Headaches

Tension Headache

Muscle contraction headache, stress headache, ordinary headache, psychomyogenic headache, and idiopathic headache are some of the many other names for tension headache. A mild to moderate squeezing or pressing pain which is steady and nonthrobbing on both sides of the head, back of the neck, and possibly the facial area characterizes a typical attack. It can last from an hour to several hours or more and may occur once or twice a week.

By IHS standards, tension headache can be either an episodic tension headache or a chronic tension headache. The problem is considered episodic if 10 such headaches have occurred any time previously. Sensitivity to light or sound may also be part of this kind of headache. To be labeled chronic the headache must occur more than 15 times a month.

Tension headache can occur at any age. It is often hereditary. Sore and contracted neck, shoulder, and/or back muscles usually accompany it.

Daily Chronic Headache

Symptoms of tension headache can be so vague that it used to be a sort of “diagnostic wastebasket” for all disorders that did not relate to blood vessel abnormalities or that could not clearly fit some other category. Recently, however, researchers have discovered many similarities between tension headache and migraine. Most now believe the two types may be on the same continuum, with tension headache just a mild form of migraine.

Many things known to trigger migraine also trigger tension headache. Both people with migraine and people with tension headache can benefit from biofeedback aimed at relaxing the muscles. Medications that work for one type of headache often work for the other.

These observations have led scientists to categorize a new type of headache called the daily chronic headache—a condition of daily or almost daily discomfort accompanied at various times by migraine-like symptoms.

This combination of tension and migraine headache shares many characteristics with both types. As with migraine, depression and anxiety accompany daily chronic headache, and it occurs intermittently throughout life until it ultimately subsides. The pain, like that of tension headache, is dull and moderate most of the time. Daily chronic headache is also hereditary and can disturb sleep patterns.

As with both migraine and tension headache, people suffering from daily chronic headache often overuse painkillers like aspirin or prescription drugs. The overuse of medication, and of caffeine, is believed to be a major causative factor in daily chronic headache.

Cluster Headache

Unlike migraine, which primarily affects women, cluster headache mainly affects men. Although the exact U.S. incidence isn't known, an estimated 500,000 to 2 million Americans experience cluster headaches.

These excruciatingly painful headaches occur in bursts every year or two, seemingly more often in the spring and autumn than any other time. The cluster period usually lasts between two and three months. The penetrating and mostly nonthrobbing pain is often felt behind the eyes or in the temples. Attacks can last from 45 minutes to 2 hours and tend to occur at night.

Individuals who smoke cigarettes or drink alcohol excessively are more likely to suffer cluster headaches. Many cluster headache sufferers also have peptic ulcers. Women who have cluster headaches may also have a history of migraine.

Posttraumatic Headache

As many as half of all people who suffer a head or neck injury will develop one or more headache patterns after the primary injury has healed. Symptoms are the same as those of migraine or tension headache. Certain areas of the head may also be sensitive to touch.

The condition seems to be unrelated to the amount or severity of damage caused by the primary injury. Symptoms usually develop 24 to 48 hours after the trauma, but can develop later.

Disease-Related Headache

Headache is a universal symptom; over 300 conditions cause it. The disease conditions include:

• Allergies
• Brain tumor
• Connective tissue diseases (temporal arteritis, systemic lupus erythematosus)
• Constipation
• Disorders of the head, neck, ear, nose, throat, and mouth
• Excessive cerebrospinal fluid in the brain
• Exertion
• General or local infection
• Heart valve disease
• Low blood sugar
• Nerve pain
• Pressure on the cartoid artery
• Sleep apnea (lapse in breathing during sleep)
• Stroke and stroke-like conditions (high blood pressure)
• Temporomandibular joint (TMJ) problems (malfunction at the hinge of the jaw)

THE TRADITIONAL CULPRITS

Muscle tension and constricted blood vessels have long been assigned the blame for headaches. For tension headaches, contraction in the muscles around the skull was considered the culprit. For migraine, constriction of blood vessels in the head—both within the skull and on the scalp—was assumed to be the trigger. Lately, however, this distinction has blurred; and additional suspects have come under investigation (see “A New Theory Implicates the Trigeminal Nerve” ).

Next : What Causes Headaches