Stress Headaches? Cluster Headaches? Migraines? Treatments Hinge on Which Headache Type You Have

Symptoms—and treatment—differ for migraine, cluster, rebound, and tension (or stress) headaches. Identify yours before setting out to get rid of it.

stress headaches

If symptoms have your head feeling like it's being squeezed in vice grips, you likely have a tension or stress headache.

© Michael Brown | Dreamstime

Most people experience an occasional headache that is relieved by an over-the-counter pain medication. However, if you have tension or stress headaches, migraines, or other types of headaches that frequently affect your ability to function, don’t assume there’s no solution. Work with your physician or a specialist to identify which type of headaches you have so you can get the appropriate treatment.

Below, we offer details on the symptoms, causes, and treatments of several types of headaches, both common and unusual.

Tension (or Stress) Headaches

Tension headaches, also referred to as stress headaches, are the most common type of headaches, characterized by a feeling of constant pressure on both sides of your head.

Tension headaches are often related to high stress levels; when you’re stressed, the muscles in your neck, upper back, and shoulders can tense up, resulting in a headache. Other possible causes of tension headaches include:

  • Bad posture
  • Arthritis in the vertebrae of the neck
  • Anxiety
  • Depression
  • Hunger
  • Dehydration
  • Fatigue
  • Temporomandibular joint disorder (TMJD), a condition that affects the jaw joints

Tension headaches can sometimes be prevented with lifestyle changes, or with physical therapy or meditation,” says Louise Klebanoff, MD, a neurologist at Weill Cornell Medicine.

For some people, tension headaches can be alleviated by therapies that help reduce stress, such as meditation, mindfulness-based stress reduction, biofeedback, and cognitive-behavioral therapy. Massage and neck and shoulder stretches also may help prevent or ease a tension headache. If your headaches are caused by TMJD, your dentist may provide an oral appliance that may help.

Cluster Headaches

Cluster headaches occur on a daily basis at the same time each day, typically for about six to 12 weeks, followed by a period of remission. A cluster headache is characterized by intense pain around the eye on one side of the head.

Factors that contribute to a higher risk of cluster headaches include genetics (about 20 percent of cluster headache sufferers have a family history of the condition), current or previous tobacco use, and taking nitroglycerin, a medication used to treat heart disease.

WHAT YOU SHOULD KNOW

WHICH HEADACHE MEDS?

Medications commonly used to treat headaches include:

  • Nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen
  • Analgesics, such as acetaminophen
  • Fenoprofen (Nalfon), ketoprofen (Actron), nabumetone (Relafen), or flurbiprofen (Ansaid) for migraines and tension headaches
  • Keterolac (Toradol), meclofenamate (Meclomen), carisoprodol (Soma), orphenadrine (Norflex), cyclobenzaprine (Flexeril), and metaxolone (Skelaxin) for tension headaches

Migraines

Migraines produce throbbing pain that tends to occur in the front or one side of the head and is worsened by movement. You may notice an “aura”—a visual disturbance such as flashing lights, spots, or zigzag lines across your field of vision—before your headache starts. However, Dr. Klebanoff notes that only about 25 to 30 percent of migraine patients experience an aura. Migraine causes sensitivity to light and noise and may cause nausea and vomiting. Migraines are more common in women than in men.

Factors linked with a higher likelihood of having migraines include a genetic predisposition (the majority of migraine patients have a family history of migraines), hormonal changes, especially in women, epilepsy, asthma, and bipolar disorder. Some evidence suggests that fatigue, hunger, dehydration, and overexertion also may play a role in migraines.

Common triggers for migraines include bright or flashing lights, strong odors, and certain foods, including chocolate, aged cheese, processed meats, monosodium glutamate (commonly used in Chinese food), red wine, and caffeine.

Rebound Headaches

“If you take over-the-counter medications three times a week or more, you can get a ‘rebound’ headache, which is caused by analgesic overuse,” explains Dr. Klebanoff. Analgesic medications—acetaminophen (Tylenol) and medications that combine acetaminophen, aspirin and caffeine (for example, Excedrin)—put you at greater risk for rebound headaches than NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn).

Help for Headaches

Occasional, mild headaches usually do not warrant a trip to a specialist. “However, if your headaches are frequent, bothersome, and your current treatment regimen is not giving you relief, consult a neurologist,” says Dr. Klebanoff. A neurologist has expertise in diagnosing and treating headaches.

Dr. Klebanoff says that most headaches are primary, meaning that they are not caused by another medical condition. However, on rare occasions, headaches may be secondary, meaning they are due to an underlying condition, such as a brain tumor or aneurysm.

If you have headaches that regularly interfere with your ability to work or take care of your daily responsibilities, see a headache specialist and get help.

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