Headache: Main Causes of Head Pain

First comes a tightening around the temples, as if someone is slowly pulling a band tighter. Then the pain spreads across the whole head, and ordinary tasks become hard work. Headache is the most common type of pain: about 90% of people experience it at least once a year, and most often it goes away on its own.

What types of headache exist

Doctors classify as headache the sensations above the line that connects the outer corner of the eye, the external auditory canal, and the first cervical vertebra — this is how it is distinguished from facial and neck pain. The brain itself has no pain receptors: pain originates in the vessels, meninges, nerves, and muscles of the head and neck.

All headaches are divided into primary and secondary. Primary pain has no organic cause and is related to a disturbance in the formation of the pain sensation; it accounts for 95–98% of all cases. Secondary pain is a symptom of another disease.

The most common form is tension-type headache: it is caused by tension in the muscles of the shoulders, neck, scalp, and jaw, often against a background of stress, depression, or anxiety. Less common are migraine, cluster, and sinus pain; women suffer from migraine three times more often than men, and from cluster headache — conversely, men 5–8 times more often.

What can cause a headache: common causes

An ordinary headache can last from 30 minutes to several days. Common causes:

• a cold or flu;
• stress;
• alcohol;
• poor posture and vision problems;
• irregular meals and lack of fluids.

Uncontrolled use of painkillers also leads to headache: medication-overuse headache develops, which only gets worse from them. In women, pain may be related to hormonal changes — menstruation or menopause. A headache diary can help identify what triggers the pain.

When headache is related to other diseases

Secondary pain is a symptom. A thunderclap, sudden, and very severe pain may be the only sign of subarachnoid hemorrhage. Pain together with fever and neck stiffness suggests meningitis, and confusion suggests encephalitis.

Pain that worsens with exertion or changes in body position, becomes stronger in the morning, and is accompanied by vomiting is characteristic of increased intracranial pressure. Its cause may be a brain tumor, idiopathic intracranial hypertension (more often in young women with excess weight), and in rare cases thrombosis of the dural sinuses. In older adults, pain with visual impairment and jaw problems may be a sign of giant cell arteritis.

Warning signs that make the pain dangerous

Pain together with visual impairment, or eye problems, is a reason to see a doctor without delay. The same applies to pain triggered by coughing, sneezing, bending over, or physical exertion, pain with vomiting, and pain accompanied by jaw pain when chewing or tenderness of the scalp. If a child's pain worsens or wakes them at night, that is also a reason to visit a doctor.

A headache by itself is not a reason to call an ambulance; 103 or 112 are needed if the pain came on suddenly and was extremely severe, if seizures, numbness or weakness in the body or face, difficulty speaking, walking, balancing, or with memory, loss of vision, drowsiness and confusion, a rash that does not blanch when pressed, very high fever, neck stiffness, or intolerance of bright light have appeared. You should also call if the pain appeared after a head injury within the last three months.

How a doctor determines the cause of a headache

The doctor looks for warning signs — "red flags": their presence may indicate a dangerous nature of the pain and becomes a basis for additional tests.

Which doctor to see if you have a headache

First, you can see a primary care doctor; if the pain does not go away, worsens, or recurs regularly, as with warning signs, a doctor's consultation is needed. The specialist in headache is a cephalalgist (neurologist). With the signs from the box above, you should immediately call 103 or 112; with other warning signs, see a doctor urgently.

This text is for reference: it explains what causes a headache and when it is time to see a doctor, but it does not replace a doctor's consultation — only a specialist determines the diagnosis and cause.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer