Headaches 101: The basics on the three types of headaches

Most headaches fall into one of these three categories:

Migraine

Usually begin on one side and build to an intense, throbbing pain, often with nausea or vomiting. Light, noise and movement make it worse. One in six sufferers gets an aura ... flashing lights or bright spots before the eyes.

Some sufferers also experience neck pain and eye tearing, runny nose or nasal congestion.

How long they last: Without treatment, four hours to three days.

Who gets them: More than 10 percent of adults and almost 20 percent of women. Migraines run in families.

What causes them: A variety of stimuli inflames blood vessels and provokes nerves in and around the brain to release pain-inducing neurotransmitters. Triggers can include food and drink, (red wine, chocolate, MSG are infamous) hunger, lack of sleep, hormones and weather changes.

Preventive measures: Lifestyle consistency is often key. Hormonal fluctuation, stress, what you eat or drink or the weather can trigger migraines.

Some drugs including some antiseizure medications, low doses of antidepressants, and beta-blockers and calcium channel blockers (used to treat high blood pressure), are used for migraine prevention.

Nutritional supplements magnesium, riboflavin and coenzyme Q10 might help. The herbs feverfew and butterbur might help curb migraine frequency. Consult your healthcare practitioner before using any of these remedies.

Biofeedback, which teaches you to relax muscles during times of stress, might help some people.

Injections of Botox, the popular wrinkle-reducer, may help reduce the frequency and intensity of headaches possibly by blocking the protein that carries the pain message to the brain.

Treatment options: Over-the-counter migraine remedies that include acetaminophen, aspirin or ibuprofen and caffeine sometimes can relieve mild-to-moderate migraines. But, frequent use can cause rebound headaches.

Triptan drugs, which constrict vessels and moderate chemical reactions in the brain, often are prescribed. Best taken at the first twinge of a headache, some can be formulated to melt on the tongue, inhaled as a nasal spray or self-injected for times when nausea makes ingesting oral meds impossible.

Tension

A dull, steady pressure ache on both sides of the head, back of head and neck. Usually mild and transient, makes you feel as if you're wearing a tight headband.

How long they last: A few hours or until you sleep. Can occur daily.

Who gets them: Nearly 70 percent of men and 90 percent of women have tension headaches occasionally.

What causes them: Doctors used to blame muscle tension. However, more recent studies show that certain stimuli -- stress, loss of sleep, dehydration, etc. -- produce biochemical changes in the body that can increase pain sensitivity and are felt by some people as a headache.

Preventive measures: A headache diary can help you learn what brings them on. Don't skip meals, get enough sleep and exercise regularly to counter stress.

Treatment options Aspirin, acetaminophen, ibuprofen and naproxen all are effective. If one doesn't work well for you, try another. Relaxation techniques, including meditation, yoga, deep breathing and guided imagery can work to reduce tension and lessen pain.

If the headaches are frequent, see a doctor to confirm that it's not a migraine.

Cluster

Hit suddenly, often during sleep, and can quickly escalate to a continuous explosive pain on one side of the head, usually near an eye. Often causes teary eyes, runny or stuffy nose. Recognized as the most intense and debilitating headache of all.

How long they last: Tend to come in a cluster over a period of days, weeks or even months and then subside for six months to a year. Clusters typically last from 30 minutes to three hours.

Who gets them: Only about 1 in 200 people. Male sufferers outnumber females by about 5-to-1.

What causes them: Related to an explosive release of nerve impulses by the hypothalamus in the brain; alcohol and smoking may trigger them.

Preventive measures: Calcium channel blockers, a high blood pressure medicine, may help. Avoid smoking and alcohol if they trigger headaches.

Treatment options: Injectable forms of triptans often help. Inhaling pure oxygen for 15 minutes relieves headaches in up to 80 percent of cases.


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