Why does my head hurt? A guide to headaches

Clinical Editor: Megan Dodson, PA-C

Updated: March 28th, 2024

They can range from mild discomfort to a throbbing nuisance. And while for some they may occur more regularly, for others, they may seemingly come out of nowhere. No matter what your experience with headaches might be, the fact is they’re unpleasant, potentially distressing, and surprisingly common. In fact, according to the Cleveland Clinic, up to 96% of adults worldwide have experienced some sort of headache in the past year.

But even though you may be in good company with your throbbing noggin, that doesn’t make the sensation any less upsetting. There are so many answers to the “why does my head hurt?” question, but learning some of the headache basics can help you better understand the root cause of your pain and when to seek medical help. Here’s what you should know about headaches:

Unfortunately, doctors don’t totally understand what causes the actual sensation of most headaches. Experts do know, however, that although it may feel like it, headaches do not occur as the result of pain in the brain. This is because the brain does not have nerves that register pain. Instead, it is the blood vessels, nerves, and tissue surrounding the head and neck, such as those in the scalp, teeth, sinuses, and muscles and joints, that can signal pain to the brain.

While there are over 150 different types of headaches, there are two major categories: primary and secondary headaches. Primary headaches are those that are not caused by another medical condition. The most common primary headaches are tension and migraine headaches. Tension headaches typically cause pain in the forehead area. While they’re generally not considered dangerous, they can become chronic for some people. Migraine headaches can cause severe pain in addition to other symptoms such as nausea, vomiting, and light disturbance. Causes of both types of headache are unclear and it’s likely that multiple genetic and environmental factors are involved. Cluster headaches (one of the most painful types of headaches that occur in cyclical patterns) and new daily persistent headaches (NDPH) are also considered primary headaches. Secondary headaches are those that are related to another medical condition, and may include causes like blood vessel disease, head injury, infection, trauma, sinus congestion, and more.

In some cases, headaches just happen; they have a tendency to run in families, so there is a genetic component for some people. And even for people who haven’t inherited a predisposition to headaches, occasional pain can arise for no discernable reason. That said, there are certain environmental, physical, and emotional triggers that are known to cause headaches in certain people, including:

• Allergens like mold, pet dander, and pollen
• Eating specific foods like caffeine, alcohol, cheese, chocolate, or fermented foods
• Inhaling secondhand smoke
• Emotional stress and/or depression/anxiety
• Noise and lighting
• Changes in eating habits or sleep schedule
• Poor posture, resulting in strain to the back, neck, or eyes
• Changes in weather
• Breathing in fumes from household cleaners or certain fragrances

The good news for headache sufferers is that there are plenty of treatment options. If you’ve ruled out a serious health condition and you just need some relief for occasional head pain, try these remedies:

• Evaluate your sleep hygiene. It may sound simple, but a consistent, healthy sleep schedule may go a long way in helping prevent headaches (particularly migraines). To make the most of your rest, establish a regular sleep schedule, aiming for 7 to 9 hours a night, and minimize stimulating sounds, sights, and foods before bedtime. Learn more tips to revamp your sleep cycle here.
• In some cases, alternating hot and cold compresses can help relieve muscle tension, which may be at the root of your headache. Try applying a cold pack to the site of your head pain for 10 minutes and then using a heat pack for an equal amount of time.
• Stress management is a major part of headache prevention. Meditation, deep breathing, progressive muscle relaxation, and more can help soothe tension and stave off head pain. Need help getting started? Take a moment to reroot yourself in the present and relax with this mindfulness meditation from one of our health coaches.
• Some headaches can be treated with over-the-counter medications. If your headaches are infrequent and mild, you might consider trying ibuprofen (Advil and Motrin) or acetaminophen (Tylenol). Not everyone can take these medications, so talk to your healthcare provider before taking anything over-the-counter. If your headaches become more frequent or cause significant pain, you may want to discuss other medication options with your primary care provider.
• Drink plenty of fluids — dehydration can make headaches worse, so be sure to take in enough water every day.

In most cases, headaches are harmless and can be managed at home, but some people require medication or even immediate medical care. Here are some of the warning signs that signal you may need to seek urgent care for your headache:

• Your headache is severe
• There’s been a major change in the pattern or severity of your headaches
• Your headaches have gotten steadily worse over time or the pain increases when you move or cough
• You’ve had a head injury that preceded the headache
• There’s pain or tenderness near your temples that accompanies the headache itself
• Your headache is accompanied by a painful red eye
• You experience a change in your mental function or personality
• Your headache is also accompanied by fever, dizziness, stiff neck, rash, reduced alertness, confusion, decreased memory, nausea, or vomiting
• Your headache is accompanied by neurological symptoms like slurred speech, weakness or numbness, vision changes, or seizures.
• You have cancer or impaired immunity and are experiencing regular headaches

If you have three or more headaches per week or you’re relying on 2 to 3 doses (or more) of over-the-counter pain medication per week to cope with your headache pain, it’s time to see your healthcare provider for a checkup so they can help you determine the best treatment plan.

Looking to connect with a primary care provider? We’re here to help. At One Medical, our providers understand the importance of strong patient-provider relationships and will take the time to get to know you and your unique needs. Learn more about One Medical and how we can support you in your long-term health.