Understanding the Different Types of Headaches

Not all headaches share the same symptoms. Learn about the different types of headache and headache symptoms and who is more likely to experience each type.

Most people get headaches now and then, some people more than others. Then there are those who get migraines, which are much more than “just” headaches. Migraineurs — those who get frequent migraine headaches — know their migraine symptoms all too well.

Head pain can be frightening because people often think that it could be the sign of something serious. “A person with headaches should always discuss this issue with their physician,” says Steven P. Herzog, MD, an attending neurologist at Baylor University Medical Center in Dallas. "In turn, their physician can make a correct diagnosis of the type of headaches the patient is suffering with and whether or not they should see a headache specialist.”

What Is a Headache?

It sounds like an obvious question, but different types of headaches affect people in a variety of ways, and they generally have different headache symptoms.

• Tension-type headaches affect almost everyone at some point. Those that happen occasionally are just that: occasional headaches. Some people, however, have tension-type headaches just about every day, and these are considered to be chronic. Headache symptoms for tension-type headaches usually include pressure or muscle tension on both sides of the head or back of the neck; the pain is usually constant, not sharp or throbbing. Many people describe them as like having a band squeezed around their head.
• Hormone headaches are menstrual headaches that may start before your period is due or while you’re menstruating. Migraines are often associated with menstruation, and symptoms include sharp, throbbing pain on one side of the head, nausea, vomiting, and sensitivity to light, sound, and even touch.
• Cluster headaches affect men more often than women. They are extremely intense, very severe headaches that last between 30 and 45 minutes; you can have several in one day. They usually come on with no warning, catching people by surprise. The pain is piercing and usually located on one side of the head, often around the eye. People also report teary eyes on the affected side and sinus congestion. The headaches will recur over a period of time, almost always on the same side, and are followed by a headache-free period of varying length.
• Migraines are often put in a class by themselves because of the intensity of the pain and the overall effect they have on the body. For some people, migraine symptoms include auras, which are symptoms that occur before the pain hits. The auras can be visual (seeing lines or spots) or they can cause motor or verbal disturbances. “It’s estimated that 50 million people in the United States have migraine,” says Dr. Herzog. However, most do not have migraine with aura.
  Migraine pain, usually throbbing and piercing, is generally one-sided, but can affect both sides. People often report sensitivity to light and loud noises as well as nausea during migraine attacks.

When Should You See a Doctor?

Call your doctor if the quality or type of headache symptoms change, or if you feel that you are having migraines, which may need prescription-strength treatment. Other reasons to contact your doctor include:

• Any changes in the type of headache you usually get.
• Headaches that don’t go away or that get worse as each day passes.
• Headaches that occur with physical activity (including sex).
• Headaches that happen after injury or illness.
• Headache accompanied by a fever, stiff neck, signs of a stroke (such as difficulty speaking, numbness, weakness), seizures, or changes in your vision.
• Worsening of your headache if you have to strain, as when having a bowel movement, sneezing, or coughing.
• New headaches if you’re over 50.