Tension, Migraine, and Cluster Headaches

Headaches can be mild, excruciating, long-lasting or gone in a couple of hours. Each type of headache has its own set of symptoms and areas where pain is concentrated.
Tension, migraine, and cluster headaches are among the best known and most common primary headaches—headaches not linked to an underlying medical condition.

Tension Headaches
About 90% of all headaches are tension headaches, which can occur now and then or every day. Tension headaches are not the most severe type of headache, but in some cases they can last as long as a week.
Symptoms typically include a dull pain or aching on both sides of the head, including the temples. A feeling of pressure or muscle tension may be experienced in the front of the face or head or in a band-like pattern around the head.
Also called stress headaches or muscle contraction headaches, tension headaches tend to start in the teen years, and reach their peak when individuals are in their 30s. Women are somewhat more likely to have tension headaches than men.
Muscle tightening in the scalp, jaw, neck, and shoulders often lead to a tension headache. Overwork, lack of sleep (including sleep apnea), skipping meals, or drinking alcohol increases the risk of a tension headache. Stress and anxiety can also be contributing factors.

Migraine Headaches
Lasting from about four to 72 hours, migraine headaches can be debilitating. Most people are unable to work or function normally during a migraine, and require bed rest until symptoms subside.
Migraine headaches are the second most common type of primary headache, affecting one in 7 Americans.
Migraine headaches are more common in women than men, with women age 18 to 44 most affected. Children can also have migraine headaches.
In addition to severe, throbbing pain—usually in the front of head—migraine headaches are often accompanied by several other symptoms, such as:
  • Nausea
  • Vomiting
  • Sensitivity to light and sound
A minority of people with migraines get a warning of an oncoming migraine, called an aura. This warning can include images of flashing lights and other visual changes before the migraine occurs. A tingling feeling or speech difficulties may also precede a migraine in some people.
Migraine headaches can be triggered by a number of factors, including eating certain foods, fluctuations in weather, disrupted sleep, and missing a meal. Headaches experienced around the time of a woman's menstrual period or during ovulation are called menstrual migraines.

Cluster Headaches
More painful than a migraine, but shorter in duration, are cluster headaches. The name comes from the headaches' appearance up to several times in a day. Cluster headaches usually last about 15 minutes to three hours, then disappear—sometimes for months. Some people have these headaches continuously, however.
Cluster headache pain is extreme and develops quickly. The pain usually peaks and plateaus at a severe level before the headache subsides. The headache is typically felt on one side of the head or around one eye, causing deep burning or piercing pain. Nasal congestion may accompany the pain, and the nose or affected eye may become swollen or red.
Individuals may become agitated during the headache, and feel a need to move around or get away from other people.
Cluster headaches are the least common primary headache, and occur more often in men than women. People age 20 to 50 are most affected.
Because cluster headaches are more likely in the spring and fall, they are sometimes incorrectly attributed to allergies.

Other Headaches

  • Sinus headaches. Symptoms typically include a constant pain in the forehead, cheekbones, or bridge of the nose. The person may experience swelling in the face, and a full feeling in the ears.
  • Rebound headaches. Using pain medication frequently can trigger a rebound headache. Instead of easing pain, the medication causes a headache.
  • Chronic daily headaches. The pain is generally moderate, but continuous, on the top or sides of the head. Child, teens, and adults may have chronic daily headaches.

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