Headaches, a problem plaguing and haunting humanity for thousands of years, headaches have always been a huge problem to many everyday people like you and me, they have many causes, symptoms, and treatments. As far back as ancient Greece, headaches were considered powerful afflictions. Most victims would pray for relief from Asclepius, the Greek god of medicine. And if the pain continued, a medicinal practitioner would perform the best-known remedy at the time: drilling a small hole in the skull to drain supposedly “Infected” blood! This crazy technique, known as trepanation, often replaced the headache with a more severe and permanent condition.

Fortunately, doctors, today don’t resort to drilling tiny holes in people’s skulls to cure headaches. Although we’ve learned a lot about headaches since the days of the ancient Greeks, we still have a lot to learn about this ancient question. Today, headaches are classified into two groups: Primary headaches and secondary headaches. The former is symptomatic of an underlying disease, injury, or condition; they are the condition.

While primary headaches account for 50% of reported headaches, scientists know more about secondary headaches. These are caused by other health problems, usually dehydration and caffeine withdrawal to head and neck injury, and even heart disease! Doctors have classified over 15- diagnosable types, all with different causes, treatments, and symptoms. A sinus infection is a good example. The sinuses are a system of cavities that spread behind our foreheads, noses, and upper cheeks. When our sinuses are infected, our immune response heats up the area, roasting bacteria and inflaming the cavities well past their usual size. The engorged sinuses put pressure on the cranial arteries and veins, as well as muscles in the neck and head. Their pain receptors, called nociceptors, trigger in response, cueing the brain into releasing neuropeptides that inflame the cranial blood vessels, swelling and heating up the head. This discomfort, along with hyper-sensitive head muscles, causes a painful headache.

Not all headaches come from swelling, however. Tense muscles and inflamed sensitive nerves cause varying degrees of discomfort in a headache. All cases of headaches are reactions to some cranial irritation. While causes are clear in secondary headaches, the causes of primary are often unknown. Scientists are still learning about and investigating triggers for three types of primary headaches: recurring, long-lasting migraines; intensely painful, rapid-fire cluster headaches; and most common of them all, the tension headache: as the name suggests, tension headaches are known for creating the sensation of your head being squeezed. Headaches like this increase the tenderness of the pericranial muscles, which then painfully pulse with blood and oxygen. Most patients report stress, dehydration, and hormone changes as triggers, but these don’t exactly fit the symptoms. As an example, in dehydration headaches, the frontal lobe shrinks away from the skull, creating forehead swelling that doesn’t match with the location of the pain in tension headaches. Scientists have many theories as to what the actual cause may be, ranging from spasming blood vessels to overly sensitive nociceptors, but no one knows for sure, and the answer has always been unclear.

Although secondary headaches are a big problem, most headache research has focused on more severe primary headaches. Migraines are recurring headaches, which create a powerful sensation on the skull that can last for four hours or up to three whole days! In some cases (about 20%), these attacks are intense enough to overload the brain with electrical energy. This hyper-excites sensory nerve endings. This produces hallucinations called auras, which can include seeing flashing lights and geometric patterns, along with experiencing tingling sensations. Cluster headaches, another type of primary headache causes feelings of burning, stabbing pains in bursts behind one eye, this leads to red-eye, constricted pupil, and drooping eyelid.

So, what could be done about these conditions which constantly ruin people’s lives? Tensions headaches and most secondary cases can be treated with pain medications, such as anti-inflammatory drugs that reduce cranial swelling. Many secondary headache triggers, like dehydration, eye strain, and stress, can be proactively avoided. Migraines and cluster headaches are more complicated, and we haven’t yet discovered reliable treatments that work for everyone. Thankfully, pharmacologists and neurologists are hard at work on cracking these pressing mysteries that have been squeezing our heads for millennia.

TL; DR: The thing that causes headaches has always been unclear to humans for many years, but thanks to advanced neuroscience and billions of dollars worth of research being done every year, scientists are slowly but surely finding answers to the question. Headaches are usually divided into primary and secondary headaches. Secondary headaches usually have clear causes, while primary headaches are a little trickier.



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