The Headache Institute

Common Headache Types

There is no such thing as a regular headache. Headaches can be classified based on their characteristics and features as either primary or secondary.

The most commonly experienced headaches are the primary headaches whose cause is thought to be an underlying inherited predisposition. Those things that trigger primary headaches are often confused with the underlying biological causes. This has led to misunderstandings and misdiagnoses. The primary headache disorder falls into 3 main categories:

Migraine headaches are more common than expected. Over 28 million people suffer with this disease and less than 50% are properly diagnosed and even less are treated effectively. Migraine is a legitimate biological disease of the brain, which is associated with multiple symptoms. The head pain tends to be on one side but can be all over. It tends to be throbbing and severe, but can be mild, moderate or severe. It is frequently associated with light and sound sensitivity and can be associated with sensitivity to smells. It is frequently, but not always, worsened with activity.

A small number, less than 20% of migraine sufferers, experience light flashes, blindness, zig zag lines or numbness prior to developing a headache. This is known as an "AURA" and is not experienced by over 80% of migrainers.

Commonly Reported Symptoms:

  • Head pain – mild, moderate, or severe
  • Fatigue
  • Cognitive or thinking difficulty
  • Heightened sensory awareness
  • Muscle pains and aches
  • Food craving
  • Fluid retention
  • Changes in mood
  • Anorexia or loss of appetite
  • Nasal congestion/Sinus congestion
  • Visual disturbance
  • Numbness or tingling – face, arms, legs, head
  • Weakness
  • Vertigo and dizziness
  • Ringing in ears
  • Difficulty speaking
  • Pressure-like sensation of the head, face, sinuses, or jaw
  • Nausea, queasiness, or vomiting
  • Light sensitivity
  • Sound sensitivity
  • Sensitivity to smells
  • Runny eyes or nose
  • Poor concentration

The most common type of primary headache, tension-type headache, refers to head pain associated with “stress and muscle contractions.” These types of headaches can occur occasionally in response to stressful life events or more chronically and more frequently. Some tension-type headache patients experience daily or near daily pain.


The cause is thought to be contraction of muscles in the neck, face and scalp which lead to pain. The exact mechanism by which stress (muscle contraction) leads to a headache in some but not others is not understood. Multiple factors may contribute to tension-type headaches and include:

  • Stress
  • Anxiety
  • Depression
  • Eye-strain
  • Poor posture
  • Neck injuries or Arthritis
  • TMJ (Temporomandibular Joint Disease)
  • Teeth grinding
  • Insomnia
  • Sleep Apnea
  • Diet and fluid intake
  • Excess caffeine


Tension-type headaches usually begin with mild pain and build in severity.

The symptoms can include:

  • Constant-steady pain/pressure
  • Dull, achy pain (rather than throbbing pain)
  • Pain felt on both sides of the head in forehead, temples, and back of head and neck.
  • Tight pressure around the head

Intensity ranges from mild, moderate, or severe. As the pain increases, the ability to concentrate may decrease. Tension-type headaches rarely interfere with normal daily activity or sleep.

A more dramatic but less common headache disorder is called “cluster”. The name is derived from the “clustering" or pattern of the headache. There are two main categories of cluster headaches which are episodic cluster and chronic cluster.

An episodic cluster headache occurs in 90% of patients. It occurs one or more times daily for several months, and the patient enters a period of remission for months or years.

Chronic cluster headaches occur daily or almost daily with rare headache-free periods.

A cluster headache type can convert to another headache type at anytime.


Although the exact cause is unknown, it is assumed to be related to disturbances in normal body rhythms and an imbalance of brain chemicals. A cluster headache is much less common than tension or migraine. A cluster affects less than 0.1% of the population.

Risk factors:

  • Sex: Males are 3 times more likely than females
  • Age: 20 – 50 year olds
  • Prior injury or surgery to the head


Symptoms of Cluster Headaches include:

  • Stabbing, penetrating, burning or explosive head pain that is always on the side of the head and often starts in or around the eye.
  • Occurs daily or almost daily for 4 – 12 weeks
  • Can occur 1-6 times per day
  • Occurs at approximately the same time every day/night
  • May awaken you from sleep
  • Usually lasts 30 – 45 minutes.

During the headache, secondary symptoms may occur including:

  • Facial flushes/swelling
  • Stuffy or runny nose
  • Droopy eye lids
  • Constriction of the pupil

Secondary headaches are caused by underlying medical problems and are much less common than primary headache syndrome. More serious causes of secondary headache syndromes include, but are not limited to:

  • Brain trumors
  • Bleeding in the brain
  • Aneurysms or vascular abnormalties and infections.

Less serious causes include:

  • Sinus infections
  • Allergies
  • Neck or jaw problems
  • Eye problems
  • Dental problems and TMJ (Temporomandibular Joint Syndrome).