Topic Overview

Headaches are one of the most common pain-related health problems in both children and adults. You may have a headache along with another minor health problem such as a sore throat, cold, or sinus problem.

Types of headaches

The most common types of headaches usually are not serious but may occur again and again.

• Tension headaches are the most common type of headache and are often caused by stress and emotional strain. Most adults have tension headaches from time to time. See a picture of possible areas of pain from a tension headache.
• Cluster headaches
• Migraine headaches . Approximately one-third of people who have migraine headaches first began having them as teenagers.

Common causes of headaches

Common causes of headaches include:

• Alcohol, caffeine, or other drug use or withdrawal.
• Changes in the levels of chemicals in the body (neurotransmitters).
• Coughing or sneezing.
• Dehydration .
• Dental problems or procedures, such as pain from grinding the teeth or from a root canal.
• Eating or drinking cold foods and fluids.
• Emotional stress.
• Exposure to smoke or fumes from chemicals, including carbon monoxide.
• Eyestrain.
• Fever.
• High altitude. Lower oxygen levels at high altitudes can cause headaches.
• High blood pressure (hypertension).
• Infection in the sinuses, such as sinusitis or an abscess.
• Medical procedures, such as the aftereffects of a lumbar puncture (spinal tap).
• Medicines. Many medicines can cause headaches.
• Muscle strain in the neck, upper back, or shoulder muscles.
• Upper respiratory infections.
• Premenstrual syndrome .

Headaches with other serious symptoms

Although rare, a headache may be a sign of a serious illness. Other symptoms, such as vomiting, dizziness, or changes in vision, may also be present. The following serious illnesses or injuries can cause headaches.

• A head injury:
  • Injury to the brain
  • Fracture of the skull
  • Bleeding in or around the brain
• Brain tumor , which causes swelling within the brain
• Infection in the brain (encephalitis) or of the membrane surrounding the brain and spinal cord (meningitis)
• Stroke , a problem that occurs when a blood vessel (artery) that supplies blood to the brain bursts or is blocked by a blood clot
• A rupture of a blood vessel with bleeding in or around the brain (aneurysm)

Headaches and other health conditions

Other health conditions that can cause or contribute to headaches include:

• Fibromyalgia , a condition that causes widespread muscle and soft tissue pain and tenderness.
• Glaucoma , an eye disease that damages the nerves at the back of the eye.
• High blood pressure (hypertension).
• High blood sugar (hyperglycemia) or low blood sugar (hypoglycemia).
• Inflammatory problems, such as arthritis, lupus, or giant cell arteritis.
• Kidney disease , which causes wastes to build up in the blood.
• Low calcium levels in the blood (hypocalcemia) or overactivity of the gland that helps control the release of calcium into the blood (hyperparathyroidism).
• Lyme disease , a bacterial infection spread by certain types of ticks.
• Mental health problems, such as anxiety or depression.
• Problems with pregnancy, such as high blood pressure or preeclampsia.
• Sleep problems, such as insomnia or sleep apnea.
• Thyroid problems, such as hyperthyroidism or hypothyroidism.

Use the Check Your Symptoms section to decide if and when you should see a doctor.

Check Your Symptoms

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Home Treatment

Most of the time headaches get better or go away with home treatment and do not require a visit to a doctor. Home treatment for headaches can often help reduce the severity of pain and the length of time the pain is present. Home treatment may also relieve other symptoms, such as fever, nausea or vomiting, anxiety, or muscle aches. Start home treatment as soon as you can. Be sure to review the home treatment information for any other symptoms you may have.

If your doctor has prescribed a specific treatment for your headaches, begin treatment as soon as a headache starts. Be sure to follow his or her instructions when taking any prescription medicine for your headache.

For mild pain without other symptoms, try the following:

• Rest in a quiet, dark room.
• Place a cool compress on your forehead.
• Do not smoke, drink alcohol, or use illegal drugs.

Medicine you can buy without a prescription

Try a nonprescription medicine to help treat your fever or pain:

Acetaminophen, such as Tylenol Nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, such as Advil or Motrin Naproxen, such as Aleve or Naprosyn Aspirin (also a nonsteroidal anti-inflammatory drug), such as Bayer or Ecotrin Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow these safety tips when you use a nonprescription medicine:

Carefully read and follow all directions on the medicine bottle and box. Do not take more than the recommended dose. Do not take a medicine if you have had an allergic reaction to it in the past. If you have been told to avoid a medicine, call your doctor before you take it. If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to. Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

You may be able to reduce the frequency and severity of your headaches by trying:

• Relaxation exercises. These exercises can help take away tension and stress that cause headaches or make them worse. For more information, see the topic Stress Management.
• Heat, such as hot water bottles, heating pads, or hot baths, to relax tense muscles. Be careful not to burn yourself.
• Ice, such as an ice pack applied to the back or the neck or the temples.
• Massage therapy and biofeedback, which can reduce muscle tension, especially in your neck and shoulder muscles. This muscle tension can cause headaches or make them worse. For more information, see the topic Complementary Medicine.

When your child has headaches:

• Talk to your child. Let him or her know you care. Extra attention and quiet time may be all that is needed to relieve the pain.
• If your child's doctor has prescribed a specific treatment for his or her headaches, begin treatment as soon as your child complains of the pain.
• Let your child rest quietly in a darkened room with a cool compress on his or her forehead.
• If your child's headache pain is mild, encourage him or her to go on with normal activities.
• Let your child do his or her usual activities if he or she feels like it unless the headache pain is moderate to severe.

Medicine you can buy without a prescription

Try a nonprescription medicine to help treat your child's headache:
Acetaminophen, such as Tylenol or Panadol Ibuprofen, such as Motrin or Advil Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen to treat a fever. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow these safety tips when you use a nonprescription medicine:

Carefully read and follow all labels on the medicine bottle and box. Give, but do not exceed, the maximum recommended doses. Do not give your child a medicine if he or she has had an allergic reaction to it in the past. Do not give aspirin to anyone younger than age 20 unless directed to do so by your child's doctor. Do not give naproxen sodium (such as Aleve) to children younger than age 12 unless your child's doctor tells you to.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

• Pain increases or lasts for longer than 12 hours despite the use of home treatment.
• New symptoms develop.
• Symptoms become more severe or frequent.

Prevention

You may be able to prevent headaches by changing your daily routine. Identify possible causes of your headaches using a headache diary(What is a PDF document?) .

• Eat regularly. Do not skip meals. Choose nutritious foods; do not fill up on salty foods or carbonated beverages.
• Keep a regular sleep schedule. Set a bedtime and time to get up, and stick to them, even on weekends. This will help your body get used to a regular sleep time. Avoid oversleeping.
• Physical therapy may help you strengthen your neck muscles, improve your posture, and increase your mobility.
  • Exercise regularly. Walking, cycling, jogging, swimming, or even dancing or gardening are great ways to relieve stress. If you tend to hold tension in your neck and shoulders, walking may be especially helpful; the swinging motion of the arms seems to relax those muscles.
  • Practice a relaxation exercise once or twice a day for 10 to 20 minutes.
  • Try massage which can reduce muscle tension, especially in your neck and shoulder muscles. Muscle tension can cause headaches or make them worse.
• Practice good posture and body mechanics at home and at work:
  • Sit straight in your chair with your lower back supported. If you sit most of the day, take breaks once an hour to stretch your neck muscles. There are some specific exercises you can do during your breaks. For more information, see the topic Neck Problems and Injuries.
  • If you work at a computer, adjust your monitor so that the top of the screen is at eye level. Use a document holder to keep the copy at the same level as the screen.
  • If you frequently use the telephone, consider a headset or speakerphone. Do not cradle the handset between your shoulder and your ear.
• Have frequent dental check ups and yearly eye examinations.

Headaches can often be prevented by avoiding things that may cause, or "trigger," the pain. Although these triggers may be different for different people, generally avoid:

• Alcohol and caffeine (coffee, tea, or soda pop).
• Sudden caffeine withdrawal.
• Foods, such as very salty foods or foods that contain the preservative MSG.
• Poor eating habits, including missing meals, extreme diets, and fasting.
• Dehydration .
• Changes in usual sleep patterns, not getting enough sleep, or oversleeping.
• Stress , anxiety, or depression.
• Medicines, such as heart medicines, blood pressure medicines, and hormones.
• Poor posture and body mechanics.
• Smoking cigarettes, cigars, or breathing secondhand smoke.
• Glare from sunlight or artificial light.
• Exposure to strong odors.
• Strain in the muscles of the jaw from grinding or clenching teeth or chewing gum.
• Herbal remedies, such as ginseng or St. John's wort.

To prevent a child's headache:

• Make sure your child gets enough rest.
• Offer frequent nutritious snacks and beverages during the day. Do not allow your child to fill up on salty foods or carbonated beverages.
• Do not allow your child to skip meals.

Prevent head injuries to prevent headaches.

• Wear your seat belt when in a motor vehicle. Use child car seats.
• Do not use alcohol or other drugs before participating in sports or when operating a motor vehicle or other equipment.
• Wear a helmet and other protective clothing whenever you are biking, motorcycling, skating, kayaking, horseback riding, or rock climbing.
• Wear a hard hat if you work in an industrial area.
• Do not dive into shallow or unfamiliar water. Prevent falls in your home by removing hazards that might cause a fall.
• Do not keep firearms in your home. If you must keep firearms, lock them up and store them unloaded and uncocked. Lock ammunition in a separate area.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions. When you go to your appointment, be sure to bring your headache diary(What is a PDF document?) .

• What medicines do you take, either weekly or monthly, depending on the severity of your headaches? What is your response to the medicine? Make a list to help you remember your medicines and your response.
• For a headache that started suddenly (acute):
  • When did the headache start?
  • What were you doing when the headache started?
• For ongoing headaches (chronic):
  • When did your headache problems start?
  • How often do you have headaches?
  • How long do your headaches usually last?
  • Where is your headache pain located?
  • Describe your headache pain (stabbing, throbbing, dull, sharp), and how you would rate the pain?
  • How do your headaches usually begin or evolve?
  • Do you have other symptoms with your headaches?
  • Are your headaches related to your menstrual cycle?
  • What do you think causes your headaches?
  • What home treatments have you tried, and how well did they work?
  • What prescription medicines have you been given? Did they work?
  • What prescription or nonprescription medicines do you take?
  • Are you using an alternative or complementary medicine or treatment (including herbal remedies)?
  • Have you recently had a dental procedure, such as a filling or a root canal?
  • When was your last eye examination? Do you wear corrective lenses?
  • Do you have any health risks?

Other Places To Get Help

Organization

American Headache Society Committee for Headache Education (ACHE)
19 Mantua Road
Mount Royal, NJ  08061
Phone:	1-800-255-2243
Fax:	(856) 423-0082
E-mail:	achehq@talley.com
Web Address:	www.achenet.org
The American Headache Society Committee for Headache Education (ACHE) is a nonprofit partnership between health professionals and headache sufferers. ACHE provides resources and tools to health care professionals to help them help their headache patients. This Web site has many different educational resources for doctors, patients, families, schools, and employers. Resources include newsletters, articles on headaches, tools for both patients and doctors, and lists of certified headache doctors.

Related Information

• Anxiety
• Eye Problems, Noninjury
• Facial Problems, Noninjury
• Feeling Depressed
• Seizures

Credits

Author	Jan Nissl, RN, BS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Tracy Landauer
Primary Medical Reviewer	William M. Green, MD - Emergency Medicine
Primary Medical Reviewer	Martin Gabica, MD - Family Medicine
Specialist Medical Reviewer	H. Michael O'Connor, MD - Emergency Medicine
Specialist Medical Reviewer	William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Last Updated	July 9, 2008