What a headache: Types, causes, and treatments

Headaches are like gigantic storm clouds that constantly hover over us. They can hit at any moment, mess up our routine, and force us into a dark cave until the pain passes. When they finally strike, they can seem as unpredictable and mysterious as a thunderbolt.
Unfortunately, the cause of most headaches isn’t an exact science. Sometimes we don’t even know we’re getting one until after the pain hits. Headaches typically have a number of warning signs which are determined by your genetics and lifestyle. Learning to identify these warning signs and your triggers can help minimize the impact of your headaches or even prevent them.
Learn how to prevent, soothe, and lessen the frequency of cranial thunderstorms with these tips from Dr. Amy Esposito, an Internal Medicine physician at the Oscar Center in New York City.
What are headaches?
A headache is pain that occurs in your head, neck, sinuses, or ears. They come in all shapes, sizes, and frequencies. Most headaches are shorter, one-off episodes while others, like migraines, are chronic neurological events that can last for hours or even days. Headaches are often triggered by hormones, environment, diet, or mood. These triggers are different for everyone, but you can start to identify them over time by observing your personal habits and headache patterns.
Common types of headaches
From brain freeze to bike helmets to bad head colds, there are many different kinds of headaches. But in general, there are four types of headaches you’ll want to know about:
Tension headaches often accompany a stressful event like a test or performance. They are bilateral (occur on both sides of your head) and non-pulsatile (their behavior is not influenced by your pulse). Typically, these can be treated with your basic over-the-counter anti-inflammatory medicines like aspirin or ibuprofen.
Cluster headaches are recurring headaches that are strictly unilateral. These types of headaches may strike up to eight times a day and are relatively short-lived. They typically occur episodically over a short period of time, last from 15 minutes to an hour and a half, and are often accompanied by ipsilateral (same side as the pain) ptosis (aka drooping eyelid), red eye, eye tearing, and nasal congestion. Over-the-counter painkillers, prescription pain medications and preventative therapy such as calcium channel blockers (blood pressure medication) or steroids are used to treat these types of headaches.
Migraines are recurring severe unilateral headaches that have throbbing or pulsing characteristics. They’re often accompanied by nausea/vomiting, neck pain, light and/or sound sensitivity. There is a genetic component where the syndrome is usually inherited. An untreated migraine can last as little as four hours and as long as several days. Many attacks resolve in sleep. Some migraines also come with a sensory aura, which may include changes in taste, smell, or visual disturbance (like stars or flashing lights).
Secondary headaches are rarer headaches that are often the result of an underlying condition such as neurologic issue, fever, illness, trauma, or drug use.
Headache triggers
Everyone gets headaches for different reasons. Identifying your triggers can help you find relief and avoid future pain. The next time you get a headache, take note of your surroundings, your emotions, and what you’ve eaten that day. If you suffer from recurrent headaches, try a headache app, which can help you understand how to modify your lifestyle to reduce headaches.

How to treat headaches
Avoiding triggers and implementing DIY headache prevention and treatment can help you manage your headaches. Here’s how.
Build an at-home DIY stress reduction routine through daily yoga or meditation practice, warm baths, acupuncture, or massage. If you have persistent anxiety, you may want to call in a professional and give talk-therapy a shot.
Go easy, tiger.
We know when you’re in the moment you like to give it your all, but unfortunately, orgasms and sexual activity can sometimes give you a headache. We don’t want to influence your game, but just keep that in mind the next time you wanna get frisky and if it happens more than once, talk to a doctor stat.
Get green.
Sometimes, what we can’t see does hurt us. Environmental factors like chemicals, household products, paint, mold, pollen, and pet dander can contribute to head pain. If you think something might be off, check in with your landlord or have your house tested for environmental factors that may be the culprit.
Avoid trigger foods.
What you eat can directly impact the frequency and intensity of headaches. Certain foods are known triggers, especially for people who suffer from chronic migraines. These include:
  • Wine: Preservatives and tannins added to your vino are no bueno for your noggin. All types of wine can contain these additives, but red wine is the biggest culprit.
  • Processed meats and fish: Nitrates and high-sodium content in these foods can destabilize your system, triggering migraines.
  • Chocolate: Some scientists say the amino acid tyramine in chocolate causes headaches
  • Aged cheese: Tyramine stimulates neurotransmitter norepinephrine, which leads to head pain. Avoid blue cheese, Swiss, cheddar, gouda, and parmesan.
  • Salty and preserved foods: Nuts and sauerkraut are two of the biggest culprits.
  • MSG and aspartame: These chemicals are often found in takeout and prepackaged foods.
  • Coffee: High caffeine content is a trigger for some, while others may experience headaches as a result of withdrawal.
  • Alcohol: The combo of sugar and ethanol affects how your body processes salt, causing dehydration that can trigger hangover headaches and migraines.
Eat up!
There are a lot of foods you’ll want to avoid, but you still gotta eat. Skipping meals can lead to exhaustion, mental fatigue, and physical stress. Load up on foods like tofu, spinach, whole grains, healthy oils like olive and fish, white beans, and sunflower and pumpkin seeds.
Get movin’.
Stay active and maintain a healthy workout routine. Keep in mind that intense physical exertion and dehydration can up-the-ante on your headache game. Be sure to hydrate while you sweat. Lots of sport performance drinks like Gatorade and Powerade contain high levels of sodium, another trigger for aches in your noggin, so stick to H2O or coconut water.
Stay away from the light.
Sun exposure and abrupt lighting shifts can trigger headaches. If you plan on catching some rays, be sure to bring a hat, take shade breaks, wear sunglasses and sunblock, and drink plenty of water. Sitting in a dark space after the onset of symptoms can offer some relief.
Relax your peepers.
If you clock a lot of screen time, avoid eye strain by using night mode on your smartphone. Have your eyes checked. A fresh Rx may help cut down the frequency of your headaches.
Quiet down.
It can be hard to get a moment of peace and quiet, but cutting down on environmental noise is super important if you want to avoid headaches. Try taking a break from headphones. Implement a volume limit on your devices. Buy a white noise machine. Go on, unplug.
Sleep tight.
Getting a good night’s sleep will minimize your stress levels so you can keep a clear and pain-free head. Keep a regular sleep schedule and maintain consistency in your bedtime and when you wake up. Sleeping 1.5 hours longer than you normally do can trigger a migraine.
Take your vitamins.
Studies have shown that taking a course of 400 mg of Vitamin B2 for a duration of three months can decrease the frequency of migraine headaches.
De-vice yourself.
Do a personal inventory of your unhealthy habits, dependencies, and addictions. Grab a notebook and set aside some time each day to record what you eat, how much you drink (water, booze, soda), how much you smoke, and how much screen time you clock on your devices. Be honest with yourself about how much you consume. If you think things are getting out of control, then you may want to consult a mental health doctor.
Regulate your cycle.
Ladies tend to suffer more frequently from migraines, thanks to Aunt Flo and hormonal changes caused by pregnancy and birth control. Regulating your hormonal cycle through birth control (either going off or on) can help reduce the recurrence of headaches. If you experience visual auras, beware that certain types of oral birth control can make your headaches worse.
Crush the pain.
There are many different types of medications that can treat headaches. Most work best when used at the onset of symptoms, which is why it’s important to understand your triggers and and symptoms. If you don’t already have a routine in place for managing your headache pain with medication, try over-the-counter meds first before moving on to prescriptions.
  • Over-the-counter meds like Excedrin Migraine, Aleve, Advil, Tylenol, and Ibuprofen are commonly used to treat mild to severe headaches. Use these medications as advised per the label. Some contain caffeine, which can exacerbate your symptoms.
  • Triptans like Axert, Frova, Maxalt, lsuma, Imitrex, Zecuity, and Zomig are prescription medications used to treat severe or recurring migraines. These medications have known side effects like drowsiness, so while they can lessen the pain, you still may have to take it easy until your symptoms resolve. These types of meds are tough on your system, so limit the number of times you take them to no more than nine times a month.
  • Antiemetics or anti-nausea medications such as metoclopramide, chlorpromazine, and prochlorperazine are effective for reducing migraine headache pain
  • Prophylaxis drugs such as Topamax, a low-dosage depression medication, are used to treat recurrent headaches. Blood pressure meds, such as calcium channel blockers can also effectively treat cluster headaches.
  • Botox has become a popular and pricey last-resort method of treatment for migraine sufferers. It works as a muscle relaxer that targets nerve dysfunction when other forms of treatment have been unsuccessful.
If you’ve tried a variety of methods to treat your headaches and still can’t find relief, then it may be time to bring in a professional. Your primary care doctor can help you rule out underlying causes and decide if it’s time for a visit with a neurologist or headache specialist.

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