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JAMA Patient Page
March 19, 2003


JAMA. 2003;289(11):1462. doi:10.1001/jama.289.11.1462

Headaches are one of the most common health complaints people experience. Although headaches can range from irritating to incapacitating, most are not associated with a serious illness. However, the occurrence of a new type of headache requires medical evaluation to determine the cause.

The March 19, 2003, issue of JAMA includes an article about symptoms and treatments for 3 of the most common types of headaches: tension, migraine, and cluster headaches.

Types of headaches

Tension headaches are the most common type of headache. They are often accompanied by tension in the muscles of the head, neck, and shoulders. The pain from tension headaches is a constant, dull pain and is often described as a band squeezing around the head, like a tight hat. The pain is not incapacitating and usually occurs on both sides of the head. Tension headaches come on gradually and can last from hours to days.

Tension headaches can be treated with pain relievers like aspirin and acetaminophen. Stress management and relaxation exercises may also help prevent tension headaches.

Migraine headaches are less common than tension headaches but still affect about 12% of the population. They are more common in women than in men and can be debilitating. Migraines are episodic disabling headaches that may recur over years. Migraine sufferers often become nauseous and are sensitive to light and loud sounds during an episode. Some people can tell when they are about to have a migraine headache because they experience certain symptoms, called an aura, before the headache occurs. These symptoms can include visual disturbances such as seeing spots or stripes and blurred vision. Migraine attacks can occur several times a month but usually do not occur daily. Some persons with migraine headaches may believe they are having sinus headaches or tension headaches.

Migraine headaches can be treated with nonprescription and prescription pain medication. Prescription medications to prevent migraine headaches are also available for persons who have frequent migraines.

Cluster headaches are less common than other kinds of headaches and occur more often in men than in women. Cluster headaches come on suddenly with severe pain centered around one eye, which becomes watery. Nasal congestion may occur on the same side of the face. These headaches usually last about 45 minutes and can occur several times a day. Cluster headaches typically occur over a period of weeks or months, known as a cluster period, and then disappear for weeks or months until the next cluster occurs.

Prescription medications are available for treating and preventing cluster headaches. Avoiding alcohol is also recommended because it can trigger cluster headaches.

For more information

• American Council for Headache Education

• National Headache Foundation
888/NHF-5552 (643-5552)

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com. They are available in English and Spanish. A Patient Page on migraine headaches was published in the November 22, 2000, issue.

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.

Sources: National Headache Foundation, National Institute of Neurological Disorders and Stroke, American Council for Headache Education