What kinds of headache are there?

A common phenomenon

Most people are affected by headaches at one time or another. This comes as no surprise as the International Headache Society (IHS) has classified well over 200 different types of headache. These are divided into 3 categories:

1. primary headaches (including migraine, tension headaches or cluster headaches),
   
2. secondary headaches (due to injury or disease, for example),
   
3. and nerve disorders and facial pain.
   

Types of primary headache

Primary headaches are by far the most common and differ mainly in their occurrence and type of pain.

Tension headache

Tension headaches are the most common type of headache and usually occur only occasionally. They can last only a few hours but also even days. Usually the pain, which is felt as constricting and pressing (but not stabbing), is bilateral, especially around the temples – a kind of «vice-like feeling». The pain is therefore quite different from that of migraine or cluster headaches, partly because it is seldom very extreme. In very rare cases, tension headaches can also become chronic (180 days a year).

The range of triggers is vast

• Pregnancy: It's not uncommon for pregnant women to suffer from occasional headaches during the first months of pregnancy. The trigger is often the hormonal and circulatory changes.
• Menstruation: Hormone fluctuations (oestrogen) during menstruation can trigger headaches, even migraines or other menstrual pain.
• Iron deficiency: Iron plays a key role in blood formation and oxygen storage. A deficiency can lead not only to chronic fatigue but also to headaches.
• Tension and stress: Tension in the neck and shoulder area as well as pressure, stress or anxiety situations in daily life are common triggers for tension headaches.

• Weather: About half of the population reports being sensitive to the weather. Symptoms may also include headaches.
• Coughs: The headache appears moments after the cough, after which it peaks almost immediately and subsides quickly.
• Cold: This headache can appear when the head’s surface is exposed to cold, for example, but also from swallowing cold food or drink. It subsides quickly once the exposure to the cold temperature is over.
• Pressure or pull: Pressure from a tight headband, a tight-fitting hat or helmet, or pull – from a tightly tied ponytail, for example – can trigger a headache.

Migraine

In about ten percent of the population, headaches meet the diagnostic criteria of migraine. According to the Swiss Headache Society, these are – in simplified terms: one-sided, pulsating, severe headaches, often associated with nausea or vomiting, hypersensitivity to light and noise, and impaired functionality. Migraine is the second most common form of headache and can severely restrict the sufferer’s daily life – in terms of intellectual, emotional and social resilience.

The duration of a migraine attack varies from a few hours to several days. Half of all migraine patients report one attack per month, one in ten even suffers from four or more attacks.

Preliminary signs of an attack are often

• low mood,
• hyperactivity
• or even a ravenous appetite for specific foods.
  

Cluster headache

Cluster headaches, which always occur on one side, are relatively rare compared to the other two primary headache types but are highly distressing to sufferers and mostly extremely painful. They usually begin to appear between the ages of 20 and 40 and mainly affect men.

The attacks of stabbing or drilling pain around the eye socket (often with reddened and watery eyes) or temple generally occur in series – up to eight times a day for between 15 and 180 minutes. These series can last for weeks or months (referred to as cluster episodes). They are interspersed by pain-free periods that usually last for months or even years. The causes of cluster headaches aren't exactly clear, but experts presume them to be hereditary.

Triggers of an attack include

• the consumption of alcohol,
• nicotine
• and certain foods such as nuts.