I had the worst headache the other day. Like a little hammer inside my brain. Bang, bang, bang. It finally dawned on me that it was a caffeine headache. Just the day before I had decided to cut back on my coffee drinking.
Even though current research suggests that coffee has health benefits, it doesn’t agree with me. It makes me feel hoarse and I constantly have to clear my throat. My mood gets scratchy, too.
Nevertheless, I like drinking coffee — black coffee. Over the past few weeks, I’d been indulging more and more. And with a snap of the fingers, there were the side effects. I switched over to a morning cup of herbal tea and cut WAY WAY back on coffee during the day.
One day later, the nagging headache from hell.
I did some research on the possible causes of headaches and was surprised there were so many. Most of the time they aren’t too serious, but sometimes they are and you need to get to the emergency room immediately.
Dr. Eric Dinnerstein, a neurologist at Maine Medical Partners Neurology explained to me that headaches are divided into primary and secondary headaches.
“Most headaches are primary — no lesion in the brain. They are usually not life threatening, but can be disabling. The secondary headaches are potentially dangerous and if not identified and treated may lead to long term damage.”
- Tension headache
- Most common type of primary headache. Causes mild or moderate pain in the head, neck and behind the eyes. May feel like a tight band around the forehead.
- Causes throbbing pain, usually on one side of the head. Often associated with nausea, vomiting, and extreme sensitivity to light and sound.
- Cluster headache
- Least common primary headache and the most severe. Causes throbbing or constant burning feeling behind one eye or near the eye. Attacks occur one to three times a day for a period of time that may last weeks or months.
- Hemicrania Continua
- Also uncommon. Causes constant, usually dull pain on one side of the head. May be associated with drooping eyelid, red or watery eyes, stuffy or a runny nose.
Primary headaches usually develop for no obvious reason, but there is a long list of potential triggers.
Common primary headache triggers
- Certain foods, such as aged cheese, processed meats, smoked or pickled foods, nuts and chocolate and MSG, a food additive
- Glare of the sun, bright or flashing lights
- Headband, tight ponytail or braid
- Hormonal changes
- Medication side effects
- Poor posture
- Red wine or beer
- Strenuous exercise
- Sex, especially related to orgasm
- Skipping meals
- Strong odors
- Too much or too little sleep
- Weather— a change in the temperature or barometric pressure
A primary headache can be devastating, but a secondary headache could be deadly. Dr. Dinnerstein says secondary headaches are caused by an underlying disease or condition.
Possible causes of a secondary headache
- Blood clot in the brain
- Brain tumor
- Arteriovenous malformation (AVM)
- Carbon monoxide poisoning
- Concussion or post concussion syndrome
- Dental problems
- Ear infection
- Head and neck trauma
- Infection, such as Lyme disease
- Inflammation of the lining of the arteries (arteritis)
- Pain medication overuse
- Panic attack
- Sinus infection
- Stroke or TIA (trans ischemic attack that may be a stroke warning)
- Toxoplasmosis (a parasitic infection)
- Tri-geminal neuralgia
Most headaches are tension related and easily treated with an over-the-counter medication. My caffeine headache went away after I drank about one-third of a cup of coffee. I realized that instead of going cold turkey I should have weaned off it gradually.
When should you contact your doctor or go to the emergency room?
Here are some signs and symptoms that Dr. Dinnerstein considers important.
Call the doctor if you have
- Double vision
- Blurry vision
- A headache that gets worse when you lie down or stand up
- “The worst headache of my life”
- Headache with weakness or slurring
- Headache with inability to speak
- Headache with confusion
- Headache with balance problems
- Sudden, new severe headache
- Headache with fever, shortness of breath, stiff neck or rash
- Headache with severe nausea and vomiting
- Headache that develops after an accident or head injury
“I advise patients with those signs to seek medical attention and to be evaluated by their doctor.” ~ Eric Dinnerstein, MD
Do you have headaches? What are your triggers and your most effective treatment?