Headaches are a common experience, affecting nearly everyone at some point. While often perceived as a general discomfort in the head, their location and accompanying characteristics can provide insights into their underlying nature. Understanding where a headache manifests can offer clues about its type and potential triggers.
Headaches Centered in the Forehead and Temples
Headaches often felt across the forehead and temples are tension headaches. These headaches present as a dull, aching sensation, often described as a tight band or vice-like pressure squeezing the head. The discomfort can also extend to the back of the head and neck. Tension headaches are the most common type among adults.
These headaches develop gradually and are mild to moderate in intensity. Various factors can contribute to their onset, including physical or emotional stress, fatigue, and maintaining the head in an unusual or sustained position for extended periods, such as during computer work. Unlike some other headache types, tension headaches do not involve nausea, vomiting, or severe sensitivity to light or sound.
Headaches Affecting One Side of the Head
Headaches affecting one side of the head are characteristic of migraines. They involve intense throbbing or pulsing pain, often localized to one side of the head, though the pain can shift or become bilateral. These attacks can last from hours to several days, disrupting daily activities.
Migraines are often accompanied by symptoms, including heightened sensitivity to light (photophobia) and sound (phonophobia), nausea, and sometimes vomiting. Some migraines are preceded or accompanied by an “aura,” involving temporary neurological disturbances. These auras are most often visual, manifesting as flashes of light, zigzag lines, or blind spots, but can also include tingling sensations or speech difficulties.
Headaches Around the Eyes and Face
Headaches around the eyes and face can indicate distinct types, such as cluster headaches or sinus headaches. Cluster headaches cause severe, sharp, or piercing pain, typically felt behind or around one eye. This pain can be excruciating and is often accompanied by noticeable symptoms on the affected side of the face. Symptoms include tearing of the eye, redness, a drooping eyelid, and nasal congestion or a runny nose.
Cluster headaches are unique due to their cyclical nature, occurring in “clusters” that can last for weeks or months, followed by periods of remission. In contrast, sinus headaches involve pressure and pain in the forehead, cheeks, and around the eyes. This discomfort often worsens when bending forward or straining. Sinus headaches are usually associated with sinus infection symptoms like nasal congestion, facial tenderness, and sometimes fever or discolored nasal discharge.
Headaches Originating from the Neck
Headaches that stem from the neck are known as cervicogenic headaches. The pain from these headaches originates in the neck or the back of the head and radiates forward. This referred pain often spreads to the forehead, temples, or around the eyes. The discomfort is a steady ache rather than a throbbing sensation.
Neck movement or sustained awkward postures can trigger or intensify these headaches. Individuals experiencing cervicogenic headaches often report symptoms such as neck stiffness or a reduced range of motion in the neck. These headaches are secondary, caused by an underlying condition affecting the cervical spine or its soft tissues.
When to Seek Medical Advice
While many headaches are not serious, certain symptoms warrant prompt medical attention. A sudden, severe headache, often described as the “worst headache of your life,” requires immediate evaluation. Headaches that occur after a head injury also require professional assessment.
Other concerning signs include headaches accompanied by a high fever, a stiff neck, or a rash. Neurological symptoms such as confusion, difficulty speaking, weakness or numbness on one side of the body, or vision changes also require urgent medical consultation. Any new headache pattern in individuals over 50 years old, or headaches that are persistently worsening or do not improve with standard treatments, should be discussed with a healthcare professional.