What causes headaches? - Dan Kwartler | eJOY English
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In ancient Greece, headaches were considered powerful afflictions.
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Victims prayed for relief from Asclepius, the god of medicine.
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And if pain continued,
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a medical practitioner would perform the best-known remedy—
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drilling a small hole in the skull to drain supposedly infected blood.
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This dire technique, called trepanation,
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often replaced the headache with a more permanent condition.
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Fortunately, doctors today don’t resort to power tools to cure headaches.
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But we still have a lot to learn about this ancient ailment.
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Today, we’ve classified headaches into two camps—
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primary headaches
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and secondary headaches.
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The former are not symptomatic of an underlying disease, injury, or condition;
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they are the condition.
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But we’ll come back to them in a minute
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because while primary headaches account for 50% of reported cases,
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we actually know much more about secondary headaches.
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These are caused by other health problems,
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with triggers ranging from dehydration and caffeine withdrawal
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to head and neck injury,
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and heart disease.
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Doctors have classified over 150 diagnosable types,
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all with different potential causes, symptoms, and treatments.
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But we’ll take just one common case —a sinus infection—as an example.
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The sinuses are a system of cavities
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that spread behind our foreheads, noses, and upper cheeks.
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When our sinuses are infected,
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our immune response heats up the area,
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roasting the bacteria and inflaming the cavities well past their usual size.
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The engorged sinuses put pressure on the cranial arteries and veins,
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as well as muscles in the neck and head.
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Their pain receptors, called nociceptors, trigger in response,
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cueing the brain to release a flood of neuropeptides
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that inflame the cranial blood vessels, swelling and heating up the head.
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This discomfort, paired with hyper-sensitive head muscles,
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creates the sore, throbbing pain of a headache.
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Not all headache pain comes from swelling.
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Tense muscles and inflamed, sensitive nerves
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cause varying degrees of discomfort in each headache.
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But all cases are reactions to some cranial irritant.
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While the cause is clear in secondary headaches,
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the origins of primary headaches remain unknown.
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Scientists are still investigating potential triggers for the three types of primary headaches:
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recurring, long-lasting migraines;
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intensely painful, rapid-fire cluster headaches;
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and, most common of all, the tension headache.
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As the name suggests,
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tension headaches are known for creating the sensation of a tight band squeezed around the head.
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These headaches increase the tenderness of the pericranial muscles,
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which then painfully pulse with blood and oxygen.
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Patients report stress, dehydration, and hormone changes as triggers,
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but these don’t fit the symptoms quite right.
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For example, in dehydration headaches,
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the frontal lobe actually shrinks away from the skull,
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creating forehead swelling
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that doesn’t match the location of the pain in tension headaches.
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Scientists have theories for what the actual cause is,
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ranging from spasming blood vessels
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to overly sensitive nociceptors,
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but no one knows for sure.
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Meanwhile, most headache research is focused on more severe primary headaches.
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Migraines are recurring headaches, which create a vise-like sensation on the skull
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that can last from four hours to three days.
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In 20% of cases, these attacks are intense enough
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to overload the brain with electrical energy,
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which hyper-excites sensory nerve endings.
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This produces hallucinations called auras,
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which can include seeing flashing lights
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and geometric patterns and experiencing tingling sensations.
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Cluster headaches, another primary headache type,
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cause burning, stabbing bursts of pain behind one eye,
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leading to a red eye, constricted pupil, and drooping eyelid.
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What can be done about these conditions, which dramatically affect many people’s quality of life?
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Tension headaches and most secondary cases
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can be treated with over-the-counter pain medications,
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such as anti-inflammatory drugs that reduce cranial swelling.
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And many secondary headache triggers,
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like dehydration,
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eye strain,
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and stress,
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can be proactively avoided.
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Migraines and cluster headaches are more complicated,
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and we haven’t yet discovered reliable treatments that work for everyone.
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But thankfully, pharmacologists and neurologists are hard at work
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cracking these pressing mysteries that weigh so heavily on our minds.
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What causes headaches? - Dan Kwartler

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In ancient Greece, headaches were considered powerful afflictions.Victims prayed for relief from Asclepius, the god of medicine.And if pain continued,
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