Headaches are ubiquitous, but not every type of head pain is the same. Specific intensities, patterns, and, most importantly, headache location, can tell you a lot about why your head hurts and what you should do.
Defining a Headache
A headache is any pain isolated in or around the head, so identifying its cause can be difficult. Most headaches can either be classified as primary (caused by some problem in the head’s pain-sensitive regions, not related to a disease) or secondary (appearing as symptoms of an illness). Different headaches are most easily identified when they occur, how they feel, and where they feel.
Some rare headaches occur due to neuralgia (nerve pain) in facial or cranial nerves, such as the occipital (causing intense burning pain on one side of the scalp or eye). Most headaches, however, occur due to natural interactions between chemicals in the body, high blood pressure (and hydration), lack of sleep, or sore neck and shoulder muscles.
If you can isolate your pain to a specific part of your head, you may be a step closer to figuring out what kind of headache you are experiencing. If your pain is severe and you are experiencing any of the following symptoms, please consult a doctor:
- Very intense and sudden onset of severe head pain
- Extreme nausea, followed by vomiting
- A sudden jump in temperature (fever above 102° F/38.8° C)
- A fever accompanied by a stiff neck
- Fainting spells
While isolating the pain-related headache location can help identify its origin, it is still good to get a medical professional’s proper diagnosis. If you have not had any of the symptoms above, but are always worried about your headache, be sure to see a doctor.
Front of the Head
If your headache location is primarily in the front half of your head – especially near the forehead and nose – it may be related to your sinus. Hay fever and other allergies can produce similar symptoms to the common cold, putting pressure on the sinus due to inflammation and excess mucus. If you feel congested in addition to having a headache, you may be dehydrated from your cold.
Pain around the sinus absent of any other symptoms suggesting a cold or allergy, maybe some other form of sinus infection. These are relatively rare, and it is worth noting that migraine pain can also occur around the forehead and nose, often isolated or concentrated on one half of the head as well. If the pain is more concentrated behind your eyes than your forehead and nose, it may result from restlessness or excessive eyestrain.
However, most of the time, these headaches are a form of tension headache. Tension headaches are a common type of primary headache usually caused by muscles around the neck and head contracting that causes discomfort and a feeling as though a band was tightening around your skull. These headaches may be triggered by stress or eating something you are sensitive to (common triggers being aged cheeses, certain nuts, alcohol, or caffeine).
Back of the Head
Another common area for headaches is the back of the head. Ruling out apparent causes such as physical trauma, headaches around the head’s back is often caused by the neck. Anything from muscle contractions or discomfort caused by poor posture to a more severe issue with the cervical spine (the vertebrae in your neck) may cause a growing headache in the back of your head.
The neck is the second most likely spot for a herniated disc, the first being the lower back. A herniated disc is a condition wherein the shock-absorbing disc between your vertebrae leaks some of its contents through cracks or damage, pressing on the nerves around it. This compression is what may lead to pain, numbness, or weakness in the surrounding area.
If you have recently been to the doctor and received a lumbar puncture, also known as a spinal tap, then your brain may be low on spinal fluid. This can lead to a low-pressure headache, also known as spontaneous intracranial hypotension (SIH). Other signs that you may have a headache related to your spinal fluid are getting worse if you sit up or stand but improve if you lie down.
Around the Temples
Migraine and tension headaches may cause pain mainly around the temples, but if the pain is more severe or if you have recently had issues with your jaw or trigeminal nerve, or more specifically the mandibular nerve, then your pain may be related to compression or entrapment of the nerve, especially if it is not going away.
Another condition that may cause isolated pain in the temples is temporal arteritis. Due to arthritis – a condition wherein the arteries are swollen and potentially inflamed. Conditions related to the muscles or joints in your jaw, known as temporomandibular joint (TMJ) disorders, can cause pain mainly in the temple area.
On One Side of the Head
If the headache location occurs mostly on one side of the head, it is likely a migraine or cluster headache. Cluster headaches are characterized by excruciating one-sided pain, usually with a very severe and sudden onset, and typically coming and going in waves for anywhere from a few days to over a month. They are not life-threatening but can be debilitating and very painful.
Cluster attacks usually happen at night, and episodes themselves last a few minutes or up to three hours. While most other headaches have an associated chemical or physical cause – a trigger, like a particular food, emotional stress, or pressure – cluster headaches appear seemingly random and maybe mostly genetic. Their reason is still not completely understood.
Seeking Treatment for Chronic Daily Headaches
The standard treatment is an over-the-counter painkiller – usually an anti-inflammatory like ibuprofen or an analgesic like acetaminophen. Simple home remedies and creature comforts can go a long way as well – staying hydrated, getting rest in a cool dark room, and keeping one’s eyes away from harsh lights.
When these do not suffice, treatments are usually individualized by a doctor. Depending on the cause of your headache, a doctor may attempt to relieve the pain through various pharmacological therapies, including anticonvulsants, combination treatment of caffeine and analgesics, antidepressants, or triptans.
In severe cases of chronic daily headaches, depending on the cause, nerve blocks and interventions such as Botox injections may help relieve the pain. Alternative or herbal treatments may help some patients with migraine. However, it is still heavily advised to review any supplements or herbal medication with your doctor to avoid unwanted drug interactions.