Headaches: understanding your pain, head-on

A headache can be a real... pain in the head, and more common than you think. The World Health Organization reports that up to 75% of the population had a headache in the last year. There are various types of headaches, and finding out which type you have can help you get the best treatment. The International Classification of Headache Disorders provides information to diagnose and categorize headaches. In this article we’ll break down the difference between primary and secondary headaches, the most common types of headaches that fall into each, and the importance of tracking your headaches.  

Primary headaches

The first group of headaches is classified as primary headaches. This means the headache is the primary problem for which help is being sought. Headaches in this category are not a side-effect or symptom of another condition or disease.

Migraine headaches

Migraine headaches can occur with or without an aura. Migraines without an aura are called “common migraines.” These are characterized by pain, usually only on one side of the head (although children may present with pain on both sides), which is quite intense, pulsing or throbbing and lasting from 4- 72 hours. There is often nausea, light or sound sensitivity and symptoms may increase with any activity, including walking or climbing stairs. 

A migraine with an aura is known as a “classic migraine.” Classic migraines present with symptoms of aura that last up to 60 minutes, followed by a headache. Other symptoms like fatigue may also be present before the onset of an aura.    

Auras are thought of as warning signs. The most common auras are visual symptoms, such as spots, zigzags, flashes of light or even losing sight. The next most common warning sign or aura is pins and needles or numbness, again typically on one side of the body, face or tongue, but in children and adolescents, it can be on both sides. The least common aura is difficulty with speech. These symptoms can be signs of other medical problems and should always be investigated and properly diagnosed by a healthcare provider.

Tension-type headaches

Tension-type headaches are very common in the general population, with some studies reporting up to 78% of the population. They are also known as common headaches, tension headaches, or muscle contraction headaches, and are classified as episodic or chronic. Episodic headaches come and go and are further broken down to infrequent, less than once per month, or frequent. Chronic tension-type headaches are very frequent (more than half of the days in a month), last hours to days or longer. They often affect quality of life, cause disability, and are considered a serious disease that should be addressed with a healthcare provider. 

Secondary headaches

This group of headache types are those whose onset is triggered by another injury, disease, or condition. 

Headache due to trauma 

The most common type of secondary headaches is those which develop with or following trauma or injury to the head and/or neck. Injuries like whiplash or concussion are clinically the most common. The hallmark of this type of headache is that symptoms most often develop within 7 days of head and/or neck injury and present with characteristics of primary headaches, either tension-type or migraine.   

It is important to note that injury or trauma to the head and/or neck can be serious and may require immediate medical attention. Signs and symptoms constituting medical emergency when head and/or neck trauma has occurred or is suspected include vomiting, worsening headache, difficulty with speech, dilated pupil and lowered state of consciousness.

Cervicogenic headaches 

Another common type of secondary headaches is those that can be attributed to neck structures, sinuses, teeth, mouth or the temporomandibular (jaw) joint. If headache symptoms can be linked to structures in the neck area, such as arthritic neck or jaw joints or trigger points in the neck muscles, such headaches would be classified as secondary, cervicogenic headaches. This type of headache presents similar characteristics to the tension-type, primary headaches. 

Understanding your headaches

Tracking your headaches can be useful to help identify a headache pattern and to support discussion with your healthcare provider. Consider using a headache diary, be sure to include time of onset and duration of symptoms, possible triggers, types of symptoms, and whether symptoms are affected by any activity, movement, position and/or treatment, including medications. Create your own or consider using a ready-made headache diary from The National Headache Foundation.

If you would like help in determining the type of headaches you are experiencing or support in managing or reducing your headaches, schedule an appointment with one of our clinicians. Check out our locations page to find a clinic near you or book online here.