Headaches may seem like an everyday annoyance, but some people have severe, recurrent headaches that interfere with their daily lives and may not respond to over-the-counter pain relievers. Such headaches can have many different causes and triggers, so treating them successfully takes specialized knowledge and experience.

If you have tried over-the-counter remedies with little or no relief, you may start to feel that nothing will work. Take heart – many medications and advances with long safety records can dramatically reduce symptoms.

lady holding head in hands

Please note: Chronic headaches can keep you from living the life you want – and they can be a sign of a serious medical condition that requires prompt attention. Seek help immediately for:

  • Sudden, severe headache or sudden headache with a stiff neck
  • Headache with fever, convulsions, confusion or loss of consciousness
  • Headache following a blow to the head, or with pain in the eye or ear
  • Persistent headache in a person who was previously headache free
  • Recurring headache in children

Types of Headache

If you have severe or recurrent headaches, it is important to rule out possible causes that might be serious. Secondary headaches – caused by underling conditions, such as tumors, aneurysms or certain diseases – are rarer than other types of headaches. Other headaches, sometimes called primary headaches, are not caused by disease or an underlying condition. Common headache examples include:

Migraine Headaches

Migraines are the most common type of primary headache, affecting millions of Americans. Women are more likely to get migraines than men are. The exact cause is not fully understood. It may be related to swelling of blood vessels in the head, due to unusual levels of certain substances in the brain. People who get migraines may have abnormalities in the genes that control certain brain cells.

Symptoms of a migraine headache can include throbbing, moderate to severe pain, often on side of the head and feelings of nausea. Migraines can last from a few hours to one or two days. Many things can possible trigger a migraine such as sleeping too much or not enough, alcohol, certain foods, stress, anxiety and in women, hormonal changes before, during or after your period.

Treatment for migraines can include oral medications, OnabotulinumtoxinA (Botox) injections, stress management strategies, regular physical exercise and other lifestyles changes. In women, hormone therapy can helpful if migraines are related to the menstrual cycle.

Cluster Headaches

Cluster headaches are severe headaches that happen one to three times a day for a period of time, usually a few weeks. The headaches then disappear for two weeks or longer, only to return. Some people have cluster headaches so frequently that they have fewer than 14 pain free days a year. Unlike migraines, cluster headaches are more common in men than women. It’s possible to have both cluster headaches and migraines. As with migraines, the exact causes is unknown.

The pain from cluster headaches is severe and can last from 15 minutes to three hours. Many people describe it as burning or stabbing pain. It is usually on one side of the head and seldom changes sides. The eye on that side may tear and the eyelid may droop.

Treatment for cluster headaches often includes medications given orally, by nasal spray or by injection. People find quickly relief from breathing in pure oxygen. In some cases, narcotics or steroids can be helpful with care taken to avoid side effects or addiction.

Tension Headaches

Tension headaches are one of the most common types of headache. They are usually linked directly to stress or anxiety. These headaches often respond to over-the-counter medication, but overuse can lead to more headaches as well as other complications.

Combination drugs designed especially for tension headaches can often relieve symptoms. Preventive drugs such as antidepressants, anticonvulsive medications and muscle relaxants are also often helpful. Stress management and relaxation techniques can be a vital part of preventing tension headaches.

Temporal Arteritis

Temporal arteritis causes inflammation and damage to the blood vessels that supply blood to the head, neck, upper body and arms. It usually affects people who are 50 or older. The exact causes is unknown, but it may be related to a faulty immune response.

Temporal arteritis can cause throbbing headaches on one side of the head and the scalp may be tender. Symptoms can include fever and feeling ill, jaw pain when chewing, stiffness in the neck, fatigue, visions problems, hearing loss, cough or throat pain.

The condition is diagnosed using blood tests, as well as ultrasound, magnetic resonance imaging (MRI) and other imaging techniques to see the blood vessels.

Treatment is critical to help prevent severe problems such as blindness or stroke, and usually includes long-term treatment with corticosteroids.

Sinus Headaches

Sinus headaches are not as common as many people believe. Expert now believe that most people who think they are having sinus headaches are actually having migraines. However, if your headaches turn out to be related to your sinuses, a referral to an ear, nose and throat specialist is the next step in treating a sinus condition.