Headaches are common. They are the single most commonly reported illness and they have a tendency to be frequent in those prone to them, so the burden of illness is often significant. They can come at great social, occupational and financial cost to chronic sufferers.
It is important to understand that not all headaches are the same, there are many different types, with different causes and different treatments. This is by no means an exhaustive list but it covers the ones we see most commonly. Before we get into specifics, it’s also worth noting that we often categorise these different headache types as either primary or secondary headaches depending upon whether the headaches is actually the result of some other illness or pathology (think sinus infection, strokes or tumours).
Tension type headaches are the most commonly occurring type of headache but like most other headaches, the exact mechanisms underlying them are unknown. Typical symptoms include bilateral headache, lasting minutes to days. Episodes are typically less frequent and though bothersome; the pain is not usually as intense or debilitating as some other headaches. Pain is often described as pressure and though it may be associated with sensitivity to light or noise, it does not involve any visual disturbance, nausea or vomiting as a migraine might.
A migraine is a typically a unilateral headache, they are relatively common in Australia, affecting about 12% of women and 6% of men. The increased occurrence in women may relate to hormonal changes or be ‘menstrual migraine’. There is no clear consensus on the cause of migraines (likely because there are several causes); but vascular, neurological and other mechanisms have been proposed causes.
Migraines are broadly divided into two subgroups, those with and without a prodromal aura;