Headaches

• Seven in 10 people have at least one headache a year
• The majority of headaches last for only a few hours, but some can persist for weeks
• Forty-five million Americans suffer from chronic headaches
• Headaches cost billions of dollars in lost productivity every year

With a headache, pain may occur in only one part of the head, such as above the eyes, or it may involve the entire head. The type of pain experienced varies; it may be constant and dull or sudden and sharp. And sometimes other symptoms, such as nausea, occur at the same time depending on the type of headache.

Three main types of headaches

• Tension headaches typically feel like a tightening on both sides of the head. They can last for minutes or days, and can happen frequently. Tension headaches are often the result of stress or bad posture, which causes tightening of the muscles in the neck and the scalp. Tension headaches often worsen with noise and hot, stuffy environments. This type of headache occurs mostly in women over age 20.

• Migraine headaches are intense and throbbing, often involve one side of the head, and can make you sensitive to light or noise. Migraines last from hours up to three days and are more common in women. Some sufferers have an "aura" (a group of visual symptoms) just before an attack. In the U.S. each year, about 25 million people experience a migraine. Migraine sufferers usually have their first attack before age 30, but they can also occur in children as young as age three. Migraines recur at intervals of varying length. Some people have attacks several times a month; others have less than one a year. Most people find that migraine attacks occur less frequently and become less severe as they get older. There are two types of migraine: migraine with an aura and migraine without aura. An aura is a group of symptoms that develop before the onset of the main headache.

• Cluster headaches are non-throbbing and usually are felt on one side of the head behind an eye. Cluster headaches affect about 1 million people in the United States. More common in men, they can happen over several days and usually last 30 to 45 minutes. They generally occur between one and four times a day. Like migraines, cluster headaches are likely to be related to an increased blood flow as a result of the blood vessels in the brain widening.

What are the causes?

There are many possible causes of headache that determine the site and nature of the pain. About three in four of all headaches are caused by tension in the scalp and neck muscles. Very few headaches have serious underlying causes, but those that do require urgent medical attention. For example, a severe headache may be a sign of meningitis. In elderly people, a headache with tenderness of the scalp or temple may be due to temporal ateritis, in which blood vessels in the head become inflamed.

If you have a headache that lasts more than 24 hours and is severe, or accompanied by other symptoms, such as problems with vision or vomiting, medical help should be sought immediately.

What might your doctor do?

Your doctor may do a physical examination if he/she suspects an underlying disorder causing your headache. You may require tests such as a CT scan or a MRI of your brain.

Reference: American College of Physicians. Internal Medicine.  http://www.acponline.org/patients_families/diseases_conditions/headaches/