When Should I Seek Care for My Recurrent Headaches?

Many people have one-and-done headaches, but for a segment of the population, head pain is recurrent and persistent. Not all headaches are the same, though. In truth, there are more than 150 different kinds of headache disorders. Some are mildly annoying, while others are crippling; some pose no real health threat, while others are serious.

According to the World Health Organization, headache disorders and migraine are two of the most common conditions around the globe. Up to 1 in 20 adults have a headache every — or nearly every — day, and 1 in 7 endures a migraine attack. Cluster headaches are less common, but they’re a great example of a recurrent headache that needs medical attention.

At Memphis Neurology, our board-certified neurologists specialize in diagnosing and treating all types of headache disorders. Because headaches are so common, and because most people aren’t aware of when a headache requires medical care, we’ve put together this guide.

Primary versus secondary headaches

A major distinction between headaches is primary versus secondary.

Primary headaches are caused by problems with the pain-sensitive structures in your head. They may occur because of a chemical imbalance in the brain, nerves that signal improperly, dilated blood vessels, or problems with the muscles in your head and neck. 

Some people have a genetic predisposition toward headache. That means they’re more likely to experience headaches if close family members also experience them.

There are four types of primary headache disorders:

1. Tension-type
2. Migraine
3. Cluster headaches
4. New daily persistent headache

Secondary headaches, on the other hand, are triggered by an underlying medical condition and are a symptom or side effect of that condition.

The most common primary headache disorders

Let’s break down the three most common primary headache disorders that can lead to recurrent pain.

1. Tension-type headaches (TTHs)

Tension-type headaches are the most common type of headache disorder, producing mild, moderate, or severe pain behind the eyes, as well as in the head and neck. Many patients say it’s like their head is in a vice, and the pain may present on just one side or both.

The duration of any attack varies from 30 minutes to seven days, but TTH pain doesn’t worsen with activity, such as walking or bending over, and the attack isn’t associated with nausea or vomiting.

If you get them only occasionally, TTHs respond to over-the-counter pain relievers. If they’re recurrent or chronic, you may need prescription medication. Your doctor may also recommend common sense treatments such as plenty of restful sleep, regular exercise, and practicing relaxation techniques like massage or yoga.

2. Migraine

Migraine is more than just a headache. It’s a neurological disorder that produces painful attacks in response to specific triggers that vary from one person to another. According to the Migraine Research Foundation, migraine is the sixth-most disabling disease worldwide, and, by nature, it produces recurrent attacks.

Unlike TTHs, migraine pain usually presents as a throbbing only on one side of the head, which worsens with any kind of movement. The pain phase can last between 4-72 hours.

Along with crippling pain, an attack causes neurological symptoms that include:

• Heightened sensitivity to light, sound, and smells
• Nausea and vomiting
• Gastroparesis, a slowing of gut motility

Migraine requires medical attention, both to prevent attacks and to abort them when they come. Some medication options for prevention include mexiletine, a drug in the same class as the anesthetic lidocaine; Botox®, and the new class of anti-CGRP monoclonal antibodies, which target a molecule involved in initiating the pain cycle. Medication options to abort an attack include the triptans, the ergotamines, and the new gepants.

Reducing stress and avoiding any known triggers can also help prevent attacks or make them less debilitating. And neuromodulation devices can help to both prevent and abort attacks.

3. Cluster headaches

Cluster headaches recur in groups or clusters that can last for weeks or months. They present with sudden-onset, severe pain behind one eye that’s searing, burning, or stabbing. Each discreet headache in an attack lasts 30-45 minutes, and you can experience up to eight of these within each 24-hour period. They may just as suddenly go into remission for months or even years before another cluster occurs.

Cluster headaches, while not curable, do require medical care to reduce the frequency and severity of the attacks.

If you’re experiencing recurring headaches of any kind, you need to come into Memphis Neurology for an evaluation and appropriate treatment. Give us a call at either our Southaven, Mississippi, or Germantown, Tennessee, location to schedule a consultation with one of our neurologists, or book online with us today.