For anyone with a headache in Edinburgh, knowing the answer to “What kind of Headache do I have?” gets you half way to gaining control… Unfortunately there are over 200 types and subtypes of headache recognised by the International Headache Society! However, the vast majority of them are extremely rare. Let’s deal with the most common: Tension Type Headache, Migraine (with and without aura), Cluster Headache and Medication Overuse Headache.
Tension Type Headache
Feels like: A tight band or pressing headache all the way round head (not only on one side)
Cause: Tension (stress)! It is often associated with tight neck and head muscles. The exact mechanisms of pain production have not yet been pinned down, but in people who develop Chronic TTH (affected at least 15 days per month), the central nervous system (parts of your brain) becomes sensitized.
Migraine without Aura
Feels like: A one-sided severe headache, often sensitive to light or sound and feeling sick.
Cause: Believed to be a disturbance of brain activity leading to inflammation around some of the blood vessels, which in turn causes sensitisation of certain nerve pathways.
Migraine with Aura
Feels like: As for migraine without Aura, but preceded by “funny sensations” like tingling, blurry vision, tinnitus (ringing in ear) – this is the Aura.
Cause: Aura is due to a spontaneous increase in activity of certain brain cells which causes unexpected sensations; these can be in sight, sound, smell, physical sensations (e.g. pins and needles, numbness). This phase lasts from a few minutes to an hour, followed by the headache phase, the cause of which is as for Migraine without Aura.
Feels like: Short lasting (15mins – 3 hours) excruciating one-sided headache, 1 or more per day, with (on same side as headache), at least one of:
- facial or forehead sweating or flushing
- swollen eyelid
- droopy eyelid
- runny or blocked nose
- crying eye
- restlessness or agitation
Cause: A misfiring of nerves to the face and Temple area; cause unknown.
Medication Overuse Headache
Feels like: Usually affects someone with a history of Tension Type Headache or Migraine, so the headache resembles the original headache type. Headache affects sufferer on at least 15 days per month.
Cause: Overuse of headache medication over at least a 3 month period.
Here’s a questionnaire for Headache Types to help you guess yours (Warning: this is a likely indication, NOT a diagnosis – you should consult a healthcare professional)
- Does your headache limit your activities?
- Do you feel sick when you have a headache?
- Does light bother you when you have a headache?
- Do you take medication for your headaches for 2 or more days per week?
- Do you have excruciating headaches on more than 15 days per month, with 1 or more headaches per day, have red/watering eyes or blocked nose or feel agitated?
- Do you experience funny sensations immediately before your headache starts?
If you answered “Yes” to at least 2 from questions 1-3 and “Yes” to question 6, you probably have Migraine with Aura.
If you answered “Yes” to at least 2 from questions 1-3 and “No” to question 6, you probably have Migraine without Aura.
If you answered “No” to question 1, you probably have Tension Type Headache
If you answered “Yes” to question 4, you may have Medication Overuse Headache.
If you answered “Yes” to questions 1 and 5, you may have Cluster Headache.
Other important things to be aware of…
- You are unwell – high temperature, or had recent unexpected weight loss
- You have some other established disease e.g. cancer, HIV
- You are confused or drowsy
- A very sudden split-second onset of your headache
- You are over 50 when the headache starts
- Your are under 5 years old when the headaches start
- There has been a recent change in headache pattern
If any of these are true for you, please consult your doctor – being sure to mention this.
If 3 or 4 are true, call NHS 24 or go straight to A&E
If 6 is true, and the headache is severe, call NHS 24