What Causes Headache?What causes headache?If you get headaches, you should know that about 99% of all headaches come down to one of these 6 common causes
Of these 6 types, Migraine Episodes are the ones most likely to make you want to to see a doctor, especially if you are in your teens, twenties or early thirties. Chronic Migraine is the one most likely to have you referred to a specialist headache clinic. Chronic migraine is the most common headache diagnosis made in specialist headache clinics. People over 50 or people who have a previous neck injury are most likely to have cervicogenic headache.
What causes headache? The Top 6 headaches and how often they occur.
35-80% of people each year will have at least one episode. Symptoms of Tension Headache are really just a bland pain on both sides of the head. Even though it is very common, the Cause of Tension Headaches is still poorly understood. Cases where there is uncertainty should be given the benefit of the doubt as migraine usually responds well to lifestyle change and targetted migraine medication. For example what is called Tension Stress Headache is often migraine. Some migraine medicines will help many cases of tension-type headache, but here are the main Tension Headache Medicines. 6% of men and 16% of women will get symptoms of migraine each year. Typically migraine is a headache-nausea-symptom that is bad enough to make you want to lie down. About 85% of migraine sufferers will just have headache and no aura, and about 15% wiill have Migraine with Aura. Migraine affects people from all across the world - read about Migrana Ice-pick headaches affect at least 2% of all people, and one study extimated that as many as 35% of people will get these brief sharp pains in the head. They can be a sharp pain in eye or in the head. They last seconds but can have a lingering dull ache for several minutes afterwards. People with migraine are more likely than average to get these nuisance head pains. A Scandanavian Survey estimated that about 4% of adults have symptoms of cervicogenic headache. Cervicogenic Headache is a cause of pain in the back of the head, pain in the side of the head and pain above the eye. It is due to wear-and-tear change in the facet joints of the upper cervical spine (neck). Nerves in the facet joints travel via the spine into the brain where they merge with nerves from the whole of the same side of the head. (The pathway is called the trigeminocervical complex.) This causes referred pain in the head that is actually coming from the neck. Treating this headache means treating the cervical spine. About 2% of all people will experience a daily dull ache or pressure in the head that never seems to go away. One of the causes of tension headaches is depression. Unfortunately it is difficult to get relief from tension headache. My own estimate of the frequency of chronic migraine is about 0.2% of people. However, recent studies have shown that about 4-5% of people experience a pain in their head on the majority of days ie >50% of the time. How much of this is migraine is uncertain, but a fair amount of it is. Managing chronic migraine is process that takes several months. Following a headache friendly lifestyle, and keeping powerful painkillers to a minimum, is an essential part of treatment. Less Common Causes of Severe HeadacheThere are other 4 other causes of severe headaches, which turn up fairly regularly in my own clinics. Let's look at these:
What causes headache? "Sinus" ? "Stress"?So if you are not one of these 10 scenarios, how do we work out what causes headache?2 very common things people say to me in my clinics are that they think they have severe sinus headache, or they have stress headache symptoms. When you try to make a diagnosis in people who talk about "Sinus" or "Stress" headaches, almost all of them turn out to be suffering from (you guessed it) Migraine. People with migraine will also describe it as a "sick headache". The quality of the pain can be helpful in trying to work out what causes headache too. A very broad generalisation is that pressure in the head is most commonly a Tension Headache Symptom, and Throbbing Headache is usually a Symptom of Migraine.
The best scientific studies suggest that electromagnetic irradiation from mobile phones is unlikely to cause a headache. Some Headaches Only Affect WomenWhat Causes Headache at a woman's period time?Menstrual Headache affects at least 10% of women, but most will be best managed as having migraine. It is possible to target migraine medication like naproxen or frovatriptan to co-incide with the menstrual cycle. The pattern of the headache is useful, especially when considering the onset of pain. What causes headache in pregnancy? In pregnancy, most headaches are due to migraine(the vast majority in fact). There are some rarer serious disorders of arteries and veins in the head that will require further investigation. There are even Breast Feeding Headaches. What Causes Headache that is Frequent?Frequent short lived neuralgiform headaches that are very brief usually turn out to be ice-pick headaches. Frequent headaches lasting several hours are most often migraine.What Causes Headache that is Constant?Constant headaches that never go away, and make you want to visit a doctor for pain relief are usually chronic migraine.However, care needs to be taken to exclude a different underlying cause of constant severe headaches. Causes of constant severe headaches that are not migraine and might be treatable include:
There are many factors to consider, but even then 99% are still one of 6 common causes. The diagnosis rests almost entierly on knowing these different factors and seeing which pattern fits best.
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