Key takeaways
- Tension headaches are the most common type: dull, band-like pain on both sides of the head.
- Cervicogenic headaches start in the neck, usually on one side, and often come with reduced neck movement.
- Migraines and cluster headaches have distinct patterns and often need medical management.
- A headache diary is one of the most useful tools for finding the cause and your triggers.
A headache is any pain or discomfort in the head or face. But headaches differ greatly in their location, intensity and cause. Here are the most common types and how to recognize them.
Cervicogenic headaches
Cervicogenic headaches are caused by a problem in the neck, with pain referred into the head. They often start as an on-and-off pain and can become constant. Poor posture, awkward or sudden movements, coughing, sneezing and whiplash can all trigger them. Common signs:
- Pain on one side of the head, neck or face
- Reduced neck movement
- Pain that starts in the neck and spreads to the forehead, around the eye, the temple or the ear
- Pain in the shoulder or arm on the same side
Because these headaches come from the neck's joints, muscles and nerves, they often respond to treatment of the neck itself.
Tension headaches
Tension headaches are the most common type. They're linked to tight muscles and stress, and they come and go. Typical features:
- Gradual onset
- Pain on both sides of the head
- Dull pain, or a feeling of a tight band around the head
- Mild to moderate, not severe
- Usually no nausea, vomiting or sensitivity to light
Migraines
Migraines cause severe throbbing or pulsing pain, usually on one side of the head, along with other symptoms such as nausea, vomiting, light-headedness and visual changes. They often move through phases, though not everyone experiences every phase:
- Prodrome - changes in mood or behavior hours or days before
- Aura - visual, sensory or motor symptoms such as flashing lights, numbness or difficulty speaking
- Headache - throbbing pain with sensitivity to light and movement, fatigue or anxiety
- Resolution - the pain fades, often leaving tiredness, irritability or poor concentration
Neck problems can be one trigger for migraines, but migraines usually also need medical care.
Cluster headaches
Cluster headaches come in "clusters," one to three times a day for weeks or months, then may disappear for months or years. Signs include:
- Severe pain on one side of the head, usually behind one eye
- A red, watery or droopy eye, or a small pupil, on the same side
- Eyelid swelling
- A stuffy or runny nose
Warning signs: see a doctor right away
- A sudden, severe "worst ever" headache
- A headache with fever, stiff neck, rash or confusion
- A headache with changes in speech, vision, balance or coordination
- A headache with weakness or numbness on one side of the body
- A new type of headache after age 50, or one that wakes you from sleep
- A headache after a head injury
Keep a headache diary
Common ways to manage headaches include avoiding known triggers, regular sleep and meals, staying hydrated, exercise, stress management and resting in a quiet, dark room. To find your triggers, track:
- The day and time it started
- Where it hurts and what it feels like
- What you were doing when it began
- How long it lasted
- What made it better or worse
A good diary makes diagnosis much easier, whether the cause turns out to be in your neck or elsewhere.