General Headache Information*

Between 40 and 50 million Americans suffer from chronic or repeated headache. It is possible that headaches are the most common reason for missing work or school in America. However, because there is no visible sign associated with headache, it may be a source of social stigma and seen as a fake illness, a sign of weakness, or a personality flaw.

Most of the more than ten million Americans who seek physician treatment for headache suffer from primary headaches. In these cases, the headache is the primary problem and not a symptom of another disease. (Secondary headaches are symptoms of other disorders, such as the flu.) Primary headache interferes with the quality of daily life and reduces productivity.

Some headaches can be a sign of serious problems. If a headache comes on suddenly and is very severe and different than past headaches, or if a headache seems to worsen over time instead of getting better, then you should see your doctor right away. Similarly, if you have a headache with fever and stiff neck, this could be a symptom of meningitis or other serious infection, and you should seek immediate medical attention. Headache that persists for a more than a week following a head injury should also be investigated. If your headache is accompanied by disturbed, vision or speech, numbness or weakness in one part of the body, blackouts, or difficulty thinking and remembering, please seek medical attention. None of these signs is a sure sign of life-threatening illness, but please pay attention to these signs and have them investigated.

Even though tests and examinations do not show anything wrong, the headache is not imaginary. According to medical evidence, many primary headaches are caused by an electrical and chemical instability of certain key brain centers that regulate blood vessels around the head and neck, as well as the flow of pain messages into the brain. This instability appears to be inherited and involve neurotransmitters. Serotonin, in particular, may play a key role. Drugs that stabilize brain chemistry can treat these headaches.

In the past, migraines or vascular headaches were thought to be due to painful swelling of the blood vessels of the head; while, "tension-type" or muscular headache were thought to involve tightness and muscle spasms in the head, neck, and jaw. More recent research has show that many headaches may involve a mixture of these two triggers as well as other profound body changes. Many headache specialists now believe most headache attacks originate in the brain.

Transformed or "progressed" migraine is a milder, but more frequent headache that occurs daily among people suffering from migraines. Rebound headaches result from overuse of pain medications.

*Based on a publication from the American Council for Headache Education (ACHE) entitled "Why Does My Head Hurt?"