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Headache

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Jay W. Marks, MD

Questions to Ask Your Doctor About Headaches

Medical Author: Dennis Lee, MD
Medical Editor: Melissa Conrad Stöppler, MD

Questions to ask your doctor about headache, and when to call the doctor about headacheHeadache is defined as pain in the head that is located above the eyes or the ears, behind the head (occipital), or in the back of the upper neck. Headache, like chest pain or dizziness, has many causes. There are two types of headaches: primary headaches and secondary headaches. Primary headaches are not associated with (caused by) other diseases. Examples of primary headaches are migraine headaches, tension headaches, and cluster headaches. Secondary headaches are caused by associated diseases such as brain tumors, strokes, meningitis, subarachnoid hemorrhages, caffeine withdrawal, or discontinuation of analgesics. In rare occasions, headaches may signal heart attacks.

Establishing the diagnosis of the headache, arriving at effective treatment(s) for the headache, and taking measures to prevent or reduce headache episodes will require cooperation between you and your doctor. Following are suggestions on how to work with your doctor in diagnosing and managing your headaches.

How Can I Help My Doctor?

Pay attention to your symptom(s) so you can describe your condition as accurately as possible:

  1. What are your headache location, duration, severity (worst ever headache?), and character (dull, sharp, throbbing, etc.)?
  2. What brings them on (for example, certain foods, stress, bright light, fasting, or sleep disturbances)?

What is a headache?

Headache is defined as pain in the head or upper neck. It is one of the most common locations of pain in the body and has many causes.

How are headaches classified?

Headaches have numerous causes, and in 2007 the International Headache Society agreed upon an updated classification system for headache. Because so many people suffer from headaches, and because treatment is sometimes difficult, the new classification system allows health care practitioners to understand a specific diagnosis more completely to provide better and more effective treatment regimens.

There are three major categories of headaches:

  1. primary headaches,

  2. secondary headaches, and

  3. cranial neuralgias, facial pain, and other headaches

What are primary headaches?

Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache.

Tension headaches are the most common type of primary headache; as many as 90% of adults have had or will have tension headaches. Tension headaches are more common among women than men.

Migraine headaches are the second most common type of primary headache. An estimated 28 million people in the United States (about 12% of the population) will experience migraine headaches. Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected. An estimated 6% of men and up to 18% of women will experience a migraine headache.

Cluster headaches are a rare type of primary headache, affecting 0.1% of the population. An estimated 85% of cluster headache sufferers are men. The average age of cluster headache sufferers is 28-30 years of age, although headaches may begin in childhood.

Primary headaches affect quality of life. Some people have occasional headaches that resolve quickly, while others are debilitated. Tension, migraine, and cluster headaches are not life-threatening.

What are secondary headaches?

Secondary headaches are those that are due to an underlying structural problem in the head or neck. There are numerous causes of this type of headache ranging from bleeding in the brain, tumor, or meningitis and encephalitis.



Next: What are cranial neuralgias, facial pain, and other headaches? »

Headache - Effective Treatments

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