Understanding Headaches and Migraines

Headaches and migraines affect millions of Americans every year, making them one of the most common neurological conditions in the country. More than 39 million people in the U.S. suffer from migraines alone, while 1 in 6 Americans experience severe headaches or episodic migraines over a three-month period. These conditions can range from occasional discomfort to chronic, debilitating pain—impacting work, relationships, and overall quality of life. Understanding the causes, symptoms, and treatment options is the first step toward relief and better health.

What Causes Headaches

Headache triggers include overuse of pain relievers, caffeine, migraine-specific medicines, poor sleep, obesity, depression, anxiety and stress. Stress requires special mention because it is such a common issue in daily life. The pain of headaches can itself be a stressor. Stress is as much a state of body as it is a state of mind. When stressed over long periods of time, the body responds by developing other problems and mental changes. While stress is common in daily life, we can suggest lifestyle changes to help you manage and reduce stress. These changes, along with medical treatments, may reduce the severity of headaches.

Types of Headaches 

A headache is a pain or discomfort in the head, scalp, or neck. It can range from mild to severe and may occur on one or both sides of the head. Headaches are broadly categorized into primary and secondary types. Primary headaches are not caused by another medical condition, while secondary headaches result from an underlying issue. Most headaches are primary headaches. This type of headache is not due to a secondary issue, such as a tumor, circulation or an infection.

Primary Headaches

Tension-Type Headache: The most common type, characterized by a dull, aching sensation all over the head. It often feels like a tight band around the forehead. 

Migraine: Known for severe, throbbing pain, often on one side of the head. Migraines can be accompanied by nausea, vomiting, and sensitivity to light and sound. Common triggers include hormonal changes, certain foods, stress, and environmental factors. Migraines typically progress through four stages: prodrome, aura, headache and postdrome. Recognizing these stages can help in managing symptoms and seeking timely treatment.

Cluster Headache: Intense pain around one eye, occurring in clusters over weeks or months, followed by periods of remission.

Secondary Headaches

Less than three percent of headaches are secondary, meaning they are due to underlying causes. Secondary headaches require testing to determine those causes.

Sinus Headache: Caused by inflammation in the sinuses, leading to pain in the forehead, cheeks, and bridge of the nose. 

Medication Overuse Headache: Resulting from frequent use of headache medications, leading to a cycle of persistent headaches. 

Understanding Migraines 

Migraines are a type of primary headache disorder characterized by recurrent attacks. They can significantly impact daily life and vary in severity and duration. 

Types of Migraines 

Migraine with Aura: Preceded by sensory disturbances such as visual changes, tingling, or speech difficulties. Migraine without Aura: More common, lacking the sensory disturbances but still causing severe head pain. 

Chronic Migraine: Occurs 15 or more days per month, with at least eight days of migraine symptoms. 

Hemiplegic Migraine: Rare and severe, causing temporary paralysis on one side of the body. 

Symptoms and Causes 

Migraines are often accompanied by symptoms such as nausea, vomiting, and sensitivity to light and sound. Triggers can include stress, hormonal changes, certain foods, and environmental factors. Understanding these triggers is key to managing migraines effectively. 

Diagnosing Headaches and Migraines

Accurate diagnosis is essential for effective treatment. Doctors and clinicians use a combination of medical history, physical examination, and diagnostic tests to identify the type of headache or migraine. 

Diagnostic Tests 

Neurological Exam: Assesses brain function and checks for signs of neurological disorders. 

Imaging Tests: MRI or CT scans may be used to rule out structural causes of headaches. 

Blood Tests: Help identify underlying conditions that may contribute to headaches.  

Headache Progression

Headache progression refers to headaches that worsen or change over time — a main reason people seek help. There are many factors that may cause progression. Our headache specialists work with you to find factors that may be causing the changes, and through a complete treatment plan, work to reverse the progression. Finding these factors is not a quick or simple process. The greater the progression, the longer it may take to improve your response to treatment.

When to Seek Medical Help 

• Seek immediate medical attention if you experience:
• Sudden, severe headache
• Headache with fever, stiff neck, or confusion
• Headache after a head injury
• Persistent headache that worsens over time

Headache Treatment

Like other medical disorders, treating headaches involves observation, treatments, monitoring the outcome of the treatments, and making changes to improve your response. It is not a quick or simple process, but by working with our medical team, most patients can achieve positive results.

While we have discovered a lot about what happens in the body to cause headaches and what adds to progression, there is still much to learn. Much depends on each person’s genetics, overall health and lifestyle. Finding the best treatment solutions requires you to "know yourself" by keeping a headache diary to determine what influences your headaches and how your treatments are working.

Treatment Options for Headaches

Multidisciplinary Team Approach and Patient Expectations

We take a multidisciplinary team approach to examine the reasons for your headaches. Through medicine and lifestyle adjustments, we work with you to find the best answers. As our headache specialists zero in on your headache triggers and the most effective treatments for each individual, it’s important to remember that there are no quick fixes. Headaches and their treatment can be complicated. Keep your expectations realistic. Even in the best of hands with the best of medicines, only half of the people with disabling headaches will reduce 50 percent of their headaches in six months with any given single preventative approach. Looking at all the angles, our multidisciplinary approach is an effective way to achieve positive results over time.