According to the World Health Organization, about half of adults have at least one headache each year, and a minority of people with headaches are diagnosed properly by a doctor. There are many different types of headaches, and the causes and treatments differ for each type.
The most common types of headaches are tension-type headaches, migraines and cervicogenic headaches, and they come with unique causes and triggers.
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1) Tension-type Headaches
A run-of-the-mill, all-over, mild to moderate type of headache is called a tension-type headache (TTH). It is the most common type of headache. Just about everyone has experienced or will experience a TTH at some point in their life.
The exact cause of TTHs is unknown, but the best evidence supports that these headaches originate from “trigger points” within the muscles and muscle-related tissues of the head and neck. Common triggering factors include stress, inability to relax, change to sleep, dehydration, hunger, caffeine withdrawal and female hormone fluctuations.
While TTHs are most common overall, most who seek medical care (ER or doctor’s visit) for headaches actually have migraines. Unlike TTH, for which lifestyle is the most important contributing factor, one’s genetic makeup plays a large role in the tendency to get migraine headaches. This is why migraines tend to run in families.
There are multiple inherited genes related to migraine, all of which in one way or another render the brain overly excitable. Anyone is capable of having a migraine if the setting is right, but the person who suffers from migraines is at all times more likely to cross that threshold because of their genetic makeup.
In addition, the brains of people with migraines do not handle repetitive stimulation (such as light or noise) well compared to the response of a person who is not predisposed to getting migraines. The typical triggers which set the brain off into a migraine cycle are largely similar to TTH and include hormonal changes, hunger, exertion, sleep disturbances, foods, weather patterns and certain medications.
3) Cervicogenic Headaches
Some headaches occur primarily due to problems within the upper neck. These are called cervicogenic headaches. They can co-exist with TTHs and migraines or may mimic them, but a true cervicogenic headache is due to a disease of the upper neck, such as arthritis, a cervical disk herniation or whiplash injury. Pain is typically felt in the back of the head, but due to cross-talk in the brain may even be felt in the forehead. Neck movements exacerbate or bring on the headache.
The three headache types discussed above, along with many other headache types, may only represent part of the problem. It is not unusual to develop a second, co-existing headache called medication-overuse-headache after prolonged use of frequent as-needed medications, especially opioid or butalbital containing medications.