around the eyes, one complains of a feeling of tension in the eyes
  • long-lasting and persistent, without interruption
  • the intensity gradually increases
  • it is accompanied by fatigue, exhaustion, nervousness, anger, anxiety
  • also occurs as a headache in the morning after waking up
  • characterised as:
    • pain lasts up to 30 minutes and up to 7 days
    • is characterised by at least 2 of the above features:
      • sensation of pressure
      • the intensity is moderate
      • occurs bilaterally
      • normal activities do not aggravate the difficulties 
    • it takes place without the feeling of vomiting and the person does not vomit during it
    • it does not usually involve hypersensitivity to light or noise
Cluster headache
  • clustered - cumulated cephalea
  • it is a severe pain around the eye or a headache in the forehead area on one side
  • lasts 15 to 180 minutes
  • once, but also up to 8 attacks during the day
  • on the side of the headache there is also: 
    • redness of the conjunctiva
    • tears
    • nasal secretion
    • sweating of the forehead and face
    • swelling in the eyelash area
    • ptosis - eyelid droop
    • miosis - narrowing of the pupil of the eye
Other rare primary headaches
  • headache after physical activity and after sexual intercourse 
    • provocative character after physical activity and during or after an orgasm
    • high intensity
    • in the forehead and nape of the neck, as a headache in the forehead and nape of the neck
    • lasts minutes to hours
    • when first experiencing this type of pain after exertion, it is necessary to rule out a secondary cause, i.e. cerebral haemorrhage
  • chronic daily headache
    • persists every day
    • pain attacks alternate with periods of lower intensity
    • the risks that may lead to headache:
      • long-term use of painkillers and addictions
      • neurotic personality type and depression
      • stress and long-term psychological overload
      • hormonal changes after menopause
  • trigeminal autonomic cephalalgia (TAC) - among other things, this includes cluster headache
    • and others that are related to headaches without structural brain damage
    • merges the pain that comes from trigeminal nerve irritation

Are secondary headaches a symptom of the disease? 

Yes, a headache is a manifestation of another disease or health problem.

The secondary form is also referred to as symptomatic.

Symptom = sign.

The basis of the headache is some organic disorder or damage to the structure of the brain. Subsequently, pain may radiate to the head from another nearby area. An example is cephalea and vertigo in addition to cervical spine pain.

Vertebrogenic algic syndrome: Back pain and its causes and symptoms?

In this case, the headache may be a manifestation of a non-serious condition. However, it is also a disease that threatens a person's health or life. 

The most serious cases can end in death.
For this reason, a thorough examination is necessary.

The general rule is true:
The risk increases as we age.
Especially if, the first headache after the age of 40 is present.
Subsequently, if the problem occurs after an injury.

Another type is also pain in common viral diseases that affect the upper respiratory tract, sinusitis, such as influenza. In addition, the intensity can be escalated by an increase in body temperature and fever. 

This form of pain may be the only manifestation of a newly-occurring disease.

1. Headache after trauma (injury)

Just as the name suggests, the difficulty is caused by an accident. In addition to head injuries, it is necessary to think about damage to the cervical spine. 

With impacts, physical force and energy is transferred from the head to the neck, which can also cause changes in the area. 

For example:

  • concussion
  • contusion of the brain, with head trauma there is also bruising of the nervous tissue
  • post-traumatic bleeding in the skull = intracranial haemorrhage, such as epidural or subdural

2. Cerebrovascular diseases

The group is represented by cerebrovascular diseases and strokes.

A stroke, also called a cerebrovascular accident (CVA), a cerebrovascular insult (CVI), or a brain attack, may have the character of a cerebral infarction or haemorrhage.

Ischemic stroke/transient ischemic attack (TIA).

A cerebral infarction is a non-clotting of brain cells that occurs due to thrombosis or embolism.

Thrombosis has its basis in damage to the vessel wall, even as a consequence of atherosclerosis. Vascular changes gradually lead to partial, even complete, restriction of blood flow to nerve cells. 

Embolism occurs after a blood clot is introduced into the blood vessels of the brain from other parts of the human body, most commonly from the heart in cardiac arrhythmias (such as atrial fibrillation, or A-Fib) or in heart valve disease

In this case, headache may also be a symptom. However, in the foreground there are neurological difficulties such as impaired limb mobility, speech impairment and others. 

Hemorrhagic (i.e. bleeding) stroke.

Bleeding in the intracranial area is very dangerous.

Here is one way to image what goes on:
Blood leaks outside the blood vessels >
thereby oppressing surrounding parts of the brain, nearby nerve cells >
as the cerebral part of the skull is closed >
the pressure inside the skull increases >
and thus damages the nerve tissue again >
swelling of the brain occurs in addition to all of the above >
the whole situation is deteriorating and collapsing.

Therefore, when red flags occur, an immediate examination is necessary to reveal the cause of the development of acute and intense headaches.

In this case, the rule is:
Time = brain.

There are several types of bleeding:

  • subarachnoid haemorrhage (SAH)
    • overwhelmingly sharp pain thunderclap headache
    • common brain aneurysm rupture vascular aneurysm
    • difficulties occurring in parallel:
      • vomiting
      • back of the neck stiffens
      • fainting
      • and others
    • can occur after demanding physical activity, especially when bending forward or after sex
  • intracerebral haemorrhage (ICH)
    • acute headache
    • nausea and vomiting
    • neurological symptoms according to the area of bleeding
  • cerebellar haemorrhage
    • acute headache
    • back of the neck stiffens
    • postural and mobility problems

In both types of stroke, the course depends on the extent and localization of the acute condition.

More important information in the article
Headache: Sometimes it is harmless, other times it indicates a serious problem.

3. High or low blood pressure

Cephalea commonly occurs during hypertension, i.e. high blood pressure. Each person is different and also tolerates the increase in blood pressure differently.

It is reported that more severe headache occurs when the diastolic (heart) blood pressure increases above a TKd of 100-110 mmHg.

Of course, it can be added even with a less significant increase.

Watch out for the co-occurrence of headaches and nosebleeds - blood pressure control is needed. Mostly recurrent epistaxis (nosebleeds) occurs when blood pressure rises.

Untreated hypertension is particularly risky, due to dangerous complications such as stroke or heart attack and even death.

Learn more:
Untreated hypertension threatens health and life. What are the complications?

Headaches are also encountered by people who, on the contrary, have too low blood pressure.

4. Headache and cervical spine pain

These two problems occur together very often. Pain spreads from the cervical spine through the nape of the neck, back of the head.

You know the one, the tight neck muscles, the neck, the jerky movement, the wrong turn of the head or the draft or the blowing of the cold air conditioner.

Occurs after:

  • after neck strain
  • after a sharp head movement
  • workload - monotonous position, bending over, behind the computer
  • bad position during sleep
  • having a cold

The pain can spread from the neck, go across the back of the head, down one side of the head, into the temples, behind the ear and into the eye. 

In addition, dizziness, nausea, upset stomach, a feeling of vomiting and other discomforts may be associated with it.

When researching the subject, you will also come across names such as:
Cervicocranial syndrome

cervical vertigo, when dizziness is present and 
cervicogenic pain = pain coming from the neck. 

5. Brain tumours

Headache is one of the common symptoms of brain cancer. It occurs in 60-70% of cases.

However, it may not be permanent and worsens as the tumour grows. In this case, it may be benign, i.e. benign, but as it gradually increases in size, it behaves like a malignant tumour.


The cerebral part of the skull is closed. Even if the tumour is well circumscribed and does not grow into the surrounding structures, pressure will cause damage. 

With very slow tumour growth, pain may not occur.

Of course, malignancy is always a more serious condition.

The tumour may arise primarily from nerve cells and structures in the brain, but metastasis to the brain is also common.

Metastases are tumor cells transferred from site "A" to another site "B" in the human body.

6. Brain infections

Or also neuroinfections arise on the basis of the penetration of a microorganism into the brain tissue. The route of transmission may be blood or other nearby infection to the brain.

These are serious conditions that are accompanied by a number of symptoms and complications.

Some are infectious, others are not. They are caused by viruses (herpesviruses), bacteria (meningococcus, streptococcus, staphylococcus, pneumococcus, E. Coli and others).

The course is mostly sudden, abrupt, dramatic with worsening within 24 hours.

The intensity is high and the pain is severe.

Fever, petechiae, fatigue, drowsiness, confusion, disorientation, deeper disturbance of consciousness, even unconsciousness are associated. 

In infections of this type, it is also possible to hear the term meningeal irritation, which includes stiffening (opposition) of the neck and immobility of the neck, head and sensitivity to light - photophobia.

7. Other forms

That's not all.

There are also other forms. Here are some of them:

Headache is common in women

The same goes for migraine, too. Why?

16-18% of women complain of migraines. In men, the figure is around 4-5%. 

One of the provoking factors is a hormonal change. Fluctuations in estrogen levels, ovulation, menstruation (premenstrual syndrome), menopause or pregnancy. 

A few tips that generally help:

  1. eat less food but more portions per day (5 or 6)
  2. avoid foods and drinks with higher sugar and fat content
  3. fruit instead of sweets and sweetened drinks
  4. more than one yoghurt a day can be a lot, because lactose affects the level of the hormone estrogen
  5. no alcohol or caffeine
  6. more fibre in the diet

Of course, other common conditions are also present. Cervical spine, pain from draughts, in the morning after waking up from a bad sleeping position or with increased mental and physical exertion.

If other symptoms appear, such as tinnitus, upset stomach or pressure in the eyes, it is better to see a doctor.

Headaches in children - take them seriously

Cephalea in children is rather common.

Migraine is among the possible causes as early as the age of 10, especially in puberty.

Tired, mentally exhausted and stressed children will also complain of pain. The latter comes on with colds, flu, sinusitis, otitis media.

Pain all over the body, headache, chills, shivering, fatigue = rise in body temperature up to fever. These ailments occur together almost always.

A sedentary lifestyle is bad for children. It is associated with spinal problems and, like in adults, may be behind headaches.

Even in this age group, the following is true: Pay attention to warning signs.

Learn nmore:

How to get rid of headaches?

If we know the cause, will begin to get an answer...

However, from the preceding text, it can be seen that the issues surrounding pain are very complex. And so, too, is the treatment.

It is important to bear in mind that it is necessary to follow a long-term therapy of the underlying disease, which provokes various difficulties, among them headache. Consequently, if you know about the provoking factors that trigger the difficulties, you need to limit them.

As always: a healthy lifestyle, sufficient and appropriate physical activity, a rational diet and regimen measures in acute deterioration. Possibly rehabilitation, massage or spa treatment. 

Whether it is migraine or high blood pressure. It applies in both cases (and others).

Those who are lucky are those who are helped by common (even over-the-counter) pain killers (analgesics, e.g. Ibalgin, Paralen and others). Others will have to seek help from a specialist.

You will come across recommendations of grandmotherly advice or alternative products, homeopathics, as well as the use of herbs and teas.

Believe it or not, however, with uncertainty about whether it is a migraine and with the appearance of warning red flags,... no amount of folk healing will help. 

Time is brain = early recognition of symptoms with expert diagnosis and early targeted treatment > can save health, minimize brain damage, prevent permanent disability to death.

The diagnosis is based on the above-mentioned medical history (personal, family, medication), neurological examination and other special examinations, which include imaging methods such as:

  • blood collection
  • liquor analysis
  • X-ray
  • CT
  • MRI
  • USG (carotids and other blood vessels)
  • EEG
  • physicians from specialties may collaborate
    • ORL
    • ophthalmologist
    • internal specialist
    • psychiatrist

Why We Get Headaches

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Interesting resources

  • "Headache disorders". The World Health Organization. 8 April 2016. Retrieved 2021-12-14.
  • Silberstein, Stephen D. (2022-03-09), Lynch, Mary E.; Craig, Kenneth D.; Peng, Philip W. (eds.), "Headache", Clinical Pain Management (1 ed.), Wiley, pp. 336–342
  • "Headache disorders Fact sheet N° 277". The World Health Organization. 8 April 2016. 
  • Britton, Carolyn B. (2013), Green, Mark W.; Muskin, Philip R. (eds.), "Stress and headache", The Neuropsychiatry of Headache, Cambridge: Cambridge University Press, pp. 54–62
  • "Headache Causes". Mayo Clinic
  • "Headache". Johns Hopkins Medicine. The Johns Hopkins University. 
  • Ahmed F (August 2012). "Headache disorders: differentiating and managing the common subtypes". British Journal of Pain
  • Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, et al. (Global Burden of Disease Study 2013 Collaborators) (August 2015). "Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet386 (9995): 743–800. 
  • Scottish Intercollegiaine Network (November 2008). Diagnosis and management of headache in adults. Edinburgh: NHS Quality Improvement Scotland. ISBN 978-1-905813-39-1
  • Young CB (3 January 2012). "The Johns Hopkins Headache Center - Primary Exertion Headache". 
  • Goadsby PJ, Raskin NH (2012). "Chapter 14. Headache". In Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J (eds.). Harrison's Principles of Internal Medicine (18th ed.). New York, NY: McGraw-Hill. ISBN 978-0-07-174890-2.
  • Damayanti Y, Marhaendraputro EA, Santoso WM, Rahmawati D (2021-03-02). "Profile of Primary Patients in Neurological Polyclinic". Journal of Pain, Headache and Vertigo2 (1): 1–4.
  • Straube A, Andreou A (April 2019). "Primary headaches during lifespan". The Journal of Headache and Pain20 (1): 35. 
  • South-Paul JE, Matheny SC, Lewis EL (2011). Clinch C. Chapter 28. Evaluation & Management of Headache - CURRENT Diagnosis & Treatment in Family Medicine. Lange Current Series (Third ed.). McGraw-Hill. ISBN 978-0-07-162436-7.
  • "Migraine - Symptoms and causes". Mayo Clinic
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