If you count yourself among one of the many Americans who have experienced a headache this year, you are not alone! Headache disorders are one of the most pervasive nervous system disorders. 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.

The nervous system is a network comprised of nerves and cells which transmit messages from the brain and spinal cord across the rest of the body. These messages can include information about pain, touch, and temperature. When the nerve and nerve endings that control information messaging to the brain react to headache triggers, it can cause a headache. 

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.

Tension-Type Headaches

A tension-type headache is a run-of-the-mill, mild-to-moderate type of headache, and it is the most common type of headache that people experience. Just about everyone has had or will have this sort of headache at some point in their life. 

People generally feel pain behind their eyes or in their foreheads when experiencing a tension-type headache. Some describe the sensation as similar to having a band or vice around their head. These types of headaches typically last from 30 minutes and up to seven days.

The exact cause of the tension-type headache 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.

Migraines

While tension-type headaches are the most common headaches overall, most who seek medical care for headaches at a doctor’s visit or to the emergency room most likely have a migraine headache. Unlike tension-type headaches, where 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 migraines, 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 a person who suffers from migraines is more likely at all times to cross the threshold because of their genetic makeup.

In addition, the brains of people with migraines do not handle repetitive stimulation such as light or noise as well as people who are not predisposed to getting migraines. The typical triggers which set the brain off into a migraine cycle are largely similar to tension-type headaches and include hormonal changes, hunger, exertion, sleep disturbances, foods, weather patterns and certain medications.

Cervicogenic Headaches

Some headaches occur primarily due to problems within the upper neck. These are called cervicogenic headaches. They can co-exist with tension-type headaches and migraines or may mimic them. 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 crosstalk in the brain, it may even be felt in the forehead. Neck movements can 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 a medication-overuse-headache after prolonged use of frequent as-needed medications, especially opioids or butalbital containing medications.