Cause of Headache

A few years ago the International Headache Society (IHS) rewrote the classifications for cause of headache. Those of us in the profession were aware of the coming changes and fortunately they were minimal.

Mostly they involved terminology and some slight reclassification of headaches.

Headaches can be divided into two basic categories: Primary and Secondary Headaches Although this seems over simplistic, it is important to realize that these are medical classifications and basically is a starting point for diagnosis.

  • Primary Headaches

Primary headaches are those where the cause of headache is the pain not some underlying medical condition. The majority (90%) of all headaches that come into a doctor's office are from primary causes such as migraine, cluster and tension headaches. Tension headache may be episodic or chronic. Usually, these headaches are not associated with structural brain problems although numbness, tingling, and dizziness may occur with these headaches.

Indeed, entire websites (including here!) have been devoted to the causes of migraine headache.

Imaging studies and blood work are usually also normal.

When I examine a patient with one of these types of headaches, the exam is also ususally normal. Tension headache patients may, however, have cervical spasming, which can also cause cervicogenic headaches.

  • Secondary Headaches

Secondary headaches are a group that are more easily definable.

These are headaches that are caused by an underlying medical condition such as diabetes (hypoglycemic headache), hypertension, or lupus. With secondary headaches, the head pain is not the main problem, but presents as part of a constellation of symptoms.

Lab work and other studies do show an abnormality here and the physical exam may also be abnormal.

It is vital for practitioners to listen to you the patient when headaches are part of the complaint. Treatment of the underlying condition will not only relieve the headaches, but in some cases may also save your life.

The below list of causes of headaches are not "official" IHS classifications, but are more typical terms used by patients when they ask me questions about headaches. This is the most common cause of headache.

Stomach migraines in children
Analgesic rebound headache
Brain Tumor Headaches
Caffeine headache
Cervicogenic or neck pain headaches
Chronic daily headaches
Cluster headache
Emergency or thunderclap headaches
Hypertension headache
High blood pressure headache
Menstrual migraine
Menopause headaches
Migraine and Vertigo
The Migraine Personality
Does obesity cause migraines?
Sinus Headache
Tension headache

Learn how to explain to those around you about your migraine headache symptoms.

What Causes Headache?

"But what causes headache?" is the question I get from many patients. Often they come to our practice assuming a headache is just a headache is just a headache.

Well that's another "myth about headaches"! Usually there are a few different types involved and they have to be sorted out.. Even if you have been told in the past that "everyone gets headaches like that", this is not true.

Therefore there may be many causes of headache. One of them well known to women is menstrual migraine. What is the definition of a true menstrual migraine? One that occurs 2 days before, during, or up to 3 days after your cycle.

Additionally, some women might have migraines with menopause.

While migraine is a neurological attack within the brain, many people have head pain originating from musculoskelatal spasms which cause cervicogenic headaches. Additionally, cervicogenic headaches can actually become a migraine trigger through a feedback mechanism to the brain. But if this is you, you know this alreay right? The least little neck pain starts a spasm and you are off and running with a migraine.

Having said all this, the main source for cause of headache is still stress. As I tell many of my patients, most headache profiles can be significantly improved by lifestyle changes.

Read more about different types of headaches.

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