Headaches

There are many causes for headaches ranging from hangovers, migraines, vascular headaches, tension headaches, cluster headaches, viral infections, brain tumors, intracranial bleeding, icecream headache and more. Look through our dictionary of headache terms and types. If you don’t find your headache e-mail us or make an appointment to find out more about how we can help you with your headache.

The Headache Dictionary
Acupuncture

Acupuncture is an ancient Chinese technique that involves the insertion of very fine, solid needles into certain points of the body. According to traditional Chinese medicine, acupuncture helps headaches by stimulating the body’s ability to resist or overcome illnesses and conditions by correcting energy imbalances. The term “chi” (pronounced “chee”) is used to describe the energy that circulates through meridians in the body. The belief is that migraine and headache pain develops when the natural flow of chi is disrupted, leading to an imbalance of energy, and that acupuncture Anticonvulsants

Most preventive migraine medications were initially developed to treat other diseases, such as seizures, depression, or hypertension. During the past few years, there has been an increased interest in antiepileptic drugs (sometimes referred to as “anticonvulsants”) for the prevention of migraine, as both epilepsy and migraine may be caused by similar reactions in the brain.

Antidepressants
Most preventive migraine medications were initially developed to treat other diseases, such as seizures, depression, or hypertension. Antidepressants are typically used to treat people with depression, although they may reduce migraine frequency by regulating chemical levels in the brain.

Aura
About 15-20% of people with migraine get an “aura,” which is a manifestation of neurological symptoms that occurs before a migraine headache. You may see wavy or jagged lines, dots, or flashing lights; or you might experience tunnel vision or blind spots in one or both eyes. The aura can include visual or auditory hallucinations and disruptions in smell (such as strange odors), taste, or touch. Other symptoms include numbness, a “pins and needles” sensation, or difficulty in recalling or speaking the correct word. These neurological events may last as long as sixty minutes and will fade as the headache begins.

Biofeedback
Biofeedback is a technique that can help a headache sufferer learn stress-reduction skills by providing information (feedback) about muscle tension, skin temperature, brain waves, and other vital signs. Small metal sensors, called electrodes, are attached to the skin and measure the amount of muscle tension or the skin temperature. This information is displayed as numbers, electrical waves, or sounds on a screen. For example, a stress response reduces skin temperature because of constriction of blood vessels, while a relaxation response results in dilated blood vessels and warm skin. Most studies on biofeedback indicate that it reduces the frequency and duration of headaches, both in children and adults. In general, the effects of biofeedback appear to be comparable to many drugs used for chronic headaches, and can be recommended as early treatment for recurrent migraines.

Botox for Headaches
Botox to treat chronic migraines is given at intervals of about 12 weeks as multiple injections around the head and neck to try to dull future headache symptoms. The Food and Drug Administration (FDA) has approved the use of Botox as it applies to people with chronic migraine, which it defines as a “distinct and severe neurological disorder characterized by patients who have a history of migraine and suffer from headaches on 15 or more days per month with headaches lasting four hours a day or longer. Patients who respond well to Botox treatment typically describe their headache as imploding (vise-like, squeezing, crushing, etc) and have a much higher response rate to Botox injections (>80%) than those headaches described as exploding in nature (15%). Areas that generally respond well to botox injections include forehead and back neck regions. The temple areas have mixed results (some patients respond well, whereas others do not).

Childhood Headaches
By the time they reach high school, most young people have experienced some type of headache. However, once your child’s physician discovers the cause and type of the headache, many safe and effective approaches or medications can prevent a headache from occurring or stop it after it has attacked.

Cluster Headache
Cluster headache gets its name because the attacks come in groups. The pain arrives with little, if any, warning and is usually on one side of the head. A tearing or bloodshot eye and a runny nose on the side of the headache may also accompany the pain. Cluster headache, believed to be caused by chemical reactions in the brain, has been described as the most severe and intense of any headache type. Treatment for cluster headache includes prescription medication and oxygen.

Dehydration Headache
Dehydration occurs when the body’s electrolytes and water content are out of balance. Simply put, dehydration occurs when the body loses more water (through things like sweat or urine) than it takes in. Dehydration is a common underlying cause of headaches, and it’s also a common trigger for migraines. Headaches caused by dehydration can occur in the front or back of the head, or may be one-sided. Dehydration headaches also can be felt throughout the entire head, similar to a tension headache. A common symptom of dehydration headaches are an increase in pain when moving the head – especially during walking. It’s not entirely clear why dehydration causes a headache. Some studies have shown that blood vessels in the head may actually narrow in an attempt to regulate body fluid levels. The treatment includes drinking electrolyte rich fluids contained in fruits like apples, corn, beets, carrots and green beans, that are all rich in electrolytes. Other electrolyte-laden fruits and veggies include limes, lemons, oranges, sweet potatoes, artichokes, all types of squash and tomatoes. Most nuts and seeds are very high in electrolytes. Bananas are a great source of electrolytes as they are rich in minerals. There are commercial products that were designed to rehydrate the body as well like vitamin water and Gatorade. Avoid diuretic substances like alcohol and caffeine which worsen dehydration.

Flu Headache
Anyone who has suffered from the flu has probably experienced the headache that accompanies this infection. Many viral infections can either directly or indirectly cause headache. The headache related to these viral infections appears to be related to the fever, the body’s production of interferon, and other elements of the immune system combating the viral infection. Headache may also be associated with those viral infections that affect the upper respiratory tract, such as the common cold virus, the Rhinovirus. This particular infection may produce intense congestion in the nasal passages, which at times causes a blockage of the sinus drainage passages, and can also cause headaches. A severe headache may also result from viral infections that specifically attack the brain and its coverings, such as encephalitis and meningitis. Chronic viral infections have been implicated as a cause of headache and other conditions, such as the chronic fatigue syndrome. However, there is scant evidence to support chronic viral infection as a cause of chronic headache and substantial medical research that negates this theory. Regardless of the role of chronic viral infections in these disorders, there is considerable evidence that suggests antidepressant medications may be helpful in controlling these conditions.

Sometimes a benign viral infection may set off a cycle of chronic daily headaches that do not have typical features of migraine or tension-type headache. The headaches typically are aggravated by exertion or straining and usually improve in a few weeks or months.

Headache Trigger
Certain physical or environmental factors, such as foods, hormonal changes, weather, and stress, can lead to or “trigger” a migraine. However, it’s important to remember that triggers are different for everyone. That’s why, to help prevent migraine attacks, you need to figure out which triggers affect you and which ones don’t. Keeping a headache diary is an effective way to track triggers, and it will help you talk to your healthcare professional about your condition.

Hereditary Headaches
According to estimates, approximately 29.5 million people in the United States suffer from migraine. Four out of five (80 percent) of them report a family history of migraine, but scientists are not sure if this is genetic or a family predisposition. Despite the uncertainty, a child has a 50% chance of having migraine if one parent suffers and a 75% chance if both parents suffer.

Hormonal Migraine
Hormones initiate and regulate many of your body’s functions, keeping your body in balance within a constantly changing environment. When the levels of hormones in your body are unbalanced – during menstruation, pregnancy, or menopause – it can lead to a migraine attack. In fact, about three quarters of all women with migraine report that their attacks are related to the menstrual cycle.

Hypertensive Headache
High blood pressure is called the “silent killer,” because there are few physical symptoms of high blood pressure. However, hypertension can be a major cause of heart attacks and strokes.High blood pressure can cause headache, but in general is not the cause of recurring headaches. Blood pressure usually has to be quite elevated to cause headache. Studies show that headaches have been precipitated by blood pressures of 200/110 or higher. A physician should determine whether or not an elevated blood pressure is responsible for a patient’s headache. Blood pressure can also increase when you are in pain. Some high blood pressure medications can also cause headache. On the other hand, some blood pressure medications, including beta-blockers (propranolol or Inderal) and calcium channel blockers, are taken to reduce headache frequency. Sufferers with poorly controlled high blood pressure should not use triptan medications.

Ice Cream Headache
Ice cream headaches are brief, stabbing headaches that can happen when you eat or drink something cold. Ice pops, slushy frozen drinks, ice cream, and other cold foods and drinks can have the same “brain-freeze” effect.

But there’s good news. Most ice cream headaches are gone in the time it would take you to say their medical name — “headache attributed to ingestion or inhalation of a cold stimulus.”

Ice cream headaches are caused by cold material moving across the roof of your mouth and the back of your throat, as happens when you eat ice cream quickly or gulp a cold drink. This is believed to cause the rapid constriction and swelling of blood vessels around a nerve located by the roof of the mouth called the sphenopalatine nerve. There is no treatment for ice cream headaches aside from time – typically these headaches last for 20 seconds although they may occasionally last longer. To help prevent ice cream headaches, try eating cold foods and drinking cold beverages slowly. The only way to definitely avoid getting an ice cream headache is to avoid the cold food or drinks that cause them.

Immediate Relief Migraine Medications
sometimes referred to as acute abortive medications – are used to treat the pain of the headache after it has started. Examples of acute abortive medications include over-the-counter medications, Non Steroidal Anti Inflammatory drugs (NSAIDs) like Motrin, advil and ibuprofen, ergotamines like Migranal, and triptans like imitrex.

Migraine
Generally, migraine begins as a dull ache and then develops into a constant throbbing and pulsating pain that you may feel at the temples, as well as the front or back of one or both sides of the head. The pain is usually accompanied by a combination of nausea, vomiting, and sensitivity to light and noise. Some people (about 15% of migraine sufferers) experience an aura before an attack. The cause of migraine is believed to be chemical reactions in the brain. Treatment for migraine may include over-the-counter or prescription medications, as well as self-help techniques such as relaxation training and biofeedback.

Migraine Stroke
While the severity of a migraine attack often causes patients to fear they are having a stroke, the likelihood of a migraine attack causing a stroke is very remote. That is not to say that migraine sufferers cannot have a stroke associated with their migraines. In persons under age 40, the most common associated factor for stroke is migraine headache. However, over the course of a person’s normal life span, the occurrence of migraine headache may actually be associated with a reduced risk of dying from cerebrovascular disease due to stroke.

MSG Headache
MSG stands for monosodium glutamate. It is added to food to enhance flavor and is derived from an amino acid called glutamic acid, which occurs naturally in many different foods. As a matter of fact, MSG produces the fifth type of flavor that is different than bitter, salty, sour, astringent, sweet, or pungent (eg chili) – this flavor is called umami. Although researchers have not found any evidence that links MSG with migraine or headache, many headache sufferers say they have adverse reactions to any food containing it. Recent studies have shown that MSG excites neurons in the body, which may in turn trigger a headache. MSG can be found in Chinese food, processed meats, canned vegetables, salad dressings, gravy mixes, soup and dip mixes, instant noodles, soy-based items, gum and many other products. The FDA requires food companies to list MSG on food labels, but it can also be hidden as a component of other ingredients. Watch for these words, which can tip you off to the inclusion of MSG: yeast extract, textured protein, gelatin or anything that’s hydrolyzed. If you are unsure whether MSG is triggering your headaches, keep a food diary to track your headache patterns and always read food labels.

Occipital Headache
The occipital nerve transversing the back of the head can cause unilateral head pain with radiation to the temporal area of the head. These symptoms can be precipitated by injury, overlaying muscle tension or anatomic variations. This headache can be treated with medication, local blocks and in some cases surgical intervention.

Ophthalmoplegic Migraine
A rare condition considered to be an unusual form of migraine, new considered to be a neuralgia. The pain usually surrounds the eyeball and lasts from a few days to a few months, caused by weakness of the muscles surrounding the eye. Double vision is prominet. It is important to exclude many serious causes of double vision and eye pain.

Orgasmic Headache
Headaches can be associated with sexual activity, especially with orgasm. There are two types of these headaches. In the first type, the excitement accompanying intercourse causes muscle contraction in the head and neck, thus leading to head pain. The second type is a vascular headache. It is a very intense, severe headache usually occurring just before orgasm. It has been called an “orgasmic headache” or “orgasmic cephalalgia.” In some instances, the headache is a response to an increase in blood pressure, in which the blood vessels dilate. The headache is not usually related to the amount of physical exertion involved in intercourse. The pain may be located around or behind the eyes. It usually lasts a few minutes, but can last for hours. The headache is usually made worse by movement. The headache most often is a “benign” orgasmic headache; however, the possibility of organic disease should be thoroughly investigated. A headache occurring with orgasm could be a symptom of a brain hemorrhage (bleeding around or inside the brain), stroke or tumor. An accompanying stiffness in the neck may be an indication of bleeding into the spinal fluid. The benign orgasmic headache occurs more frequently in men than women and usually strikes migraine sufferers.

Over The Counter (OTC) Migraine Medications
The Food and Drug Administration (FDA) has approved three over-the-counter products to treat migraine. Excedrin® Migraine (a combination of aspirin, acetaminophen and caffeine) is indicated for migraine and its associated symptoms. Advil® Migraine and Motrin® Migraine Pain, both ibuprofen medications, are approved to treat migraine headache and its pain.

PMS Headache
Headache can be a primary symptom of PMS. PMS is one of the more difficult conditions to treat and its headaches equally as difficult to manage. If one is experiencing headache prior to, during, or immediately after menses, the use of nonsteroidal anti-inflammatory agents (compounds used to treat arthritis) ergotamine tartrate, or one of the triptans may be helpful in controlling these symptoms. In some patients, antidepressants such as fluoxetine are used to ameliorate PMS symptoms. Migraine predominantly associated with the menstrual period is referred to as menstrual migraine.

Preventative Migraine Medications
sometimes referred to as “prophylactic” treatments – are used to reduce the frequency, severity, and length of migraine attacks. Most preventive migraine medications were initially developed to treat other diseases, such as seizures, depression, or hypertension. Examples of preventive medications include antiepileptic medications, antidepressants, beta-blockers, calcium channel blockers, and NSAIDs (nonsteroidal anti-inflammatory drugs). The FDA has approved four drugs for migraine prevention. These include propranolol (Inderal®), timolol (Blocadren®), topiramate (Topamax®) and divalproex sodium (Depakote®). These have had many years of use and make up the majority of the items considered ‘first line’ therapy for migraine prevention. Amitriptyline, which is an antidepressant, may also be very effective as a migraine preventive. All migraine preventive medications require that adequate doses of the medicine be given for a sufficient length of time to determine the effectiveness. Titration of the doses may be needed to reduce adverse effects to medicines.

Rebound Headache
A pattern of taking acute headache medications too often (more than two days per week) or in excessive amounts (more than the label or a doctor advises) can lead to a condition known as “rebound headache.” With rebound headache, your medications not only stop relieving pain, they actually begin to cause headaches. Doctors treat rebound headache by tapering the medication that is being overused, sometimes by gradually substituting a different type of treatment or medication. Stopping may be a challenge, but regularly overusing a medication increases the potential for serious side effects. Consult a physician if you regularly use headache medications more than two days per week or more than the label advises.

Red Wine Headache
a headache often accompanied by nausea and flushing that occurs in many people after drinking even a single glass of red wine. This syndrome can sometimes develop within 15 minutes of consumption of the wine. The cause of red wine headache is not well understood although researchers have blamed a variety unique ingredients of red wine like tyramine, tannins, prostaglandins, histamines, sulfites and certain strains of bacteria and yeast.

Shingles Headache (Post Herpetic Neuralgia)
Shingles (herpes zoster virus) can cause pain resulting from the inflammation of cranial nerves. The pain may start during an acute rash from an infection by the herpes virus (not the sexually transmitted type but rather the same virus that causes chicken pox) but the main problem is pain that persists after the herpes rash has gone. Common symptoms include a constant deep pain, with repeated stabs, or needle pricking pain. Even light touch can trigger these symptoms which may be accompanied by itching. Half of patients have no pain after three years.

Sinus Headache
When a sinus becomes inflamed, usually as the result of an allergic reaction, a tumor, or an infection, the inflammation will cause a localized pain. If your headache is truly caused by a sinus blockage, such as an infection, you will probably have a fever. An x-ray will confirm a sinus blockage. Your physician’s treatment might include antibiotics for the infection, as well as antihistamines or decongestants. Click here for more information.

Stress Management
Life events that increase stress, anxiety, and depression have been associated with chronic migraines and headaches. Certain antidepressant drugs are the primary therapy for some types of chronic headaches, such as a tension-type headache. The results of a large study indicate that stress management therapy reduced headache, headache-related disability, and use of pain medications to a similar degree as therapy with antidepressant drugs. However, the best results were obtained when stress management was combined with antidepressant medication.

It may be helpful to incorporate a regular practice of relaxation into a health-promoting lifestyle (getting enough sleep and eating a healthy diet, for example). Biofeedback and relaxation training can be obtained at the psychology and psychiatry departments

Temporal Arteritis
Inflammation of the temporal artery, a vessel that runs in front of the ear and up along the side of the head can be a dangerous condition that may lead to blindness. The headache in this case is persistent but often worse at night and sometimes severe, in a patient over 50 who does not feel entirely well. It may be accompanied by marked scalp tenderness. Pressing against the length of the blood vessel causes pain and the treatment is with anti-inflammatory medications such as corticosteroids (e.g. prednisone).

Tension Headache
Tension-type headaches occur randomly and are often the result of temporary stress, anxiety, fatigue, or anger. Symptoms include soreness in your temples, a tightening band-like sensation around your head (a “vice-like” ache), a pulling feeling, pressure sensations, and contracting head and neck muscles. The headache begins in your forehead, temples, or the back of your head and neck. Treatment for tension-type headache may include over-the-counter or prescription medications, as well as self-help techniques such as relaxation training and biofeedback.

Thunderclap Headache
A sudden, severe headache that may mimic a thunderclap in its intensity and severity. It may be a warning of an impending rupture of an aneurysm or weak blood vessel. It can also be a benign syndrome as well, often seen individuals suffering from migraines. Since the nature of the headache by itself cannot allow distinction between benign and serious causes, it is essential to seek out prompt medical evaluation if the onset of a headache is sudden and severe.

TMJ Headache
TMJ stands for Temporomandibular joint or the joint of the lower jaw. Tooth grinding, clenching the teeth as a nervous habit frequent gum chewing, trauma, a bad bite from poor dentition and laxity of the jaw ligaments are just some causes of dysfunction of this joint. Headache is one of the most common symptoms of a TMJ problem. Usually the TMJ headache is located in the temples, back of the head, and even the shoulders. Clenching and grinding of the teeth, both of which may be TMJ symptoms, produce muscle pain which can cause headache pain. Also, a displaced disc in the TMJ may cause pain in the joint which is often referred into the temples, forehead or neck. These headaches are frequently so severe that they are confused and treated (with little success) for migraine headaches or abnormalities in the brain.

Trigeminal Neuralgia (Tic Douloureux)
This headache typically strikes people over age 50. The head pain appears on one side of the head, very intense, and recurrent, affecting mainly the facial area. It is a sharp, burning type of pain, often set off by touch, chewing, laughing, talking, or even a cold breeze.The pain is intermittent, with jabs lasting for approximately 30 seconds, followed by a few pain-free moments, and then another group of painful jabs, which may reoccur for a few hours at a time. The attacks can go on for weeks or months. Anticonvulsant medications may reduce the sensitivity in the facial region, thus preventing the attacks of pain. They may take effect anywhere from a few hours to a day after initiating treatment, and therapy should continue for weeks or months.If medication is not effective, surgery may be indicated. Attacks may at times spontaneously subside.

Triptans
Triptans such as Imitrex, Zomig, Relpax, and Maxalt are the newest class of abortive medications specifically targeted to treat migraine. In addition to shrinking the diameter of blood vessels (also called vasoconstriction), they moderate some chemical reactions in the brain. The triptans work on receptors in your brain, helping to restore the balance of a neurotransmitter called serotonin. Changing levels of serotonin are thought to be a main cause of migraine. These medications are available in a self injectable form, a pill and as a nasal spray.

TV or Computer Use Headache
Many people believe that eyestrain causes their headaches. This seems possible given the amount of time people spend reading, working on computers, watching TV and playing video games. Although refractory errors may contribute to headaches, other factors such as posture, stress and long periods of concentration may be involved in these types of headaches. If eyestrain is suspected, the first step is a complete ophthalmological exam. Any visual abnormalities should be corrected with glasses or contacts since refractive errors could produce eyestrain. After this has been addressed, the use of either a polarized (anti-glare) screen such as is used for computers, or the use of tinted eyeglass lenses (even if they are not corrective lenses) is recommended. Pay attention to proper posture, especially when working on the computer. Take frequent short breaks including stretching your neck, arms and back. Try closing your eyes and taking a few deep breaths! Eyestrain may be a trigger for migraine or tension-type headaches. If the headaches persist, see your healthcare provider.

Vascular Headaches
This headache commonly results from blood vessel dilation or swelling causing pain. The blood vessels in the tissues surrounding the head swell, become distended and inflamed, so that the normal pulsation of the vessels causes a throbbing type of pain. Vascular headaches are usually throbbing in character, and physical exertion increases the pain. Included under the classification of vascular headaches are migraine headaches, cluster headaches, and toxic headaches. All involve dilation, or swelling of the blood vessels in the head and scalp.

Weather Headache Effect
Bright sunshine, hot, humid conditions, and drastic changes in barometric pressure may lead to, or “trigger,” a migraine attack in some migraineurs. However, studies have shown that weather does not act as a trigger for everyone who has migraine.

Weekend Headache
A Change in your sleep pattern — too much or too little — may instigate a headache. It is best to get the same amount of sleep each night and get up the same time each day, even on the weekend. Of course alcohol intake including red wine can cause hangover type headache which is more common at the end of a work week.