Headaches may cause pain anywhere in the head, including the scalp, behind the eyes, in the face or in the neck. They can have a big impact on your work, home life and overall well-being.
There are many possible causes of headaches. Some are fairly mild concerns, like missing your daily caffeine or spending too much time in front of a screen. Other headaches come from long-term conditions, like chronic migraines or tension headaches. And some headache causes are very serious, such as stroke or brain tumors, though these are much rarer.
Most people have occasional headaches in their lifetimes. But when headaches cause major concern, interfere with your life or aren’t well controlled by usual treatments, a headache specialist can help. They can give you an accurate diagnosis and offer care options that will help you get back to your normal routine.
Types of Headaches Treated at Rush
Rush headache specialists are experts at treating all types of headache disorders, from common issues to rare conditions. Headache disorders can be hard to accurately diagnose because they often share similar symptoms and types of pain. But our headache specialists can identify the often subtle differences in these conditions and make sure you have the most appropriate treatment.
Some of the types of headaches they treat include the following:
Migraine: These intense, throbbing headaches usually affect one side of the head. They can cause sensitivity to light, sound, movement or other sensory stimuli and often come with feelings of nausea, changes in mood or fatigue.
Some people have migraine with aura. An aura may be an early warning sign of a migraine and usually appears as changes in vision, such as flashes of light, or tingling in the face, arms or legs among other symptoms.
Migraine is often hereditary, so it is common for patients to have blood relatives who also get these headaches. This is often a chronic, or lifelong, condition, but proper treatment can provide relief.
Tension-type headaches: These headaches are very common and usually feel like a tight band of dull pain around the temples and forehead. They are often triggered by emotional stress or tension in the muscles. They can last from a few minutes to several days at a time.
Tension-type headaches can be episodic, which means they happen from time to time, or they can be chronic, which means they happen for at least 15 days a month for several months.
Cluster headaches and other trigeminal autonomic cephalalgias: Also called TACs, trigeminal autonomic cephalalgias are severe headaches that appear on one side of the head and come with other symptoms, like tears or redness in the eye, runny nose or swelling of the face.
Cluster headaches are the most common TACs. They usually appear as bursts of intense pain behind the eye that last from a few minutes to several hours. They can happen several times a day, but they often occur near the same time of day based on the person’s circadian rhythm, or biological clock.
SUNCT and SUNA are other types of TACs that involve shorter, throbbing bursts of pain that can happen up to hundreds of times a day.
Other TACs include paroxysmal hemicrania, which can cause pain attacks that last for a few minutes dozens of times per day, and hemicrania continua, which involves constant headaches with sharp spikes of pain lasting up to three days at a time.
Neuralgias: Headaches from neuralgias are caused by nerve damage or nerve disorders. The pain can be severe and feel like a sharp, stabbing, burning or throbbing sensation. It can also come with numbness or weakness in the muscles.
There are several types of neuralgia. Trigeminal neuralgia comes from the trigeminal nerve that carries sensation from the face to the brain. Postherpetic neuralgia comes from nerve pain as a complication of shingles. Occipital neuralgia comes from the occipital nerves that run from the spinal cord through the scalp. And glossopharyngeal neuralgia causes pain in the throat, ears and tongue.
Headaches due to change in CSF pressure
Intracranial hypertension happens when too much CSF builds up in the skull, putting pressure on the brain and nerves. It causes pain that is often worse in the morning and when lying down. It can also cause pain when coughing or sneezing.
Intracranial hypotension happens when there isn’t enough CSF in the skull, usually because of a CSF leak. It tends to cause pain that gets worse when sitting up or standing but gets better when lying down.
These headaches can sometimes indicate an emergency that needs medical attention right away.
- Post-traumatic headaches: These headaches appear within days of an injury to the head, neck or brain. They often appear along with other symptoms of a concussion, like dizziness, confusion, fatigue or mood swings.
- Post-stroke headaches: It is very common for stroke survivors to have headaches caused by damage to the brain’s blood vessels or irritation to the brain’s lining. Some medications can also cause these headaches. They often improve over time but may need medical attention to stay under control during recovery.
Meet our headache providers
When to See a Rush Specialist for Headaches
Many people who have headaches rely on at-home treatments for relief, such as taking over-the-counter medications, using ice packs, drinking water or getting more sleep.
But at-home treatments can become less effective over time. And relying too much on OTC medications, like acetaminophen or NSAIDs, can lead to a condition called medication overuse headache, or medication overexposure headache. This causes a dull, daily headache that can make the headaches you already have even worse.
Your primary care physician or general neurologist may be able to prescribe some treatments, like common medications for migraines. But these may not provide enough relief from your symptoms.
A Rush headache specialist can provide an accurate diagnosis of your headache disorder and prescribe treatments that are better tailored to your needs.
You should see a specialist if the following apply to your headaches:
- They interfere with your day-to-day life or ability to function
- Medication and usual treatments aren’t providing enough relief
- Frequent or daily use of medications to treat headaches
- They cause the worst pain you’ve ever felt
- The type of pain you are experiencing changes
- They happen daily or more than 15 days a month
- They last for several days or are getting worse
- They appear following a head injury
- They appear after the age of 50
In some cases, headaches can be signs of serious issues, such as stroke, brain tumors or CSF pressure imbalances, that need to be treated immediately. These cannot wait for an appointment.
Go to the emergency room if you experience the following:
- The worst headache you’ve ever had in your life
- A sudden “thunderclap” headache that appears severely and without warning
- A severe migraine lasting more than three days
- A headache with accompanying symptoms of fever, stiff neck, vomiting, loss of consciousness or any neurologic symptoms, such as dizziness, weakness, confusion, numbness, slurred speech or vision changes
Second Opinions on Headaches at Rush
Getting a second opinion on your headache disorder can help you explore new care options, give you peace of mind and help you feel confident in making decisions about your treatment.
Many patients who seek second opinions have tried several treatments in the past that have not provided enough relief from headaches. These are called refractory headaches
Rush headache specialists are highly experienced with these and other rare and complex headache conditions. They have access to advanced diagnostic tools and treatments, as well as clinical trials that can provide you with care options that are not yet available elsewhere.
They also work closely with experts across many fields, including neurosurgery, neuro-oncology, pain management, infectious diseases and stroke care. This team of specialists will create a custom treatment plan for you.
Rush Excellence in Headache Treatment
- Nationally ranked headache care: U.S. News & World Report includes Rush University Medical Center on its Best Hospitals Honor Roll and ranks its neurology and neurosurgery program among the best in the country. Castle Connolly also names many Rush headache experts "Top Doctors," a recognition voted on by fellow physicians for exceptional patient care.
- Advanced headache treatments: Our headache specialists can offer cutting-edge treatments, such as onabotulinumtoxinA injections, or Botox; intranasal devices; and infusion therapy for headache and migraine relief. They also have access to clinical trials that can provide care options that aren’t yet available anywhere else.
- Dedicated headache clinic: The Rush Headache Clinic in Chicago is dedicated entirely to diagnosing and treating headache disorders. Specialists at this clinic combine headache expertise with stroke care, sleep medicine, neuro-ophthalmology and many other fields to ensure you get the holistic treatment you need to address your headaches and restore your quality of life.
- Care plans tailored to you: Many who have headache disorders have other conditions, such as high blood pressure or heart failure, that can make their needs more complex. They may already be taking several medications. Others have rare conditions that are difficult to diagnose or don’t respond well to the usual treatments. Our specialists know that each patient is unique and will work with you to understand your needs on a personal level. They’ll create a customized care plan that takes your whole health profile into account, providing you with options that are as safe and holistic as possible.
FAQs About Headaches
Chronic headaches have a variety of causes. Some are related to known triggers and daily habits. For example, stress and anxiety, dehydration, poor nutrition, and overuse of alcohol or caffeine can cause frequent headaches. Poor sleep, sometimes related to disorders like sleep apnea or insomnia, can also cause chronic headaches. Overuse of medications, including over-the-counter headache drugs, can cause headaches too.
Other issues, like heart and vascular conditions or hormone changes, can cause headaches. And traumatic brain injuries, like concussions, can lead to headaches for months or years without treatment.
But primary headache disorders can have many causes that are sometimes not fully understood. Migraine, for example, is often genetic, meaning it can be passed down from a parent or grandparent. But it can also be related to blood flow in the brain, nerve signals, pain processing centers of the brain and changes in brain chemistry. Chronic tension headaches can be caused by muscle contractions and heightened sensitivity within the brain. Primary headache disorders can also have a variety of triggers, such as light, certain sounds, certain foods, eye strain, stress, poor sleep or weather changes.
Your specialist can discuss the causes of your headaches with you and address them when possible. They can also help advise you on reducing your exposure to triggers.
Headache disorders are diagnosed using a set of criteria called the International Classification of Headache Disorders, or ICHD-3. It classifies headache disorders in three main groups based on symptoms: primary headache disorders, secondary headache disorders, and cranial neuralgias and other facial pain. These groups are also divided into more specific types of headache disorders.
These categories are based on many factors, like how often headaches appear, where the pain is located, the type of pain, accompanying symptoms, and known triggers or causes.
Headache specialists are experts at understanding the subtle differences that make up these headache disorder types. They interview and examine patients thoroughly to make sure they have accurate diagnoses.
In some cases, imaging can also be used to confirm a diagnosis or explore the causes of headache disorders. For example, MRI can reveal a brain tumor or stroke that may lead to chronic headaches.
Treatments for migraines can be abortive, meaning taken as needed to stop a headache that has already started, or preventive, meaning taken in advance to prevent headaches from appearing.
Abortive treatments usually involve oral medications, nasal sprays or injections. Triptans are among the most common abortive migraine medications that block pain pathways. Gepants are newer medications that target certain pain receptors without contracting blood vessels. Several other medications can be used to stop a migraine headache.
Preventive treatments can also involve medications, like antidepressants, antiseizure medications and blood pressure medications. Other medications, such as injectable monoclonal antibodies that target the neuropeptide CGRP, or gepants can be used in migraine prevention as well. But there are other preventive treatments available. Botox injections, for example, can be given every three months to prevent chronic migraine. Noninvasive devices can also be used to send electric or magnetic pulses that block pain signals — a process called neuromodulation.
Controlling other conditions that cause headaches, like sleep disorders or occipital neuralgia, make also be a part of preventive treatment. Stress reduction techniques and relaxation therapy may reduce migraines, as well.
There are many treatment options for migraines, and new ones are always being developed. A headache specialist can guide you through them and try alternative care plans if previous treatments have not provided enough relief.
Yes, headaches can be a sign of a serious issue that requires emergency treatment. A brain hemorrhage, stroke, or concerning disease like meningitis can cause headaches and be life-threatening. Rarely, headaches can be caused by brain tumors. If you have certain kinds of headaches, like the worst headache of your life, a severe migraine lasting more than three days, or a headache accompanied by fever, neck stiffness, seizures, confusion, loss of consciousness, dizziness, weakness, numbness, slurred speech or vision changes, you should go to an emergency room for treatment as soon as possible.
