Headaches always seem like mysterious third cousins who show up uninvited at your door with lots of luggage just as you were about to go out and enjoy your life. There are times when we can predict the onset of head pain — right before our menstrual cycles seems to be a popular time slot that our bodies reserve for the kinds of annoying headaches that make work impossible. But, if you find yourself consistently frustrated at why your head is pounding and why it’s always a dull pain or a shooting one or one that feels like it’s spreading across the center of your forehead, it’s time to pay closer attention to the location of your headache.
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Headaches aren’t one and the same. Certain types of headaches, along with migraines, have the potential to be defined and accurately diagnosed based on whether they’re one-sided or throbbing at the back, front or sides of the head, says Dr. Ilan Danan, a neurologist at the Kerlan-Jobe Center for Sports Neurology and Pain Medicine at Kerlan-Jobe Orthopaedic Clinic in Los Angeles. The next time you’re suffering from head pain, take a second to reflect on its location in order to determine the source of your problem.
Classic migraine
A textbook migraine will present as an intense pain, often one-sided, pulsating or throbbing in nature with associated nausea and/or vomiting and sensitivity to light and sound, Danan says. A migraine often starts on one side of the head and then shifts to the other or affects the entire head. In order to accurately determine whether you have a migraine, it’s important to pay attention to the other accompanying symptoms you feel, which set it apart as the mother of all headaches.
Tension headache
A tension headache will typically present as a dull, squeezing ache in a “band-like” distribution, involving the front of the head and temple regions, Danan says. Stress, lack of sleep and poor posture are all described as culprits for tension headache pain.
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Cervicogenic headache and occipital neuralgia
These two types of headaches are sometimes confused with one another, so it’s worth including both to understand the differences. A cervicogenic headache is the result of cervical or neck tightness, which can then makes its way towards the back of the head and scalp, resulting in a similar sensation of tightness or pressure in that region, Danan says. This one is considered a secondary headache because cervicogenic headaches are caused by neck disorders or lesions.
Occipital neuralgia, which also presents in the upper neck or back of the head, is commonly described as a one-sided, piercing, electric shock-like sensation that spreads upward, sometimes making its way to the forehead or back of the eye, Danan says. Occipital neuralgia is often the result of an injury (like a car accident) or a pinched nerve root in the neck, and if left untreated, can come to resemble a migraine. “As a clinician, it is important to accurately diagnose what the underlying cause of the headache may be, as the approach to treatment may vary,” Danan says.
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Generalized head pain
Got a headache that seems to exist anywhere and everywhere in your head? You’re likely suffering from a dehydration headache, Danan says, or headaches that we may experience when we are ill or fatigued, which tend to be more generalized headaches. Danan notes that dehydration and illnesses can often trigger migraine headaches in their own right. The good news? These types of headaches usually respond well to pain medication like acetaminophen and can sometimes be prevented by keeping your fluid intake balanced.
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