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Oh, my aching head! Oh, my aching head!
Headaches are defined as "a pain in the head or upper neck." Headaches are one of the most common physical complaints involving pain.... Oh, my aching head!

by Kimberly Allen R.N.

Headaches are defined as “a pain in the head or upper neck.”  Headaches are one of the most common physical complaints involving pain.  Over 30 million people a year complain of recurrent headaches.  There are numerous causes for headaches and it is because of these two factors that the International Headache Society approved a classification system to assist physicians and practitioners with diagnosing the type of headache a person is suffering from.  They are divided into three major categories:

Headaches can be severe or mild, but see a doctor if they are persistent.

1. Primary headaches

2. Secondary headaches

3. Cranial neuralgias, facial pain and other

Primary headaches are those that occur independently without another underlying problem.  These include; tension headaches which are the most common and are usually caused by stress, lack of sleep, skipping meals, or dehydration.  Migraines are a more intense headache that is usually longer in duration and more difficult to relieve than tension headaches.  It is estimated that 12% of the population will at one time or another experience a migraine.  Women are approximately three times more likely to experience a migraine than men.

Cluster headaches are the least common of the primary headaches with only about 1% of the population being affected.  They are extremely painful causing intense pain around one eye.  They occur in clusters that last for 1-2 months approximately the same time every year.  This type of headache is most common in men between 25-35yrs old.

Secondary headaches are caused by an underlying problem like an illness or injury.  The “hangover headache” falls in this category.  The headaches you get when suffering from the flu or sinusitis are examples of secondary headaches.  Other causes can range from bleeding in the brain or tumors to serious infections such as meningitis or encephalitis.  Treatment of the underlying cause is always the focus when treating secondary headaches. Once the underlying cause is treated the headache usually resolves itself.

Cranial neuralgia’s are headaches that occur when the nerves in the head and upper neck have become inflamed.  Facial pain in this category usually occurs as a result of an abscessed tooth or injury to the face.

The most important factor when your Dr is diagnosing a headache disorder is that you give a complete and accurate medical history.  The doctor will need to know when the headache(s) began, how long do they last? and how severe is the pain?  Do the headaches impair your ability to function?  Are there other symptoms like nausea and vomiting? Is there a sensitivity to light?  The doctor will do a complete physical and neurologic exam to determine the type of headache you are suffering from.

Treatment is based on the type of headache you are suffering from.  Tension headaches can usually be treated effectively with over the counter medication like ibuprofen or acetaminophen.  Migraine headaches usually require a more in depth treatment plan that includes finding the “trigger” of the migraine.  Cluster headaches are also very difficult to treat.  Treatment of these headaches has 2 goals; control the pain of the initial headache and prevent further headaches.  Over the counter medications are rarely effective in relieving the pain associated with this type of headache.

Treatment for secondary headaches and cranial neuralgia’s  focuses on the underlying cause.  Infections need to be resolved before the headache can be effectively treated and resolved.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at