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Headaches: Know the type before you treat

Bookmark and Share You know the feeling. It starts as a dull pain that radiates behind your eyes, or as a tightness that stretches across your neck. Then, a full-blown headache erupts. The pain won't let you focus on your kids or work, and disrupts your entire day.

For most people, an over-the-counter pain reliever is a quick fix for a nagging headache. But if you experience headaches more than two or three times a week, it may be time to see your doctor. "Treating headaches is about maintaining your quality of life," says Seth Keller, MD, Virtua neurologist. "If headaches regularly interfere with your daily activities, that's a problem."

Track triggers and treatment
Identifying what triggers your headaches is the key to treating them and to preventing more. Before you meet with your doctor, record your headache patterns. Identifying the characteristics of your headaches can help your doctor determine the best treatment.

Keep a headache journal, and note the type of pain you feel, how you treat it, and how long it lasts. Information such as the time of onset, what you ate and drank that day, and any other symptoms that accompanied the pain will also help your doctor determine the proper treatment.

Dr. Keller also warns patients not to wait too long before taking a pain reliever. "Medications are less effective if you wait until the pain is unbearable. On the other hand, if you take medication too often, it can make your headache worse." Talk to your doctor about alternatives if your medication does not provide rapid relief.

When it becomes an emergency
"The concerning headache is the one that comes on like a thunderclap," according to Ken Sprankle, DO, Virtua emergency medicine physician. "If you suddenly have the worst headache of your life, you need to go to the emergency room."

Symptoms you should never ignore include: a sudden agonizing headache, a headache that becomes worse each time it comes back, or a headache accompanied by other symptoms such as weakness, blurred vision, slurred speech or fever. These are signs of serious medical conditions, and you should seek immediate medical attention.





Symptoms and solutions for common headaches

  • Tension Headache
    Symptoms: Mild to moderate pressure on both sides of the head; squeezing sensation in the forehead, temples or back of the head that radiates to the neck; pain builds gradually

    Solutions: An over-the-counter pain reliever such as aspirin, acetaminophen or ibuprofen is recommended, but be sure to follow the dosage instructions. Relaxation and a cold cloth on the forehead may also help.


  • Migraine Headache
    Symptoms: Mild to severe, one-sided throbbing pain often accompanied by nausea or vomiting, sensitivity to light and sound; sometimes preceded by a visual aura such as zigzag lines, blind spots or flashing lights


    Solutions: Use a cold compress, take a nap, drink a moderate amount of caffeine, or try an over-the-counter pain reliever. Prescription medications may be necessary to decrease or prevent migraine attacks.


  • Sinus Headache
    Symptoms: Gnawing pain in the forehead or cheekbones often increasing in severity throughout the day; accompanied by nasal discharge; caused by an infection in the sinus ducts

    Solutions: A decongestant or prescription antibiotic may be recommended by your doctor. Please note that mild migraines can be mistaken for sinus headaches. Talk to your doctor about the frequency and severity of your headaches to ensure appropriate treatment.


  • Cluster Headache
    Symptoms: Intense, severe pain around or behind the eyes accompanied by tearing of the eye, congestion and feelings of restlessness; attacks occur daily for weeks then disappear for up to a year; least common type of headache

    Solutions: Professional medical care is required and can include medications and oxygen therapy.


Download your own headache journal. Use it to track headache triggers and treatments.