Primary headaches are their own condition and don’t appear to be triggered by something else. Secondary headaches can result from medication overuse, trauma to the head, sinus infections and other causes.

Story by: Henry Winkelhake on February 16, 2021

Understanding the types of headaches and which kind are affecting you can help you understand better whether your primary care provider or a headache specialist can help.

“If you’re uncomfortable or your life is being disrupted, please don’t hesitate to seek help,” said neurologist Brian M. Plato, D.O., headache and migraine specialist with Norton Neuroscience Institute.

There are two broad types of headaches: primary and secondary. Primary headaches are their own condition and are not caused by another condition. Examples are tension type headache and migraine. Secondary headaches can result from medication overuse, trauma to the head, infections or other causes.

“The most common forms of daily headache are chronic tension-type headache and chronic migraine, both of which are primary disorders” Dr. Plato said.

Primary headaches

Chronic tension headache

A chronic tension-type headache occurs more than 15 days per month. Symptoms include aching head pain and contraction of muscles between the head and neck. Patients often describe the feeling as a tight band around their head, according to Dr. Plato.

When medical attention can help:

• If you are having symptoms that you don’t feel comfortable with or that are concerning.
• If you need to take medication for your headache more than twice a week. Medication overuse can create a perpetuating cycle by leading to more headaches.

Migraine

Migraine headaches are typically more severe than tension-type headaches and can last anywhere from a couple of hours to a couple of days. Common symptoms are nausea, vomiting and heightened sensitivity to light and sound. Many patients also report a throbbing pain, generally on one side of the head.

When medical attention can help:

• If a headache limits your activities for a day or more during a three-month period
• Nausea accompanying headache
• Light sensitivity when you have a headache

Seek urgent medical attention for a sudden “thunderclap” headache or neurological symptoms such as weakness, numbness or inability to speak.

Secondary headaches

The American Headache Society’s “SNOOP” acronym helps to break down secondary headaches and evaluate how dangerous they may be.

• Systemic symptoms such as fever or weight loss accompanying headaches could be causes for concern. Secondary risk factors such as cancer or HIV also may be a red flag.
• Neurologic symptoms or abnormalities like confusion, seizures and loss of feeling or consciousness are signs that you should seek immediate attention.
• Onset of headaches in an abrupt or sudden manner (called a thunderclap headache when maximum intensity is reached in under a minute) could indicate a stroke or brain bleed.
• Older people (usually over 50) need to be particularly cautious when experiencing headaches that occur with sudden intensity or progressively worsen. These could be a sign of a condition called giant cell arteritis that causes inflammation to arteries in and around the scalp.
• Prior headache history helps determine how concerned you should be. Is this headache more severe than usual? Is it occurring more frequently? Are new symptoms accompanying?

“We have specialists who have dedicated their careers to the study and treatment of headache disorders, but it starts with you. Know your body, know your symptoms, but most of all know that these are serious conditions that can be debilitating,” Dr. Plato said.