Headaches: Types and Treatment Options

Tension Headaches

Tension headaches can feel like dull, aching pain in the head accompanied by a sensation of tightness or pressure across the forehead or back of the head. Those who suffer from tension headaches may also feel tenderness on the scalp, neck, and shoulders. Tension headaches can either be episodic, where they occur during less than 15 days out of the month, or chronic, in which case they occur more frequently and for a longer duration. This is the most common form of headache.


Migraine headaches are very severe headaches that tend to occur on one side of the head and are often accompanied by symptoms like nausea, extreme sensitivity to light or sound, or visual issues like tunnel vision or blurry “spots.” Migraines can also be accompanied by nausea and vomiting. Although the precise cause of migraines is not known, studies have found people with a family history of migraines are more likely to have the headaches themselves, and they can also be triggered by factors like alcohol, stress or hormonal fluctuations.

Cluster Headaches

Cluster headaches are very severe headaches that tend to occur in groups or “clusters” over a period of days, weeks or even months, separated by periods of time when no headaches occur. Some people who have cluster headaches experience them around the same time each day during an “outbreak” or flare-up. The cause of cluster headaches hasn’t been identified, but some researchers believe they may be related to hormonal fluctuations or to issues concerning the body’s internal “clock” that are controlled by the hypothalamus gland located in the brain.


Having an accurate diagnosis for headaches is essential for ensuring the most appropriate care is provided in order to achieve relief of pain and related symptoms. Diagnosis begins with a detailed patient medical history and a review of the symptoms to help differentiate among different types of headaches, including migraine headaches, cluster headaches, tension headaches and other types of headaches. A physical exam will also be performed, and some patients may be asked to keep a diary or log of their symptoms. Additional testing including blood tests, CT scans, x-rays, and MRIs may be ordered to rule out other conditions that can cause head pain and to aid in diagnosis and treatment.

What treatments are available for headaches?

Typically, pain management has a goal of completely stopping the pain a person is experiencing. With headaches, the approach is more complicated. The focus of pain management for headaches is to significantly reduce the severity, duration, and frequency of the headaches. Treatment options for headache pain include:

The exact course of treatment will depend on your specific medical needs. Pain management may include several of these methods in order to provide each patient with the level of support they need.

Often, people with serve chronic headaches have trouble managing their pain with over the counter medication. Because of this, frequent headaches are a major cause of individuals seeking help from a doctor. Headache injections are one tool a headache expert has to address the pain of frequent and reoccurring headaches.

Headache Injections

There are a number of different headache injections available that provide different benefits based on a person’s unique needs: 

Sumatriptan Injection

Sumatriptan injections are used to treat migraine and cluster headaches. Sumatriptan injections work by narrowing blood vessels in the brain. Additionally, this medication can help to block the symptoms of migraine headaches, including vision changes.

The medication is self-injected just below the skin as soon as a person feels a headache coming on. If relief is not felt, a second dose may be given after an hour.  Although this treatment is effective, it does not work the same way for everyone. If you do not experience relief with Sumatriptan, consult with your headache doctor.

Botox Injection

Botox injections are often used on individuals who have 15 or more migraine headaches per month. A series of injections are given in the forehead, back of the head, and sides of the head. When administered for headaches, Botox is prescribed in 12 week increments. It is recommended that people try two treatments, a total of 24 weeks, before determining if Botox is decreasing the number of headaches a person has. It is not completely understood why Botox injections can prevent headaches. One belief is that Botox interferes with neurotransmitters that play a role in beginning a headache.

There are a number of side effects of Botox including dry mouth, headache, neck pain, blurred vision, and dry eyes. As with any medication, experienced side effects must be compared with the relief the medication provides.

D.H.E. 45

Dihydroergotamine, commonly referred to as D.H.E. 45, works by narrowing the blood vessels in the brain and regulating blood flow to the surrounding area. The medication is used during a headache attack to decrease the pain. It cannot be used to prevent headaches from occurring. It has been found to be effective for some migraine and cluster headaches.

To begin the process to manage your headache pain, contact NY Neurology Associates today.  

NY Neurologists

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