Headache or headache is a very common problem that can be disabling if its intensity or frequency is high.
While the most common types of headache are not due to diseases and therefore are not dangerous, others are symptomatic of underlying conditions that require medical treatment.
There are more than 150 types of headaches with their own causes and symptoms. If we want to discover how we can resolve our headaches, a fundamental first step is to identify the headache we suffer.
What are the causes of pain?
Usually the sensation of pain is caused by lesions in tissues that trigger cells known as nociceptors. These receptors capture mechanical, thermal and chemical signals that indicate possible damage to the body.
However, neither the damage in the cells nor the reaction of the nociceptors are direct causes of the sensation of pain, but it is greatly influenced by non-biological variables such as experience or emotion.
When it reaches the nervous system, nociceptive stimulation joins our thoughts, memories and feelings before the pain occurs. Thus, the final sensation depends on both external factors and our own mind .
Headache in particular is usually influenced by factors such as muscle tension, vascular problems or the body's idiosyncratic response to stress , certain substances or medical disorders . However, the causes and characteristics of headaches depend largely on the specific type to which we refer.
Primary headaches
According to the International Classification of Headaches there are more than 150 types of headache that can be divided into three main categories: primary, secondary and other headaches .
Unlike the secondary ones, primary headaches occur in the absence of physical disorder, so they are not dangerous.
1. Tension headache
Tension type headache is the most common of all . These headaches are caused by muscle tension; This may be due to stress or physical causes, such as intense and continuous contraction of the neck or jaw muscles.
This type of headache usually manifests as a constant tension or pressure on both sides of the head. In the most intense cases, even touching the affected muscles can cause pain.
Tension headaches usually cause milder pain and are therefore less disabling than migraines and other types of headaches, but there is a high risk that episodic tension headache will become chronic, with all or almost all attacks occurring. days.
2. Migraine
Migraines are headaches caused by the activation of neurons in the cerebral cortex . Some experts also attribute them to the narrowing of brain blood vessels, which would cause blood and oxygen to not reach the brain correctly. However, the migraine vascular hypothesis has lost support in the recent past.
This type of headache produces more intense pain than most tension headaches. Migraines usually consist of sensations similar to punctures or pulsations on one side of the head.
The stimuli that trigger migraine vary greatly depending on the person: it can be due to stress, effort, lack of sleep, intense lighting, consumption of certain foods ...
We distinguish between migraines with aura and migraines without aura . Migraines without aura are the most frequent and appear suddenly, while migraines with aura are preceded by visual, sensory, linguistic and motor symptoms.
3. Trigeminal-autonomic headache
The trigeminal nerve receives the sensations captured by many muscles of the head, such as those of the face, eyes, mouth or jaw. Headaches that mainly involve the reflex action of the trigeminal are known as "trigeminal-autonomic" . In addition, they make up one of the most painful and difficult-to-manage types of headache, since they have nothing to do with circulation or with certain alterations in the nerve.
The symptoms of this type of headache are very similar to those of migraine, so they usually affect only one half of the head and consist of throbbing pain. However, the intensity of pain is greater than that of migraines.
Trigeminal-autonomic headache includes syndromes such as cluster headache, a very painful type of headache that affects the region of the eyes and temples and is associated with symptoms such as nasal congestion, tearing and facial sweating.
4. Tuscan headache
Although it is uncommon in the general population, tusiogenic headache occurs in an important proportion among people who go to the doctor as a result of intense cough .
Some common symptoms of tusiogenic headache are nausea, dizziness and sleep disorders. These headaches are triggered after coughing attacks and can be very short or last more than an hour.
5. By physical effort
Those in which the symptoms are not due to any intracranial cause, but simply to the practice of very intense exercise are classified as "headache due to physical exertion ." Abnormal blood flow can cause parts of the nervous system to suffer
It occurs more frequently in places where it is very hot or at a high altitude, and the pain that it entails is usually pulsatile.
On the other hand, performing a task that requires a constant effort of the same type can cause this symptom to appear, which is a way of warning that we should stop as soon as possible.
6. By sexual intercourse
The primary headache associated with sexual activity is attributed to loss of cerebrospinal fluid that causes a decrease in intracranial tension . The pain occurs on both sides of the head and intensifies as the person becomes excited, peaking when he reaches orgasm.
It is a problem that has to do with attention management, difficulties in relaxing, and the realization of continuous physical efforts.
7. By cryostimulation
"Cryostimulus headache" is the official name of the classic headache caused by contact with something very cold , either because it touches the outside of the head, because it is inhaled or because it is swallowed, as with ice cream. Cryostimulus headache pain tends to be stabbing, unilateral and short-lived.
8. Equestrian headache
The "alarm" headaches appear only during sleep, causing the person to wake up . It normally affects people over 50 and tends to be persistent. They share some characteristics with migraine, such as the feeling of nausea.
Secondary headaches
Secondary headaches are a consequence of conditions, such as vascular disorders or brain lesions , which have pain as a symptom and may require specific treatment depending on the underlying cause.
1. For trauma
Blows in the skull or cervical, such as those caused by traffic accidents, can cause temporary or chronic headaches (if they last more than three months from the trauma).
Not only the blows can cause trauma headaches, but these can also be due to other causes, such as explosions and the presence of foreign bodies in the head.
In general, these headaches appear together with other symptoms caused by the same trauma, such as problems with concentration or memory, dizziness and fatigue.
2. For vascular disorder
This type of headache is a consequence of cerebrovascular problems such as ischemic stroke, cerebral hemorrhage , aneurysm or congenital arteriovenous malformation. In these cases the headache is usually less relevant than other consequences of the vascular accident.
3. By substance use or withdrawal
Abusive use or inhalation of substances such as alcohol, cocaine, carbon monoxide or nitric oxide can also cause and aggravate headaches. Also the suppression of substances that are consumed in a habitual way, as it can happen with alcohol and drugs, is another frequent cause of headache.
4. By infection
Some common causes of this type of headache are meningitis and bacterial or viral encephalitis , parasitosis and systemic infections. Although in most cases the headache disappears once the infection has healed, in some cases it can persist.
5. For mental disorder
Occasionally headaches are categorized as secondary to psychiatric disorders if there is a temporary and causal relationship between both phenomena. However, in these cases the pain seems to have a psychogenic rather than biological origin.
In this sense, the International Classification of Headaches gives special importance to psychotic and somatization disorders, consisting of the presence of physical symptoms in the absence of identifiable medical pathology.
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