Headache

What is Headache?
A headache happens when pain-sensitive nerve fibers (called nociceptors) are triggered in the network of nerves that extends over the scalp, face, and along the surface and the base of the brain. Ninety percent of all headaches are triggered by stress or tension. These muscle contraction headaches usually resolve on their own or with the help of over-the-counter painkillers. Other types of headache have different triggers and are not as easily treated. 

Doctors classify headaches as belonging to one of the following classes:

  •   Muscle contraction headaches are caused by sustained tension in the muscles of the face and neck. The pain is usually mild to moderate and feels like pressure is being applied to the head or neck.

  •   Vascular headaches are caused by abnormal blood flow changes in the brain. This type includes migraine headaches; toxic headaches due to fever or exposure to triggering chemicals such as MSG, insecticides, or solvents; and cluster headaches, which strike in groups or clusters over several weeks to a month. Vascular headaches are characterized by intense, throbbing pain on one or both sides of the head.

  •   Traction headaches happen when nerve fibers are pulled, stretched, or displaced, for example, by squinting to compensate for poor eyesight. Brain tumors can also cause traction headaches as they press against pain-sensitive blood vessel walls. Traction headaches typically feel as if a strong pressure is being applied to the head.

  •   Inflammatory headaches are caused by irritation or infection of the arteries or nerves in the head, sinuses, spine, neck, ears, or teeth. Arteritis, an inflammation of arteries in the head, and meningitis, an inflammation of the brain’s outer covering, are examples of this type of headache. Pain is usually mild to moderate and can be periodic or continuous depending on its cause.

    Most headaches can be easily diagnosed, since types of headaches tend to have clear-cut symptoms that fall into recognizable patterns. If a headache isn’t relieved by standard treatments, people may be referred to a specialist.

    Is there any treatment?
    Treatment depends on the type of headache. Muscular contraction headaches, such as tension headaches, are relieved using over-the-counter painkillers, muscle relaxants, or stress reduction techniques. Migraine headaches are treated with drugs that can either prevent attacks or relieve symptoms when attacks occur. Some people try to prevent migraines by eliminating foods that appear to trigger the attacks. Traction headaches caused by brain tumors may require surgery to remove the source of pressure. Inflammatory headaches, such as those caused by arteritis and meningitis, are treated with corticosteroids to reduce tissue swelling.

    What is the prognosis?
    Not all headaches require medical attention. About 90 percent of all headaches resolve on their own, or with the aid of over-the-counter painkillers. The recent development of drugs to treat migraine headaches has helped many people cope more successfully with the pain of migraine. Some types of headache are signals of more serious disorders and call for medical attention. These include sudden/severe headache, headache with convulsions, headache with confusion or loss of consciousness, headache after a blow to the head, headache associated with pain in the eye or ear, persistent headaches in adults, recurring headaches in children, and headaches associated with fever.

    What research is being done?
    Understanding why headaches occur and improving headache treatment is the goal of research sponsored by the NINDS and NIH. NINDS also supports and conducts studies to improve the diagnosis of headaches and to find ways to prevent them. Recent research using an experimental technique called thermography, in which an infrared camera converts skin temperature into a color picture (thermogram) coded according to temperature level, showed that headache patients have strikingly different heat patterns from those of people who never or rarely get headaches. Another study looked at the best ways to use progressive muscle relaxation techniques and biofeedback to ease the pain of migraine and tension headaches.

    Johns Hopkins patient information

    Last revised:

    Diseases and Conditions Center

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