Nearly everyone has an occasional headache. The most common type of headache — a tension headache — is usually caused by tight muscles in your shoulders, neck, scalp and jaw. They are often related to stress, depression or anxiety. You are more likely to get tension headaches if you don’t get enough sleep, are overworked, miss meals or use drugs or alcohol.

Tension headaches tend to be on both sides of your head. They often start at the back of your head and spread forward. The pain may feel dull or squeezing, like a tight band or vice. Your shoulders, neck, or jaw may feel tight and sore. The pain is usually persistent, but it does not get worse with activity. Most people can feel much better by making lifestyle changes, learning ways to relax and taking pain relievers.

Headaches can also be triggered by certain foods or food additives including cheese, chocolate and monosodium glutamate.

People who drink caffeine can have headaches when they don’t get their usual daily amount.

Other types of headaches include migraines, cluster headaches and sinus headaches. Migraine headaches are severe headaches that usually occur with other symptoms such as vision disturbances or nausea. The pain may be described as throbbing, pounding, or pulsating and tends to be located on one side of the head.

You may have an “aura” (a group of warning symptoms that start before your headache.) The pain usually gets worse as you try to move around, or can be made worse by certain odors, noise or light.

Cluster headaches are sharp, very painful headaches that tend to occur several times per day for months and then go away for a similar period of time. They are far less common than other types of headaches.

Sinus headaches cause pain in the front of your head and face. They are due to inflammation in the sinus passages behind the cheeks, nose, and eyes. The pain tends to be worse when you bend forward and when you first wake up in the morning. Postnasal drip, sore throat, and nasal discharge usually occur with sinus headaches.

Headaches may also occur if you have a cold, the flu, fever, or premenstrual syndrome.

When to Contact a Medical Professional

Headaches can have many causes, but serious causes of headaches are rare. Rare causes of headache include: Brain aneurysm - a weakening of the wall of a blood vessel that can break open and bleed into the brain, brain infection like meningitis or encephalitis, brain tumor and stroke or TIA.

Take the following symptoms seriously. If you cannot see your health care provider right away, go to the emergency room or call 911. If this is the first headache you have ever had in your life and it interferes with your daily activities. If your headache comes on suddenly and is explosive or violent. If you would describe your headache as “your worst ever,” even if you regularly get headaches, or if have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss with your headache.

You should also be concerned if your headache gets worse in a 24-hour period, if you have a fever, stiff neck, nausea, and vomiting with your headache, and if your headache occurs with a head injury.

Other concerns might be if your headache is severe and just in one eye, with redness in that eye, if you are over age 50 and your headaches just began, especially if you also have vision problems and pain while chewing, if you have cancer and develop a new headache.

Also, see your health care provider soon if your headaches wake you up from sleep, a headache lasts more than a few days, if your headaches are worse in the morning, and if you have a history of headaches but they have changed in pattern or intensity

You should also be concerned if you have headaches often, and there is no known cause

(Editor’s Note: Moeen Din, M.D., is a neurologist practicing with Northwest Allied Physicians. His office may be reached at 229-2578 or

Common causes of tension headaches include:

• Clenching or grinding your teeth

• Exerting yourself too much

• Holding your head in one position for a long time, like at a computer or microscope

• Poor sleep position

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