Headache

What aches when you have a headache?

There are several areas in the head that can hurt when you have a headache, including the following:

a network of nerves that extends over the scalp
certain nerves in the face, mouth, and throat
muscles of the head
blood vessels found along the surface and at the base of the brain (these contain delicate nerve fibers)

The bones of the skull and tissues of the brain itself do not hurt because they do not have pain-sensitive nerve fibers.

What happens during a headache?

Nociceptors (the ends of the pain-sensitive nerves) are stimulated by stress, muscular tension, dilated blood vessels, and other headache triggers, and send a message to the nerve cells in the brain, signaling that a part of the body hurts.

Different chemicals help transmit pain-related information to the brain, including endorphins - natural painkilling proteins. It has been suggested that people who suffer from severe headaches, or other chronic pain, have lower levels of endorphins than people who are generally pain-free.

How do headaches differ?

There are two main types of headache, primary and secondary:

primary headaches
Primary headaches account for more than 90 percent of headaches, and include the following:
- tension (muscular contraction) headaches
- vascular (migraine) headaches
- cluster headaches (not caused by other underlying medical conditions)
secondary headaches
Secondary headaches account for fewer than 10 percent of all headaches, and include headaches that result from other medical conditions. These may also be referred to as the following:
- traction headaches
- inflammatory headaches

Statistics about headaches:

According to the National Institute of Neurological Disorders and Stroke (NINDS) and the American Council for Headache Education (ACHE):

As many as 45 million Americans have chronic, severe headaches that can be disabling.
Headaches result in more than 8 million doctor visits a year.
Migraine sufferers lose more than 157 million workdays because of headache pain.
Nearly 90 percent of men and 95 percent of women have had at least one headache.
Most people with a headache use nonprescription pain relievers to treat their symptoms. Because store shelves hold a vast array of pain relievers, and there is a growing trend towards self-care, Americans have a responsibility to examine facts about headaches and pain relievers.

When to see your physician regarding your headache:

According to the ACHE, headaches are rarely a symptom of serious underlying medical conditions. However, you should consult your physician if any of the following apply to you:

you experience three or more headaches per week
you must take a pain reliever every day or almost daily
you need more than the recommended doses of over-the-counter medications to relieve headache symptoms
you have a stiff neck and/or fever, in addition to a headache
the headache is accompanied by shortness of breath, fever, and/or unexpected symptoms that affect your eyes, ears, nose, or throat
dizziness, unsteadiness, slurred speech, weakness, or numbness and/or tingling are present, in addition to your headache
confusion or drowsiness accompany your headache
headaches begin with, but persist after, a head injury
headaches are triggered by exertion, coughing, bending, or sexual activity
headaches keep getting worse and will not go away
headaches have changed in character
headaches are accompanied by persistent or severe vomiting
you experience your "first and/or worse" headache
headaches began after you reached the age of 50