What are Headaches?

Jason T
4 hours ago
5 min read

A Nurse's Guide to Understanding Headaches: Types, Signs, Triggers & Treatments

Headaches are among the most common and diverse complaints encountered in both acute and primary care. As nursing students, it is critical to distinguish between headache types, recognize red flags, understand potential triggers, and be familiar with both pharmaceutical and holistic treatment options. Below is a clinical breakdown of the most common headache types and how to treat them effectively—in hospital and at home.

1. Migraine Headache

Definition: Migraines are a type of primary headache characterized by recurring episodes of moderate to severe throbbing or pulsating pain, typically affecting one side of the head. They may be preceded by an aura and are often accompanied by nausea, vomiting, or sensitivity to light and sound.

Signs & Symptoms:

Unilateral or bilateral pulsating pain
Nausea and vomiting
Visual disturbances (aura)
Photophobia and phonophobia
Symptoms may last 4–72 hours

Diagnostic Methods:

Clinical history and symptom pattern
Headache diaries
Rule out secondary causes via imaging if red flags present

Triggers:

Hormonal changes (especially in women)
Foods like aged cheese, chocolate, red wine
Stress, lack of sleep, dehydration, strong odors
Weather changes and bright lights

Chronic Side Effects:

Risk of developing chronic migraine (≥15 days/month)
Medication overuse headaches
Increased risk of anxiety and depression

Causes:

Genetic predisposition
Dysregulated brainstem activity affecting pain pathways
Imbalance in neurotransmitters like serotonin
Musculoskeletal damage.

Treatment Methods: Hospital/Pharmaceutical:

NSAIDs, triptans (e.g., sumatriptan), antiemetics (e.g., metoclopramide)
Preventive medications: beta-blockers (propranolol), anticonvulsants (topiramate), CGRP inhibitors

Holistic/Home Remedies:
Cold compress to forehead
Essential oils (lavender, peppermint)
Regular sleep, hydration, magnesium supplements
Yoga, meditation, and dietary trigger avoidance

2. Tension-Type Headache (TTH)

Definition: Tension headaches are the most common type of primary headache, described as a dull, aching, bilateral pressure or tightness—like a tight band around the head. They are typically less severe and not associated with nausea or aura.

Signs & Symptoms:

Bilateral mild to moderate pain
Dull pressure or tightness
Neck or shoulder tension
No vomiting or significant nausea

Diagnostic Methods:

Clinical history
Physical exam to assess muscle tension
Rule out other headache types

Triggers:

Emotional stress
Fatigue, eye strain
Poor posture, lack of sleep
Dehydration

Chronic Side Effects:

Reduced quality of life
Overuse of pain medication may lead to rebound headaches

Causes:

Muscle tension and contraction
Stress and mental health strain
Central nervous system sensitivity

Treatment Methods: Hospital/Pharmaceutical:

OTC analgesics (acetaminophen, ibuprofen)
Muscle relaxants for persistent cases
Stress management referrals
Holistic/Home Remedies:
Warm compress or heating pad on neck/shoulders
Regular exercise and stretching
Mindfulness meditation and journaling
Adequate hydration and eye breaks from screens

3. Cluster Headache

Definition: Cluster headaches are excruciating, unilateral headaches that occur in cyclical patterns or “clusters,” often around the eye. They are less common but intensely painful and can be disabling.

Signs & Symptoms:

Sudden, severe one-sided pain
Tearing, nasal congestion, eyelid drooping (ptosis)
Restlessness or agitation
Short duration (15 minutes to 3 hours), often at night

Diagnostic Methods:

Clinical assessment
Neuroimaging to rule out secondary causes
Cluster patterns documented over time

Triggers:

Alcohol use during a cluster period
Histamine exposure
Sleep disturbances
Strong smells or intense stress

Chronic Side Effects:

Sleep disruption
Depression and anxiety due to pain severity
Persistent cluster periods in chronic cases

Causes:

Abnormal hypothalamus activity
Circadian rhythm dysfunction
Possible vascular inflammation

Treatment Methods: Hospital/Pharmaceutical:

High-flow oxygen via face mask
Subcutaneous or nasal triptans
Preventive options: verapamil, lithium, corticosteroids

Holistic/Home Remedies:
Magnesium supplementation
Melatonin for sleep support
Keeping a strict sleep-wake schedule
Avoiding alcohol during active periods

4. Rebound Headache (Medication Overuse Headache)

Definition: Rebound headaches result from the frequent use of pain medications, creating a cycle of dependency and daily headaches when medication wears off.

Signs & Symptoms:

Daily or near-daily headaches
Occurs upon waking or when medication wears off
Associated with fatigue, irritability, and poor concentration

Diagnostic Methods:

Patient medication history
Headache diary
Improvement after medication withdrawal

Triggers:

Regular use of analgesics (>15 days/month)
Frequent use of triptans or opioids

Chronic Side Effects:

Medication dependency
Withdrawal symptoms
Escalation in headache frequency and intensity

Causes:

Overactivation of pain receptors due to chronic medication use
Neurochemical changes in pain pathways

Treatment Methods: Hospital/Pharmaceutical:

Gradual discontinuation of overused meds
Bridge therapy with NSAIDs or steroids
Preventive medication initiation

Holistic/Home Remedies:
Hydration and detox support
Sleep hygiene and caffeine reduction
Acupuncture and behavioral therapy for pain tolerance
Education on medication use limits

5. Thunderclap Headache (Possible Subarachnoid Hemorrhage)

Definition:A thunderclap headache is a sudden-onset, severe headache often described as the worst headache of someone’s life. It may indicate serious conditions like a subarachnoid hemorrhage, warranting emergency evaluation.

Signs & Symptoms:

Instant, peak-intensity pain within 60 seconds
Neck stiffness, nausea, photophobia
May involve LOC, seizures, or weakness

Diagnostic Methods:

Immediate CT scan
Lumbar puncture for xanthochromia
CTA/MRA for aneurysm detection

Triggers:

Valsalva maneuvers (coughing, straining)
Trauma, hypertension
Ruptured aneurysm or vascular anomaly

Chronic Side Effects:

Cognitive impairments
Post-hemorrhagic headaches
Risk of re-bleed or vasospasm

Causes:

Cerebral aneurysm rupture
Arteriovenous malformation
Cervical artery dissection

Treatment Methods: Hospital/Pharmaceutical:

Neurosurgical intervention (coiling/clipping)
Blood pressure control, anticonvulsants
ICU monitoring and stroke rehab
Holistic/Home Remedies:
None recommended; this is a medical emergency
Long-term rehab may benefit from gentle yoga, cognitive therapy, and stress management post-recovery

Conclusion: Empowered Nursing = Empowered Care

Understanding headache types allows nursing students to confidently assess, triage, and refer patients appropriately. Whether it’s spotting the warning signs of a brain bleed or helping someone escape a cycle of tension and stress, knowledge is power. Remember, treatment is both an art and a science: blend medication knowledge with holistic care for the best patient outcomes—both in the hospital and in the real world.

Saving Grace Medical Academy is committed to training compassionate and competent healthcare professionals. Stay curious, stay informed—and never underestimate the power of understanding someone’s pain.

Want to Learn More? Take a Basic Life Support (BLS) or Standard First Aid CPR-C & AED course to learn how to identify and respond to medical emergencies like stroke or head injury. It could save a life—maybe even your own.

>> View Upcoming Courses [www.savinggracemedical.com]

“This material is for informational purposes only and is based on guidelines from The Canadian Red Cross, Alberta Heart & Stroke Foundation, and Alberta Health Services. This content does not replace professional medical advice or official safety training. Consult your physician or safety training facility for further guidance.”