The Basics of Headaches


A headache is pain in the scalp, head, face, or neck. Around 45% of the adult population have experienced a headache at least once during the past year. Headaches affect people of all races, ages, and income levels. A headache can be a primary disorder or can be a symptom of a serious underlying medical condition.

Types of Headaches

  • Tension headache – This is the most common type of headache. Tension headaches occur due to tense muscles in the jaw, scalp, neck, and shoulders, and they may be related to depression, anxiety, stress,Migraine headaches or holding the head in an abnormal position. The pain is often dull, squeezing, and described as a tight band or vice on the head.


  • Migraine headache – This type of headache is described as pounding, throbbing, or pulsating, and the pain occurs on one side of the head. Many people who have migraines have an aura, which is a group of warning symptoms that occur before the onset of the head pain. Things that trigger migraines include chocolate, certain cheeses, caffeine withdrawal, alcohol, and lack of sleep.


  • Cluster headache – This is a painful headache that occurs several times in a period of time. The patient will have long episodes of pain-free days. Cluster headaches often are accompanied by tearing of the eye and nasal stuffiness.


  • Sinus headache – This type of headache causes pain in the front of the face or head. A sinus headache is due to swelling in the sinus passages behind the eyes, nose, and cheeks.


Causes of Headaches

Headaches are classified as either primary or secondary. Primary headaches are caused by problems with or overactivity of structures in the head that are sensitive to pain. These structures include the nerves, muscles, and/or blood vessels. Primary headaches can be associated with direct physical stimuli, such as pressure, temperature, or physical exertion.

Secondary headaches are symptoms related to another condition that stimulates the pain-sensitive nerves of the neck, scalp, and head. Causes of secondary headaches include concussion, dehydration, overuse of medication, elevated blood pressure, infection, and blood clots.

Treatment for Headaches


  • Botox – Botulinum toxin type A is a neurotoxin used for prevention of headaches. This agent interrupts signal transmission of the nerve cells to the muscles. Botox produces muscle paralysis and blocks the release of acetylcholine (neurotransmitter) from the nerve cells. The paralysis effect lasts Occipital Nerve Blockfor approximately three months. The doctor injects the agent in the forehead, jaw, and back of the head.


  • Occipital nerve block – This technique has a long and proven track record for treating head and neck pain. The doctor inserts a small needle into the scalp at the back of the head. An anesthetic and corticosteroid is injected into the tissue near the occipital nerves, which is called the occiput. The anesthetic agent relieves pain, and the steroid reduces inflammation.


  • Radiofrequency denervation – This procedure involves the cervical facet joints at the back of the neck. The doctor inserts a small needle into the space between the cervical vertebrae (facet joint) using x-ray guidance. Radiofrequency energy is used to disrupt the pain signal transmission, so the nerves no longer sense pain.



World Health Organization (2012). Headache disorders. Retrieved from:

Mayo Clinic (2014). Headache. Retrieved from: