Headaches take on many shapes: From a dull ache to a full-blown migraine that can stretch for days.

Dr. Megan Donnelly, a Novant Health neurologist who specializes in headache medicine, explains the types, how they differ, and your best hope for relief.


Dr. Megan Donnelly

The prevalence of migraines in the U.S. adult population is high, affecting roughly 1 of every 6 Americans, according to 2018 National Institutes of Health data. For women, the rate is higher, with 1 in 5 reporting a migraine during a three-month period.

  • Symptoms: Usually includes a headache of moderate to severe intensity, nausea, pain on one side of the head, pulsating, and can last from a few hours to two or three days. Migraines are often recurring. They can affect people of all ages, but mostly affect those between 35 and 45 years old.

The causes of migraines aren’t completely understood.

About 20 percent of people will get auras – visual and sensory disturbances that usually last between five and 60 minutes – before the migraine arrives, Donnelly said.

“Vision changes, tingling in one arm or problems finding their words are some examples,” Donnelly said. “That’s quite concerning to patients when it’s happening.”

  • Treatment: Over-the-counter painkillers, prescription drugs to relieve nausea and vomiting, and migraine-specific drugs your physician can recommend. Resting in a dark, quiet place, ice or cold cloth on the forehead and drinking water often help.

Donnelly offered these tips for reducing migraine headaches:

  • Limit stress in your life.
  • Make sure you’re sleeping well. Make sleep a priority.
  • Eat a healthy, well-rounded diet.
  • Exercise. A recent study in Sweden found that exercising 40 minutes three times a week will help reduce the frequency of migraines, Donnelly said.

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Tension headaches

  • Symptoms: A feeling of pressure or tightness, often described like a band around your head. Sometimes it spreads to the neck, or begins there. This is the most common type of headache. Can last from 30 minutes to several hours. The severity varies, but it usually doesn’t prevent you from normal activities.
  • Treatment: Over-the-counter painkillers, such as ibuprofen, acetaminophen and aspirin are usually effective in stopping or reducing the pain.

Medication overuse headache

  • Symptoms: Also known as a “rebound” headache. They’re usually frequent or daily, and often have similar symptoms as a migraine or tension headache. They can result from someone taking painkillers more than 15 days per month.

“It’s common for us to want to reach for something for pain, whether it’s ibuprofen, acetaminophen or other products,” Donnelly said. “If you’re doing that more than two days per week, it can actually cause more headaches to happen and then it becomes a really ugly picture. So we need to have less use of all of those medications and better preventive medications, so we don’t run into rebound headaches.”

  • Treatment: Stop taking the medication, but do so under the supervision of a doctor. The headaches will usually stop in about 10 days.

Cluster headaches

  • Symptoms: Frequently recurring, brief but very severe headache, usually focused in or around one eye. They can happen up to several times a day. You could have tearing and redness in the eye, a runny or clogged nose, and a droopy eyelid. They’re usually sudden, and can last between 15 minutes and three hours.
  • Treatment: Check with your doctor for specific medications that can help reduce the severity and frequency of the headaches.

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