Headache

Headache is pain felt in the head or neck. It is one of the most common medical complaints and can affect people of all ages. Most headaches are primary disorders, meaning they are not caused by another condition. Secondary headaches result from an underlying problem such as infection, head injury, medication use, or a vascular or metabolic issue.

Common primary headaches are migraine, tension-type headache, and cluster headache. Migraine is typically unilateral and throbbing, may be accompanied by nausea, sensitivity to light or sound, and some people experience aura. Tension-type headache presents as a pressing or tight band-like pain, usually on both sides, with mild to moderate intensity. Cluster headache causes severe unilateral orbital or temple pain with autonomic symptoms such as tearing, nasal congestion, or eyelid swelling.

Secondary headaches arise from another condition, including infections, head trauma, medication overuse, sinus disease, or vascular problems. Red flags that require urgent evaluation include a sudden "thunderclap" headache, new headaches in people over 50, headaches with fever and stiff neck, new neurological symptoms, or a worsening pattern.

Diagnosis is largely clinical. Most typical headaches do not require imaging, but tests may be used if red flags are present or if the headache pattern changes.

Acute treatment depends on the headache type. Analgesics such as NSAIDs or acetaminophen are common. For migraine, specific therapies like triptans can be effective. Cluster headaches may respond to high-flow oxygen and triptans, with preventive medicines considered for frequent attacks.

Prevention focuses on lifestyle measures and avoiding triggers. Regular sleep, hydration, balanced meals, exercise, stress management, and avoiding analgesic overuse can help reduce frequency. Most headaches improve with appropriate treatment and self-care, but red flags or new, distinct headaches warrant medical evaluation.