Find Headache Specialists near you

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FAQs:

What is a Headache Specialist?

Headache specialists are neurologists who have completed an additional year of training (called a fellowship) specifically in headache medicine and have been certified by the United Council for Neurologic Subspecialties. They stay up to date on headache research and new treatment options.

What is a Headache?

A headache is a pain in your head or face that’s often described as a pressure that’s throbbing, constant, sharp, or dull. Headaches can differ greatly regarding pain type, severity, location, and frequency. Headaches are a very common condition that most people will experience many times during their lives. They’re the most common form of pain and are a major reason cited for days missed at work or school, as well as visits to healthcare providers. While most headaches aren’t dangerous, certain types can be a sign of a more serious condition.

What is a Migraine?

A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so bad that it interferes with your daily activities.

For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking.

Medications can help prevent some migraines and make them less painful. The right medicines, combined with self-help remedies and lifestyle changes, might help.

What Exactly Happens During a Headache?

A headache may feel like a pain inside your brain, but it’s not. Most headaches begin in the many nerves of the muscles and blood vessels that surround your head, neck, and face. These pain-sensing nerves can be set off by stress, muscle tension, enlarged blood vessels, and other triggers. Once activated, the nerves send messages to the brain, and it can feel like the pain is coming from deep within your head.

Tension headaches are the most common type of headache. They can cause a feeling of painful pressure on the head and neck. Tension headaches occur when the muscles in your head and neck tighten, often because of stress or anxiety. Intense work, missed meals, jaw clenching, or too little sleep can bring on tension headaches.

Why Do We Feel Headaches?

Though the brain has billions of neurons (cells that transmit sensory and other information), it has no pain receptors. The ache from a headache comes from other nerves — inside blood vessels in your head, for example — telling your brain something is wrong.

Does Lack of Sleep Cause Headaches?

Generally, a lack of sleep is known to trigger headaches and migraines in some people.2 In a large study of migraine sufferers, half said sleep disturbances contributed to their headaches. And those who slept only six hours a night on average had more frequent and more severe headaches than those who slept longer. But the opposite is also true. Too much sleep can trigger headaches as well – particularly migraines and tension-type headaches.

How Do I Know if My Headache is Serious?

The pain always strikes one side of the head and is very severe. The eye on the painful side is red and watery, the eyelid may droop, and the nose runs or is blocked. The attack starts abruptly and lasts for 30 to 60 minutes. Most sufferers become restless and agitated during the attack; unable to sit still, they pace, jog in place, or beat their heads against a wall. Nausea and sensitivity to light and sound may accompany the pain.

Is Headache Genetic?

Although headaches are one of the most common medical complaints, relatively little is known about their causes. Primary headaches may have a genetic component to them, meaning that if someone in your family experiences certain types of headaches, you may be prone to them as well. In many cases, your race, gender, and age are some of the other genetic factors that may predispose you to certain types of headaches. There are often structural similarities in family members that are genetically related. This does not mean the symptoms are genetic but family members often go through similar treatment regimens.

At What Age is it Normal to Get Headaches?

Headaches are common in children. Among children between 5 and 17 years of age, 20% have reported getting headaches. The most common types of headaches in this age group are tension headaches (reported by 15%) and migraines (reported by 5%). Many parents worry that their child’s headache is a sign of a brain tumor or serious medical condition. However, less than 3% of headaches are the result of these conditions. Many headaches in children are the result of stress and lifestyle issues.

Who Is More Prone To Headaches?

In the U.S., headaches cause 112 million sick days each year. While one-third of the population gets headaches, women suffer more than men do. Changes in hormones could be among the reasons women have more headaches than men do. These hormone-related headache triggers include menstruation, taking oral contraceptives, pregnancy, lactation, and menopause.

How Long Should a Headache Last?

Tension headaches — the most common type of headache — can be as brief as 30 minutes or a few hours, but some last as long as a week, according to the Mayo Clinic.  Meanwhile, the headache portion of migraine — a neurological disease that causes debilitating head pain along with other symptoms — usually lasts from four hours to three days, according to the American Migraine Foundation. “Typically, headaches that are longer than a day and disabling are migraine,” says the headache expert Peter Goadsby, MBBS, MD, PhD, a professor of neurology at the David Geffen School of Medicine at the University of California in Los Angeles. “The median duration for migraine is about a day.”

Can an Ice Pack Help a Headache?

Using ice as a remedy for headaches and migraines isn’t new. Cold therapy for headaches goes back as many as 150 years. “Ice is often the ‘go-to’ to treat pain and inflammation, so it makes logical sense to be applied when your head hurts,” explains Dr. Tania Elliott, chief medical officer at EHE. But how does ice work on headaches or migraines? Elliott says the cold can constrict blood vessels and help reduce the neurotransmission of pain to the brain. Instead of registering pain, it registers “Oh, that’s cold.” A 2013 study found that applying a frozen neck wrap at the onset of a migraine significantly reduced pain in participants with migraine headaches. Researchers believed that the cooling pack cooled the blood flowing to the carotid artery in the neck. This helped to reduce the inflammation in the brain, which helped improve the pain felt by migraines.

Symptoms of a Headache

Headache symptoms depend on the type of headache. The frequency of headaches and the intensity of the symptoms may vary, too. Typical headache symptoms include:

1. Slow onset of the headache

2. Head usually hurts on both sides

3. Pain is dull or feels like a band or vice around the head

4. Pain may involve the back part of the head or neck

5. Pain is mild to moderate, but not severe

Tension-type headaches typically do not cause nausea, vomiting, or sensitivity to light (photophobia). The symptoms of a headache may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

Causes of Headaches

The pain you feel during a headache comes from a mix of signals between your brain, blood vessels, and nearby nerves. Specific nerves in your blood vessels and head muscles switch on and send pain signals to your brain. But it isn’t clear how these signals get turned on in the first place. Common causes of headaches include:

1. Illness. This can include infections, colds, and fevers. Headaches are also common with conditions like sinusitis (inflammation of the sinuses), a throat infection, or an ear infection. In some cases, headaches can result from a blow to the head or, rarely, a sign of a more serious medical problem.

2. Stress. Emotional stress and depression as well as alcohol use, skipping meals, changes in sleep patterns, and taking too much medication. Other causes include neck or back strain due to poor posture.

3. Your environment, including secondhand tobacco smoke, strong smells from household chemicals or perfumes, allergens, and certain foods. Stress, pollution, noise, lighting, and weather changes are other possible triggers.

4. Genetics. Headaches, especially migraine headaches, tend to run in families. Most children and teens (90%) who have migraines have other family members who get them. When both parents have a history of migraines, there is a 70% chance their child will also have them. If only one parent has a history of these headaches, the risk drops to 25%-50%.

Doctors don’t know exactly what causes migraines. One theory suggests that a problem with the electric charge through nerve cells causes a sequence of changes that cause migraines. Too much physical activity can also trigger a migraine in adults.

Common Types of Primary Headaches

Primary headaches occur when the pain in your head is the condition. In other words, your headache isn’t triggered by something your body is dealing with, like illness or allergies. These headaches can be episodic or chronic:

1. Episodic headaches may occur occasionally but no more than 15 days in one month. They can last anywhere from half an hour to several hours.

2. Chronic headaches are more consistent. They occur more than 15 days a month. In these cases, a pain management plan is necessary.

A. Tension headache

If you have a tension headache, you may feel a dull, aching sensation all over your head. Tenderness or sensitivity around your neck, forehead, scalp, or shoulder muscles also might occur. Anyone can get a tension headache. Stress often triggers them.

B. Cluster headache

Cluster headaches may occur with severe burning and piercing pain. They occur around or behind one eye or on one side of the face at a time. These headaches occur in a series. Each headache can last from 15 minutes to 3 hours. During a cluster, people may experience headaches anywhere from one every other day to eight per day, usually around the same time each day. After one headache resolves, another will soon follow. A series of cluster headaches can be daily for months at a time. In the months between clusters, people are symptom-free. Cluster headaches are more common in the spring and fall. They are also three times more common in men. Doctors aren’t sure what causes cluster headaches.

C. Migraine

Migraine is a headache disorder that causes intense pulsing pain deep within your head. Migraine episodes may last between 4 and 72 hours untreated, significantly limiting your ability to carry out your daily routine.

D. Hemicrania continua

Hemicrania continua is a moderate headache on one side of your head that lasts continuously for at least 3 monthsTrusted Source. You might feel periods of increased intensity a few times per day.

E. Ice pick headache

Primary stabbing headaches, or ice pick headaches, are characterized by short, intense stabbing pains in your head lasting only a few seconds. These headaches can occur a few times daily and come on without warning. Ice pick headaches could feel like a single stab or multiple stabs in succession. Ice pick headaches usually move to different parts of your head. If you have ice-pick headaches that always occur in the same spot, it might be a symptom of an underlying condition.

F. Thunderclap headache

A thunderclap headache is a severe headache that comes on rapidly, reaching peak intensity in under a minute. It may be benign, but it could also be a symptom of a serious condition requiring immediate medical attention.

Common Types of Secondary Headaches

Secondary headaches are a symptom of something else that is going on in your body. If the trigger of your secondary headache is ongoing, your headaches can become chronic. Treating the primary cause generally brings headache relief.

A. Allergy or sinus headache

Headaches sometimes happen as a result of an allergic reaction. The pain from these headaches is often focused in your sinus area and the front of your head. Migraine is sometimes misdiagnosed as sinus headaches. People with chronic seasonal allergies or sinusitis are susceptible to these headaches.

B. Hormone headache

People who menstruate may experience headaches that are linked to hormonal fluctuations. Menstruation, using birth control pills, and pregnancy all affect estrogen levels, which can cause a headache. Those headaches associated with the menstrual cycle are also known as menstrual migraine. These can occur between 3 days before your period to the third day of your period and during ovulation.

C. Caffeine headache

Caffeine affects blood flow to your brain. Too much can give you a headache, as can quitting caffeine “cold turkey.” People who have frequent migraine headaches are at risk of triggering a headache due to caffeine use. When you’re used to exposing your brain to a certain amount of caffeine, a stimulant, each day, you might get a headache if you don’t get caffeine. This may be because caffeine changes your brain chemistry, and withdrawal can trigger a headache.

D. Exertion headache

Exertion headaches happen quickly after periods of intense physical activity. Weightlifting, running, and sexual intercourse are all common triggers for an exertion headache. It’s thought that these activities cause increased blood flow to your skull, leading to a throbbing headache on both sides of your head. An exertion headache shouldn’t last too long. This type of headache usually resolves within a few minutes or several hours. These headaches may also occur due to a secondary cause. If this type of headache is new to you or lasts longer, it may be best to seek medical attention for a diagnosis.

E. Hypertension headache

High blood pressure can cause a headache. This kind of headache signals an emergency. It occurs in some people when the blood pressure becomes dangerously high (greater than 180/120). In most cases, hypertension does not cause a headache. A hypertension headache usually occurs on both sides of your head and is typically worse with any activity. It often has a pulsating quality.

F. Medication overuse headache

Medication overuse headaches, also known as rebound headaches, can feel like a dull, tension-type headache, or they may feel more intensely painful, like a migraine episode. You may be more susceptible to this type of headache if you frequently use over-the-counter (OTC) pain relievers. Overuse of these medications leads to more headaches rather than fewer. These headaches are likelier to occur anytime OTC medications are used more than 15 days a month.

G. Post-traumatic headache

Post-traumatic headaches can develop after any head injury. These headaches feel like tension headaches or migraine episodes. They usually last up to 6 to 12 monthsTrusted Source after your injury occurs. They can become chronic.

H. Spinal headache

A spinal headache results from low cerebrospinal fluid pressure following a lumbar puncture. For this reason, it’s also known as a post-dural puncture headache. Research estimates that spinal headaches follow a lumbar puncture between 10 and 40% of the time. Onset usually begins within 2 to 3 days but could start several months later. It can also occur following an epidural or spontaneously. This headache typically worsens when you are upright and improves when you lie down.

When to be Concerned about a Headache

Most headaches don't have a serious underlying cause. The things that would suggest to a clinician that a headache might need further investigation include the following. They do not mean that the headache is serious or sinister but they mean that the clinician might wish to do some further checks to be sure:

1. There has been a significant head injury in the previous three months.

2. The headaches are worsening and accompanied by high temperature (fever).

3. The headache started extremely suddenly.

4. Problems with speech and balance have developed along with the headache.

5. There are problems with memory or changes in behavior or personality as well as headaches.

6. The headaches are accompanied by confusion or feeling muddled.

7. The headache started with coughing, sneezing or straining.

8. The headache is worse when you sit or stand.

9. The headache is associated with red or painful eyes.

10. The headaches are not like anything experienced before.

11. There is unexplained vomiting with the headache.

12. There is reduced immunity - for example, if in someone with HIV, or who is on oral steroid medication or immune-suppressing drugs.

13. The person has or has had a cancer that can spread through the body.

How a Headache is Diagnosed

Your doctor will want to do a comprehensive medical evaluation and diagnostic testing. He or she will also ask about your medical history and do physical exams and certain tests. Questions commonly asked during the exam may include:

1. When do headaches occur?

2. What is the location of the headache?

3. What do the headaches feel like?

4. How long do the headaches last?

5. Have there been changes in behavior or personality?

6. Do changes in position or sitting up cause the headache?

7. Do you have trouble sleeping?

8. Do you have a history of stress?

9. Is there a history of head injury?

If your doctor suspects migraine or tension-type headaches and the neurological exam is normal, no further testing may be needed. However, if it is not a primary type headache, then other tests may be done to find the cause.

Tests used to find the cause of a headache may include:

1. Blood tests. Various blood chemistry and other lab tests may be run to check for underlying conditions.

2. Sinus x-rays. An imaging procedure is done to evaluate for congestion or other problems that may be corrected.

3. Magnetic resonance imaging (MRI). A test that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.

4. Computed tomography scan (also called a CT or CAT scan). An imaging test that uses X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

10 Headache Triggers

It's not just stress and nasty colds that cause headaches. Cleaning your home or sleeping in late can cause them too. We reveal 10 headache triggers and how to fix them.

1. Relaxing after stress

You put in 10-hour days from Monday to Friday and you feel fine, only to wake up after a lie-in on Saturday with a pounding headache. Why is that? It's because as the tension of the week subsides, your levels of stress hormones drop, which causes a rapid release of neurotransmitters (the brain's chemical messengers). These send out impulses to blood vessels to constrict and then dilate, which causes a headache.

How to fix it: Avoid the temptation to sleep in at weekends. More than 8 hours of sleep at a time can bring on a headache. Introduce some relaxation time, such as a yoga class, into your working week, rather than squeezing it all into the weekend.

2. Pent-up anger

When you're angry, muscles in the back of your neck and scalp tense up, causing a tight band-like sensation around your head. This is a sign of a tension headache.

How to fix it: When you start feeling angry, breathe deeply and slowly. Breathe in through your nose and out through your mouth. This should relax your head and neck muscles.

3. Poor posture

Poor posture causes tension in your upper back, neck, and shoulders, which can lead to a headache. Typically, the pain throbs in the base of the skull and sometimes flashes into the face, especially the forehead.

How to fix it: Avoid sitting or standing in one position for long periods. Sit up straight and support your lower back. Consider using a special headset if you spend a lot of time on the phone, as holding a handset between your head and shoulder can strain muscles and cause headaches. You could also see a physical therapist, such as an osteopath or Alexander technique practitioner. They may be able to help you identify and correct any posture problems.

4. Perfume

If you think housework is giving you a headache, you could be right. Household cleaners, along with perfumes and fragranced air fresheners, contain chemicals that can bring on headaches.

How to fix it: If you’re susceptible to headaches brought on by certain smells, avoid heavy perfumes and strong-smelling soaps, shampoos, and conditioners. Use fragrance-free air fresheners and household cleaners, and keep your doors and windows open as much as possible at home. If a colleague's perfume is bothering you, put a fan on your desk at work.

5. Bad weather

If you're prone to getting headaches, you could find that grey skies, high humidity, rising temperatures, and storms can all bring on head pain. Pressure changes that cause weather changes are thought to trigger chemical and electrical changes in the brain. This irritates nerves, leading to a headache.

How to fix it: There's not much you can do to change the weather. However, by looking at the forecast, you can predict when you're likely to have a headache and make sure you have some painkillers ready for when you might need them.

6. Grinding teeth

Grinding your teeth at night (the medical name is bruxism) makes your jaw muscles contract, causing a dull headache.

How to fix it: Your dentist may recommend a mouth guard or splint, which you wear at night to protect your teeth while you sleep.

7. Bright lights

Bright lights and glare, especially if flickering, can induce migraines. This is because bright and flickering lights boost the levels of certain chemicals in the brain, which then activate the migraine center.

How to fix it: Sunglasses are great at reducing light intensity, and you can wear them inside and outside. Polarised lenses can also help to reduce glare. At work, adjust your computer monitor or attach a glare screen. You may be able to turn off certain lights or move them. If you cannot, change where you sit in the office. Fluorescent lighting tends to flicker, so if you're able to, substitute it with some other form of lighting.

8. Food triggers

Your turkey and cheese sandwich and a small bar of dark chocolate might be a tasty lunch but beware of the headache that could follow it. All these foods contain chemicals that can cause a migraine. Other culprits include aged cheeses like stilton and brie, diet fizzy drinks, and processed meats and fish.

How to fix it: Keep a migraine trigger diary and once you suspect a certain food may be the cause of your headaches, eliminate it from your diet for a couple of months to see if you get fewer headaches. If you're concerned about avoiding any food-related trigger factor, see your GP or practice nurse or ask to be referred to a dietitian for specialist advice. Remember to eat regularly, because skipping meals can bring on a headache.

9. Sex headaches

It's a standing joke that headaches are used as an excuse to avoid sex, but for many men and women coital headaches that come on at the height of passion are a real and distressing problem. Doctors think sex headaches are due to pressure building up in the head and neck muscles. The headaches can happen during foreplay or just before orgasm and can last for a few minutes or up to an hour.

How to fix it: They’re inconvenient, but these headaches are usually harmless and do not mean you have to avoid sex. Take a painkiller a few hours beforehand to block the headache.

10. Ice cream

Do you get a sharp, stabbing pain in your forehead when you bite into an ice cream cone? Then you're susceptible to ice cream headaches, caused by cold material moving across the roof of your mouth and the back of your throat. Ice lollies and slushy frozen drinks have the same effect.

How to fix it: The good news is that ice cream headaches do not need treatment. They're over in a flash, rarely lasting more than a minute or two.

How to Prevent Headaches

Certain care strategies can help prevent headaches or ease the pain. A person may try:

1. Use a heat or ice pack against the head or neck, but avoid extreme temperatures and never apply ice directly to the skin.

2. Avoiding stressors whenever possible and using healthy coping strategies for unavoidable stress.

3. Eating regular meals, and taking care to maintain stable blood sugar levels.

4. Getting enough sleep by following a routine and keeping the bedroom cool, dark, and quiet.

5. Exercising regularly to boost overall health and lower stress.

6. Limiting alcohol intake and drinking plenty of water.

7. Take breaks when working to stretch and prevent eye strain.

How to Get Rid of a Headache

There are several ways to try to prevent headaches or to help get rid of a headache. No one method works for everyone or every headache so it is sensible to experiment with different options.

1. Drinking enough fluids but avoiding or limiting alcohol.

2. Getting enough sleep and avoiding screen time (TV, computers, etc) before going to bed.

3. Drinking a small amount of caffeine.

4. Apply a cold pack to the eyes or head.

5. Have a warm bath or shower.

6. Staying in a darkened, quiet room.

7. Trying methods to help relaxation, such as mindfulness, breathing exercises, lavender oil, meditation, or yoga.

8. Try acupressure, acupuncture, massage, or osteopathic or chiropractic treatments.

9. Take simple pain relief, such as paracetamol, ibuprofen, or aspirin. (Aspirin cannot be taken by children under the age of 18.)

How to Find a Neurologist or Headache Specialist

If you think it’s time to get help from a neurologist or headache specialist, you may want to consider these options:

1. Ask friends or family for recommendations.

2. Ask a family doctor or primary care healthcare professional for a referral.

3. Call your insurance company to ask for a headache specialist who is covered by your policy.

4. Use the Find a Doctor page of the American Migraine Foundation website.

5. Search the UCNS website for a list of everyone with a headache medicine subspecialty.

Sources:

Duke Health

Cleveland Clinic

Hopkins Medicine

WebMD

Medical News Today

Healthline

Better Health

Patient

Mayo Clinic

Excedrin

NIH

OHSU

I Hate Headaches

Everyday Health

NHS