Table of ContentsView AllTable of ContentsCommon CausesGeneticsLifestyle and EnvironmentFrequently Asked QuestionsNext in Headache GuideWhat to Do About a Continuous Headache
Table of ContentsView All
View All
Table of Contents
Common Causes
Genetics
Lifestyle and Environment
Frequently Asked Questions
Next in Headache Guide
The cause ofheadaches, or why headaches develop, is complex, often involving an intricate web of pain receptors, abnormal brain processes, genetics, and a neurological phenomenon called sensitization.Outside or environmental factors are also commonly involved, serving as headache triggers—the factors that unmindfully activate pain signals within the brain.
By understanding the biology behind your headaches (at least what experts know so far), you can hopefully tease out what parts of your head pain you can perhaps control (like various environmental triggers), and which ones you cannot (like your genetic makeup).
Bailey Mariner / Verywell
Headaches are unpleasant experiences, so treating them promptly is key. But in order to effectively treat your headaches, you must understand them.
The vast majority of headaches fall into three categories:
These three headache types are primary headache disorders, meaning they exist on their own and are not due to some other condition (called secondary headaches).
Migraine
Migraine may be the most complicated headache disorder and feels like a moderate to severe throbbing sensation on one or both sides of the head.Nausea, vomiting, sensitivity to light (photophobia), and/orsound(phonophobia) commonly co-occur with a migraine headache.
Research suggests that migraine headaches develop as a result of the activation of the trigeminovascular system—a complex pathway that linkstrigeminal nervefibers to blood vessels of the brain.
Once the trigeminal nerve fibers are activated, they release various peptides, likecalcitonin gene-related peptide (CGRP)and substance P. These peptides induce a phenomenon called neurogenic inflammation, which is connected to the prolongation and intensification of pain in migraine.
Other variables linked to migraine development include structural brain changes and serotonin release. Lastly, a phenomenon called cortical spreading depression—where waves of electrical activity spread across the brain—is believed to be the culprit behindmigraine aura.
Causes and Risk Factors of Headaches
Tension-Type Headache
Tension-type headache is the most common headache type and is often described as a squeezing or tight sensation around the head.Along with this pressure or “rubberband-around-the-head” sensation, tension-type headaches may be associated with muscle tenderness in the muscles of the head, neck, or shoulders.
Experts believe that tension-type headaches result from the activation of myofascial (the tissue that covers muscles) pain receptors.Once activated, pain signals are transmitted to the brain.
As with migraines, experts also believe that the sensitization of pain pathways in the brain occur with tension-type headaches. This sensitization is thought to play a pivotal role in the transformation from episodic tochronic tension-type headache.
Cluster Headache
Cluster headaches are uncommon and often begin without warning. These headache attacks are often short-lived, lasting between 15 and 180 minutes,and they are excruciating—causing a burning, piercing, or stabbing pain located in or around the eye or temple.
The pathogenesis, or the “why” behind cluster headache development, is not fully understood. Experts suspect that the cause is likely linked to thehypothalamus—a gland located within your brain that helps regulate sleep and circadian rhythm.
In addition to the hypothalamus, trigeminal nerve stimulation, histamine release, genetics, and activation of the autonomic nervous system may contribute to the development of cluster headaches.
What Causes Cluster Headaches?
Injury or Illness (Secondary Headaches)
Head injuries or trauma or an acute illness, ranging from a run-of-the-mill viral orsinus infectionto more serious infections, likemeningitis, may cause headaches.
In addition, serious underlying (non-infectious) health conditions may cause headaches.
Examples include:
Headache Behind Eyes
Headaches, especially migraine headaches, tend to run in families. In fact, according to theAmerican Migraine Foundation, if one or both of your parents suffer from migraine, there is a 50% to 75% chance that you will too.
Genetics Behind Migraines
That said, thegenetic basis for migrainesis complicated. For most migraine types, in order for a person to develop migraines, they must have inherited one or more genetic mutations.
But having a certain genetic mutation(s) is not necessarily a slam dunk case for developing migraines. Rather, that genetic mutation may make you more vulnerable to getting migraines, but other environmental factors, like stress, hormone changes, etc, need to be present for the migraine disorder to manifest.
The good news is that researchers are working tirelessly to identify genetic mutations that increase migraine risk. So far, 38 single nucleotide gene mutations have been discovered, although how these discovered mutations can translate into migraine therapies remains unclear.
Familial Hemiplegic Migraine
When linking migraines and genes, it’s important to mention a rare but severe type of migraine calledfamilial hemiplegic migraine. With this migraine type, a person experiences temporary weakness on one side of their body during the aura phase.
Mutations in four specific genes have been linked to familial hemiplegic migraine. These four genes include:
Other Primary Headache Disorders
In addition to migraines, keep in mind genetics likely plays a role (albeit more minor) in the pathogenesis of cluster headaches and tension-type headaches. Overall, the research into these specific genetic patterns is less robust than with migraines.
Numerous lifestyle-related and environmental factors have been found to trigger primary headache disorders, especially migraines. It’s believed that these triggers are the factors that signal the brain, nerve, muscle, and/or blood vessels to go through changes that ultimately create head pain.
Common Migraine Triggers
Some common triggers for migraines include:
Common Cluster Headache Triggers
The two most commontriggers are:
Common Tension-Type Headache Triggers
Some common triggers for tension-type headaches (of which there is a large overlap with migraines) include:
Trigger Factors for Other Types of Headaches
Various lifestyle and environmental factors have been linked to other types of headaches. For example, missing your morning coffee can precipitate acaffeine withdrawal headache, which is located on both sides of the head, worsens with physical activity, and can be quite painful.
Another common type of headache ismedication overuse headache, also called “rebound headache.” This headache occurs after frequent and excessive use of a headache or migraine medication—for example, atriptanor anonsteroidal anti-inflammatory (NSAID).
Lastly, while alcohol can trigger a person’s underlying primary headache disorder, it can also cause its own headache,either as acocktail headacheor as ahangover headache. A hangover headache is throbbing, like a migraine, but is usually located on both sides of the forehead and/or temples, like a tension-type headache.
In the end, remain dedicated and empowered in your journey to learning more about headaches—but also, be good to yourself and seek out guidance from your primary care physician or headache specialist.
Stress can cause tension-type headaches. These are often described as a squeezing or tight sensation. The pain from a stress-related headache usually wraps all the way around your head, like a headband.
How Headaches Are Diagnosed
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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