There are 300 different types of headaches, and there’s a lot of overlap in where they cause their particular brand of pain. However, there are also subtle differences in headache location and other symptoms that can help distinguish one type of pain from another. And knowing what type of headache you’re dealing with is important so you can get the right treatment—pronto.
Even though location is less important for headaches than it is for real estate, it can still matter. Here’s a guide to what the location of your pain might mean.
If the pain is around your eye
Head pain in and around your eye can be a classic sign of a cluster headache, so named because these headaches tend to occur in groups over a period of weeks or months before going away for a while. Usually just one eye is affected (though not always the same one), and that eye may also be red, teary, swollen, or droopy.
Cluster headache pain may also radiate down your neck, cheek, nose, temple, or shoulder, again, usually just on one side.
You may also have a runny or stuffy nose and even nausea and sensitivity to light and sound. Because they’re usually one-sided and can involve sensitivity to stimuli, cluster headaches are often confused with migraines.
Each cluster headache can last as little as half an hour or as long as several hours, usually appearing at the same time each day and often when you’re sleeping, which is why they’re nicknamed “alarm clock headaches.” Cluster headaches are one of the most painful types of headaches, but also one of the rarest.
“They are very painful, like a hot poker in the eye,” says Mark W. Green, MD, a spokesperson for the National Headache Foundation and the director of headache and pain medicine at the Icahn School of Medicine at Mount Sinai, in New York City.
Certain medications can help after a cluster headache attack has already happened. These include injectable triptans (a family of medications developed to treat migraines), some local anesthetics, and breathing 100% oxygen through a mask. Other medications, taken on a regular basis, may help prevent the attacks before they happen, including corticosteroids, calcium channel blockers, and melatonin. Talk to your doctor about preventive therapies if you get cluster headaches.
If the pain is in your neck
Neck pain may not be the first thing you think about when it comes to migraines, but they are a common feature of the condition.
“About 75% of people with migraines get neck pain, which is something many people don’t realize,” says Dr. Green.
Some people can avoid migraine attacks by staying away from triggers. Although these vary from person to person, common migraine triggers include stress, alcohol, and certain foods. Medications approved for other conditions like beta blockers, antidepressants, and antiseizure drugs may help prevent migraines. Last year, the FDA approved the first-ever migraine prevention drug: Aimovig (erenumab).
If you’re prone to migraine, prevention is probably the most attractive option. If you only get them once in a while, there are several medications you can turn to for treatment, including over-the-counter pain relievers like ibuprofen to triptans and other prescription drugs.
If the pain is on your scalp
Tension headaches don’t cause actual pain in your scalp, but they may cause that area to feel tight, almost like a band is being pulled around it.
Unlike migraines and cluster headaches, tension headaches usually cause pain on both sides of your head, mainly your forehead, temples, the back of your head, and sometimes your neck and shoulders, and the pain usually feels like pressure, Dr. Green says.
Stress is the most common cause of tension headaches, although physical problems with your muscles or joints can contribute. Try over-the-counter pain relievers for every-so-often tension headaches, but talk to your doctor if they become chronic.
If the pain is in your sinuses
Many so-called “sinus headaches” are actually tension headaches or migraines, the first and second most common types of headaches, respectively. In fact, says Dr. Green, a true “sinus headache” probably doesn’t really exist. “Most headaches are referred to the sinus region,” he says.
Acute sinus disease can cause a headache, he adds. But then you’re also likely to have a fever and a pussy discharge from your nose.
Always talk to your doctor if pain anywhere in or around your head becomes chronic and disabling, if headaches feel different than they used to, if they come on very suddenly, or if they’re accompanied with a fever, confusion, stiff neck, double vision, or seizures.