Your head is pounding. Is it a normal headache or a migraine? Or something worse? And does it really matter what kind of headache it is?
“An occasional throbbing that goes away after taking some aspirin may not be a problem. But if your headaches are regular or they make it hard to live a normal life, it does matter what they are,” says Jin Li, MD, medical director of headache service at WMCHealth.
According to the World Health Organization, about 40% of the global population has a headache disorder, defined as repeated or frequent headaches. That’s a lot, and they can affect your quality of life. Most people do not go to the doctor for a diagnosis and instead self-treat with over-the-counter medications or through lifestyle changes. But seeking medical guidance can be helpful in finding relief. Understanding the source of your head pain may help you identify what brings them on, or if there’s another medical problem.
What Causes a Headache?
Think of “headache” as an umbrella term. If you’re feeling a constant pain in your head, that’s a headache. Under the headache umbrella, though, are headache types with different causes.
- Migraine: A migraine typically lasts 4-72 hours and can be paired with other symptoms, like nausea, vomiting, and sensitivity to light, odors, and sounds. They have a number of possible triggers.
- Tension headache: If you feel tightness or pressure around your head, sometimes into your neck, this can be a tension-type headache. They can be caused by stress and usually last no more than a few hours.
- Cluster headache: These headaches are not common. Someone with cluster headaches can get several short but severe headaches a day, often in the eye area.
- Medication-overuse headaches: Ironically, if you use medication too often to treat your headache, you can get a medication-overuse headache, also called a rebound headache.
- Secondary headaches: A secondary headache is head pain caused by another health issue. It can be a signal that something else is wrong, like an infection, brain tumor, neck injury, meningitis or aneurysm. “Secondary headaches are not common—most headaches are not serious,” says Dr. Li. “But if you experience other symptoms besides a headache, or your headache is extremely painful and persistent, it’s important to talk to your doctor to determine if a more serious issue is the cause.”
How Do I Know if It’s a Migraine?
Migraines affect at least 38 million people in the U.S., according to the American Migraine Foundation.
If you think you may have a migraine, answer these questions:
- Do you feel nauseous, and/or have you vomited?
- Are you sensitive to light, sound, or odors?
- Is the pain on one side, and does it feel like throbbing or pulsating?
- Do you see visions of bright or flashing light?
- Has it lasted 4-72 hours?
If you answered yes to any of these questions, it may be a migraine.
Different triggers can lead to a migraine, and each person can have their own experience triggers:
- Looking at strobe or other flashing lights
- Hormonal changes, including menstruation (one reason why migraines are three times more common in women than men)
- Stress and exhaustion
- Low blood sugar
- Sudden weather changes
- Certain foods and alcohol
- Some medications and medical conditions
How Can I Make a Migraine Go Away?
There is not a cure for migraines, but there are lifestyle changes you can make to try to avoid them as much as possible. Try keeping a headache diary to find patterns for what might be triggering your headaches. To minimize migraines, experts suggest that you:

- Avoid triggers
- Drink plenty of water
- Eat regular meals
- Regular exercise
Typically, migraine symptoms are treated with medication. Over-the-counter treatments can be effective, whether it’s ibuprofen, aspirin, or acetaminophen. A doctor can prescribe medications to relieve your pain.
BOTOX injections may help. BOTOX is best known as a way to temporarily reduce facial wrinkles. It is Food and Drug Administration (FDA)-approved for migraine prevention for people with chronic migraines, meaning they get migraines at least 15 days a month, more than 3 months, with the headache lasting at least four hours. BOTOX treatment temporarily paralyzes the muscles and blocks the nerves in the injected area, which can prevent migraine symptoms.
For those with severe symptoms—about 10% of migraine sufferers— there are surgical options. Typically those who qualify for surgery have headaches due to a compressed nerve leading to the symptoms. The doctors first need to understand your headache triggers and you would try other treatments first.
When Should I Go to the Doctor?
If you are concerned about a severe or persistent headache, never hesitate to call 911. Be sure to seek medical help if your headache:
- Is causing explosive pain
- Lasts more than a few days
- Is worse in the mornings, or after activity
- Is accompanied by other symptoms, like vomiting, fever, confusion, or slurred speech
“There are many reasons and causes for headaches, and most are not life-threatening,” says Dr. Li. “But if your headaches are causing problems with daily life or you have new and distressing symptoms, talk to your doctor. Your doctor may refer you to a neurologist or headache specialist.”
A headache specialist can help get to the root of the problem and determine the best solutions to help you find relief. Go to your visit prepared with information to share with your doctor:
- How often you have headaches
- Where they occur
- A description of their severity (think about a 1-10 scale of pain, or relate it to another type of pain you’ve had)
- Share anything from your headache diary
The doctor will perform a physical examination and ask you questions. They may also perform some tests, including a blood test, spinal tap, or MRI/CT scan, to look for secondary reasons for your headache. The doctor may also recommend a block or injection to help with diagnosis or treatment, or they may recommend a different type of minimally invasive option.
At WMCHealth, our headache specialists have experience, expertise, and access to advanced treatment technologies. Our team includes internists, neurologists, pain management specialists, and reconstructive surgeons. Our program is the New York metropolitan area’s first integrated academic multidisciplinary center focusing on headache treatments. We can help.
Visit Our Neurosciences Team