Headaches can be more complicated than most people realize. Different kinds can have their own set of symptoms, happen for unique reasons, and need different treatments. The most common types of headaches are tension and migraine headaches. Tension headaches strike when the muscles in the head and neck tighten. Migraines come on when supersensitive nerve endings in the brain create pain. But what makes the muscles tense, or causes some nerve endings in the brain to become so sensitive? That’s not as well understood. Those causes of headaches can vary from person to person. But some triggers are common.
Tension headaches are the most common type of headache among adults and teens. They cause mild to moderate pain and come and go over time. They usually have no other symptoms. Headache or head pain sometimes can be difficult to describe, but some common symptoms include throbbing, squeezing, constant, unrelenting, or intermittent. The location may be in one part of the face or skull or may be generalized involving the whole head.
You could have intense burning or piercing pain behind or around one eye. It can be throbbing or constant. The pain can be so bad that most people with cluster headaches can’t sit still and will often pace during an attack. On the side of the pain, the eyelid droops, the eye reddens, pupil gets smaller, or the eye makes tears. The nostril on that side runs or stuffs up.
Many of those triggers for tension headaches—especially stress, hunger, fatigue, and lack of sleep—can also set off a migraine headache. But nailing down causes of headaches in the migraine category is a little trickier; the headaches may stem from many factors, or combinations of factors. The particular combination is specific to an individual. Potential culprits include
being around smoke
bright light, such as sunlight, or flashing lights
foods, such as aged cheeses, avocados, bananas, chocolate, peas, pork, sour cream, nuts, peanut butter, or yogurt
changes in estrogen levels for women
With sinus headaches, you feel a deep and constant pain in your cheekbones, forehead, or on the bridge of your nose. They happen when cavities in your head, called sinuses, get inflamed. The pain usually comes along with other sinus symptoms, like a runny nose, fullness in the ears, fever, and a swollen face. A true sinus headache results from a sinus infection so the gunk that comes out of your nose will be yellow or green, unlike the clear discharge in cluster or migraine headaches.
The key to making the diagnosis of any headache is the history given by the patient. The health care professional will ask questions about the headache to try to help make the diagnosis. Those questions will try to define the quality, quantity, and duration of the pain, as well as any associated symptoms. The person with a tension headache will usually complain of mild-to-moderate pain that is located on both sides of the head. People with tension headaches describe the pain as a non-throbbing tightness, that is not made worse with activity. There usually are no associated symptoms like nausea, vomiting, or light sensitivity.