"It's a very rare person indeed who has never experienced a headache," says headache expert Seymour Solomon, M.D.
About 90 percent of all headaches are classified as muscle contraction, or more commonly, "tension headaches," according to the National Headache Foundation. These are the head knockers that hit hardest with the onslaught of bills, work, and arguments.
The pain is typically generalized all over the head. You may feel a dull ache or a sense of tightness and perhaps experience a sense of not being clearheaded, says Fred Sheftell, M.D. "Most people will describe it as feeling like a band is wrapped around their head."
More than 45 million Americans not only get headaches, they get them time and time again. "Some people are born with biology that makes them headache prone," explains Joel Saper, M.D. For these people, headaches are a chronic problem. Further, an estimated 28 million of them experience migraines, which rightfully have an even uglier reputation than tension headaches.
Migraines are part of the vascular headache family and most often strike women. Seventy percent of those who get migraines are female.
"Migraines can be crippling," says Patricia Solbach, Ph.D. So much so that they cause a loss of more than 157 million workdays each year.
Typically, migraines bring severe, one-sided throbbing pain. In 25 percent of cases, however, the pain occurs on both sides. Often nausea and vomiting, and perhaps tremor and dizziness, accompany these headaches. Some people also experience premigraine warning symptoms, including blurred vision, "floating" visual images, and numbness in an arm or leg.
Unfortunately, even the doctors who operate headache clinics can't guarantee that they can diagnose which kind of headache a patient has. "There's no laboratory test that can tell you this patient has migraine, this one has tension," says Jerome Goldstein, M.D. Diagnosis is usually based on the patient's history.
Thus, regardless of the name you give your headaches—tension, migraine, various obscenities—you are the one in the best position to recognize what habits and factors bring on your headaches. It's up to you to do everything within your control to prevent or treat them. So for a better chance of heading off pain tomorrow, read this today.
"The average person," says Seymour Diamond, M.D., "typically has a tension headache." No big deal, no danger. But occasionally headaches are warning symptoms for serious disease. Here are the red flags to signal you to call your doctor.
• You are over 40 and never had recurring headaches before.
• The headaches have changed locations.
• The headaches are getting stronger.
• The headaches are coming more frequently.
• The headaches do not fit a recognizable pattern; that is, there seems to be nothing in particular that triggers them.
• Headaches have begun to disrupt your life; you've missed work on several occasions.
• The headaches are accompanied by neurological symptoms, such as numbness, dizziness, blurred vision, or memory loss.
• The headaches coincide with other medical problems or pain.
Seymour Diamond, M.D., is director and founder of the Diamond Headache Clinic and the Inpatient Headache Unit at St. Joseph Hospital in Chicago. He has written several books on headaches.
Harry C. Ehrmantraut, Ph.D., is the author of Headaches: The Drugless Way to Lasting Relief.
Jerome Goldstein, M.D., is a private practitioner and director of the San Francisco Headache Clinic and the San Francisco Clinical Research Center.
Robert Kunkel, M.D., is a consultant in the department of neurology at the Cleveland Clinic Headache Center in Ohio.
Ninan T. Mathew, M.D., is director of the Houston Headache Clinic in Texas and is the former president of the International Headache Society and the International Headache Society. He is also the former chairman of the headache and facial pain section of the American Academy of Neurology.
Joel Saper, M.D., is director and director of the Michigan Head Pain and Neurological Institute in Ann Arbor and director of the Head-Pain Treatment program at Chelsea Community Hospital in Chelsea, Michigan. He is also a clinical professor of medicine in the department of neurology and opthalmology in the College of Osteopathic Medicine at Michigan State University in East Lansing, as well as the author of several books, including the Handbook of Headache Management, Help for Headaches, and the Clinician's Manual on Headaches.
Fred Sheftell, M.D., is director of the New England Center for Headache in Stamford, Connecticut.
Patricia Solbach, Ph.D., was formerly director of the Headache and Internal Medicine Research Center at the Menninger Clinic in Topeka.
Seymour Solomon, M.D., is a professor of neurology at Albert Einstein College of Medicine at Yeshiva University and director emeritus of the Headache Unit at Montefiore Medical Center, both in Bronx.