Tension-type headaches
Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers.
- As many as 90% of adults have had tension-type headache.
- Tension-type headaches are typically a steady ache rather than a throbbing one and affect both sides of the head.
- Some people get tension-type (and migraine) headaches in response to stressful events or a hectic day.
- Tension-type headaches may also be chronic, occurring frequently or even every day.
- Psychologic factors have been overemphasized as causes of headaches.
Migraine Headaches
Migraine headaches are less common than tension-type headaches. Nevertheless, migraines afflict 25 to 30 million people in the United States alone.
- As many as 6% of all men and up to 18% of all women (about 12% of the population as a whole) experience a migraine headache at some time.
- Roughly three out of four migraine sufferers are female.
- Among the most distinguishing features is the potential disability accompanying the headache pain of a migraine.
- Migraines are felt on one side of the head by about 60% of migraine sufferers, and the pain is typically throbbing in nature.
- Nausea, with or without vomiting, as well as sensitivity to light and sound often accompany migraines.
- An aura –a group of telltale neurologic symptoms–sometimes occurs before the head pain begins. Typically, an aura involves a disturbance in vision that may consist of brightly colored or blinking lights in a pattern that moves across the field of vision.
- About one in five migraine sufferers experiences an aura.
- Usually, migraine attacks are occasional, or sometimes as often as once or twice a week, but not daily.
Characteristics Associated with Primary Headaches Help Differentiate Tension-Type Headaches from Migraine
Columns A and B show the symptoms commonly seen in two types of headache. Compare your symptoms with those listed and determine what type of headache you may have by noting whether your symptoms are most like those in column A or B. Some people have both of these types of headache. If your headache are very severe or if you think they are some other type, do not delay in seeking professional medical attention.
| Symptom | A Tension |
B Migraine |
| Intensity and Quality of Pain | ||
| Mild-to-moderate | • | • |
| Moderate-to-severe | • | • |
| Intense, pounding, throbbing and/or debilitating | • | |
| Distracting but not debilitating | • | |
| Steady ache | • | |
| Location of Pain | ||
| One side of head | • | |
| Both sides of head | • | • |
| Associated Symtoms | ||
| Nausea/vomiting | • | |
| Sensitivity to light and/or sounds | • | |
| Aura before onset of headache such as visual symptoms | • | |
| Note: Rebound headache may have features of tension and/or migraine headache | ||
Cluster Headaches
Cluster headaches are relatively rare, affecting about 1% of the population. They are distinct from migraine and tension-type headaches.
- Most cluster headache sufferers are male-about 85%.
- Cluster headaches come in groups or clusters lasting weeks or month.
- The pain is extremely severe but the attack is brief, lasting no more than a hour or two
- The pain centers around one eye, and this eye may be inflamed and watery. There may also be nasal congestion on the affected side of the face.
- These “alarm clock” headaches may strike in the middle of the night, and often occur at about the same time each day during the course of a cluster.
- A history of heavy smoking and drinking is common, and alcohol often triggers attacks.
Rebound Headache
Rebound headache may occur among people with tension-type headaches as well as in those with migraines.
- It appears to be the result of taking prescription or nonprescription pain relievers daily or almost every day, contrary to directions on the package label.
- If prescription or nonprescription pain relievers are overused, headache may “rebound” as the last dose wears off, leading one to take more and more pills. This is a good reason to call your doctor!