Headaches are incredibly common. There are many different types of headaches, all of which have different causes, characteristics and treatment options. Brian Gerhardstein, M.D., Ph.D., a neurologist at JFK University Medical Center, offers insight on the three most common types of primary headaches.

1. Migraines

Symptoms: A person with a migraine typically reports moderate to severe throbbing pain often located on one side of the head. The headache may last for hours up to a few days or longer. Migraines are commonly associated with nausea and vomiting as well as sensitivity to light and/or sound. 

“Some people may experience an aura with their migraine, which are a transient neurological symptoms including visual disturbances such as zig-zag lines, flashing lights, spots or vision loss, dizziness, speech problems, weakness or sensory disturbances such as tingling or numbness,” says Dr. Gerhardstein.

Causes: The underlying cause of migraines is still under investigation, although there is probably a genetic component since they often run in families.  Migraine triggers may include:

• Stress
• Dehydration or hunger
• Certain foods
• Medications
• Bright lights
• Loud noise
• Menstruation
• Menopause
• Disruption in sleep patterns

Treatment Options: Options for treating migraines include simple tasks such as lying down in a quiet, dark room or putting an ice pack or cold compress on the head.

There are also many different migraine medications which can stop the headaches when they occur, and these include both prescription and over-the-counter medicines.  There are also many treatment options which may prevent migraines, such as anti-seizure medicine, antidepressants, blood pressure medicine, Botox, peptide inhibitors or electrical stimulation.  “In addition, lifestyle modifications, such as getting good sleep, maintaining proper diet and eating habits, exercise as tolerated, smoking cessation, and avoiding triggers such as dehydration may also help prevent headaches from occurring” says Dr. Gerhardstein. 

2. Tension Headaches 

Symptoms: Tension headaches are due to muscle tension and are characterized by a dull pain, tightness or pressure in the head and/or neck. They may last less than an hour up to a few days. 

Causes: Triggers or tension headaches include:

• Physical or emotional stress 
• Not getting enough sleep
• Anxiety and depression
• Fatigue
• Hunger and dehydration
• Teeth/jaw clenching
• Overexertion
• Neck or back problems

Treatment and Prevention: Tension headaches are usually managed with over-the-counter pain medication. “If you experience frequent or prolonged headaches or if they don’t improve with self-care, then it may be time to see a doctor,” says Dr. Gerhardstein. “If your doctor diagnoses tension headaches, they may recommend lifestyle changes, therapy or medications to treat your pain.”

3. Cluster Headache

Symptoms: Cluster headaches generally occur behind or around the eye on one side, and these can be very painful.  These headaches often occur for a few weeks or months, typically in the night time. They may go away for a period of time but they can spontaneously start back up again. 

Symptoms can include:

• Extreme pain in or around the eye on one side of the head
• Restlessness
• Feeling flushed
• Tearing up
• Sniffling with a runny nose
• Swelling, droopiness and redness around an eye 

Causes: The cause of cluster headaches is still under investigation. This type of headache usually isn’t associated with triggers such as food or stress, like some of the other headache types. 

Treatment and Prevention: If you are experiencing cluster headaches, Dr. Gerhardstein recommends seeing a doctor. “It’s important to find a doctor who can help diagnose cluster headaches and work with you to find an effective treatment.”

When to See a Doctor 

Make an appointment to discuss your headaches with your doctor if:

• Your headaches are becoming more severe, more frequent, not responsive to treatments or are associated with any other new or worsening symptoms.

Your doctor may refer you to a neurologist or other specialist for additional evaluation and treatment, if needed.

Next Steps & Resources:

• Meet our source: Brian Gerhardstein, M.D., Ph.D. 
• To make an appointment with Dr. Gerhardstein or a doctor near you, call 800-822-8905 or visit our website.
• Learn about headache and migraine treatments at Hackensack Meridian Health

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.