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Head Pain & Tension Headaches

Head pain can be described as any pain or discomfort in the head or face. A headache can range from pain on top of head, pain on side of head or pain in back of head. Headache is the most common form of head pain:

  • Primary headache—tension headache, migraine, cluster headache.
  • Secondary headache—related to an underlying medical condition, e.g., sinusitis, neck injury, and rare but serious conditions such as brain tumor, encephalitis, and hydrocephalus.

Facial pain and cranial neuralgias are related to injury or inflammation of head or to facial nerve conditions, namely the trigeminal and occipital nerves.

Tension Headaches, Migraines & Other Type of Headaches

  • Tension headache—dull pain, tightness, or pressure on the forehead, top or sides of the head; feeling tired and irritable; difficulty focusing; difficulty sleeping; occurs at the end of the day.
  • Migraine—severe throbbing pain or pulsing sensation, usually affecting one side of the head; may be accompanied by nausea and vomiting; extreme sensitivity to light and sound; tingling on one side of the face or in an extremity; difficulty speaking; may be signaled by an “aura” characterized as flashes of light, blind spots, or other visual disturbance.
  • Cluster headache—sudden onset of pain that increases over the next 10-15 minutes, pain around or behind an eye, red or watering eyes, swelling around one or both eyes, facial redness or flushing, feeling restless or agitated, nasal congestion, sweating on forehead.
  • Sinus headache—pain or pressure in the cheeks, brow, bridge of nose, or forehead; worsening pain when leaning forward or lying down; stuffy nose and nasal discharge; fatigue.
  • Cranial neuralgias—severe piercing, throbbing, or other excruciating facial pain in the areas directly affected by the nerve in question; may be associated with dizziness, weakness, facial twitch, hearing loss, local paralysis.
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Head Pain Causes & Types of Headaches

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  • Tension headache—generally related to stress from work, school, family or relationships; also caused by tension and tightness in the neck muscles and pain in back of the head.
  • Migraine—no clear cause but may be related to stress; sensory stimuli (light, sound, taste, smell); abnormal brain activity that temporarily affects nerve signals, chemicals, and blood vessels in the brain; tendency to run in families.
  • Cluster headache—multiple theories as to cause, such as triggering of a nerve pathway in the brain; dilation of blood vessels in the face that put pressure on the trigeminal nerve which sends sensations to the brain; abnormalities in the hypothalamus; sudden release of histamines or serotonin.
  • Sinus headache—sinusitis (inflammation of the sinuses due to allergies or infections); rhinitis (hay fever or seasonal allergies).
  • Cranial neuralgias—pressure on the nerve from nearby blood vessels; injury or inflammation of head or facial nerves.

Headache Treatment & Headache Relief - When to See a Doctor

In general, headaches cannot be completely cured. Seek immediate medical attention if:

  • Your headache is the result of an accident, injury or fall.
  • Your headache is sudden and severe.
  • Your face droops.
  • You are weak or numb.
  • You are confused or find it difficult to speak, see, or think.
  • You have frequent, severe headaches that affect your daily life.

Headaches can be found in many places but the most common areas are:

  • Headache behind the eyes.
  • Headache back of the head or pain in back of head.
  • Headache in the front of the head.
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