Headaches (Migraine & Tension)

A headache is pain or discomfort in the head, scalp, or neck. Headaches can range from mild to severe and may occur occasionally or frequently. There are several types of headaches, with tension headaches and migraines being the most common.

A migraine is a neurological condition that causes recurring headaches, often with moderate to severe throbbing or pulsing pain. Migraines are frequently accompanied by symptoms such as nausea, vomiting, and sensitivity to light or sound. The pain can interfere with daily activities and may last for hours or days.

The exact cause of migraines is not fully understood, but genetics and changes in brain chemistry are believed to play a role. Headaches, especially tension headaches, are often linked to muscle tension and stress.

Common triggers for headaches and migraines include:

• Stress and anxiety
• Hormonal changes
• Lack of sleep or poor sleep quality
• Caffeine use or withdrawal
• Alcohol consumption
• Dehydration
• Bright lights or strong smells
• Weather or barometric pressure changes
• Certain foods or food additives
• Screen overuse or eye strain

Many people experience migraines in distinct phases, though not everyone experiences every phase.

Prodrome

Hours or days before a migraine, early warning signs may appear, including:

• Mood changes
• Food cravings
• Fatigue
• Neck stiffness
• Increased thirst or urination
• Difficulty concentrating

Aura

Some people experience aura, which consists of temporary neurological symptoms that may last up to an hour.

Aura symptoms may include:

• Flashes of light or zigzag lines
• Blind spots or blurred vision
• Tingling or numbness in the face or limbs
• Difficulty speaking

Attack

This is the headache phase of a migraine and can last from several hours to multiple days if untreated.

Symptoms include:

• Throbbing or pulsing head pain
• Pain on one or both sides of the head
• Sensitivity to light, sound, or smell
• Nausea or vomiting

Post-drome

After the migraine ends, some people feel exhausted or mentally foggy, while others feel relief or mild euphoria. Sudden movements may briefly trigger pain

• Tension headaches can last from 30 minutes to several hours, and sometimes days.
• Migraines typically last between four and 72 hours but may vary from person to person.

• Tension headaches usually cause pain across the forehead, temples, or back of the head and neck.
• Migraine pain is often felt on one side of the head but may affect both sides. Some symptoms, such as nausea, occur throughout the body.

Occasional headaches are common, but frequent headaches or migraines may indicate a chronic condition. Chronic migraines are defined as headaches occurring on 15 or more days per month. Common contributors include stress, sleep disruption, overuse of pain medications, dehydration, and caffeine intake.

Getting quality sleep can be difficult during a headache or migraine, but good sleep habits may help reduce attacks:

• Keep a consistent sleep schedule
• Create a dark, quiet, cool sleep environment
• Avoid screens before bedtime
• Limit caffeine, alcohol, and nicotine
• Avoid heavy meals late at night
• Work with a medical provider to manage pain effectively

A migraine is a specific type of headache that includes neurological symptoms and heightened sensitivity. Regular headaches, such as tension headaches, are typically less intense and do not include nausea or light sensitivity.

Tension headaches are the most common type of headache and are usually described as a dull, pressing pain or tight band around the head. They are not typically associated with nausea or sensory sensitivity.

Migraines cause more intense, throbbing pain and often include nausea, vomiting, and sensitivity to light or sound.

Cluster headaches cause severe, sharp pain typically around one eye and occur in cycles. They may include eye redness, tearing, nasal congestion, and restlessness. Migraines tend to last longer and are often associated with nausea and sensitivity to light.

Treatment often includes medications and lifestyle adjustments. Medications fall into two main categories:

Acute (pain-relief) medications:

• Over-the-counter pain relievers
• Triptans
• CGRP receptor antagonists
• Anti-nausea medications

Preventive medications:

• Blood pressure medications
• Antidepressants
• Anti-seizure medications
• CGRP monoclonal antibodies
• Botox® injections for chronic migraine

A medical provider can help determine which option is right for you.

Yes. Non-medication approaches can help reduce headache and migraine frequency, including:

• Identifying and avoiding triggers
• Improving sleep habits
• Dietary changes
• Regular physical activity
• Stress management techniques
• Behavioral and relaxation therapy

Yes. Telehealth services allow you to consult with a licensed provider online. If appropriate, prescription medication can be delivered directly to your home.

At the first sign of symptoms, try the following:

• Rest in a quiet, dark room
• Apply heat or cold to the head or neck
• Stay hydrated
• Use prescribed or over-the-counter medication
• Sleep if possible

Eating regular meals and maintaining stable blood sugar levels can help prevent headaches. An anti-inflammatory diet may reduce migraine frequency, including:

• Fruits and vegetables
• Whole grains
• Lean proteins
• Healthy fats

Seek emergency care if you experience:

• Sudden, severe headache
• Fever with headache
• Confusion or difficulty speaking
• Vision changes
• Weakness or numbness
• Neck stiffness

If symptoms are severe or unusual, call 911 immediately.

Yes. With telehealth providers like Future Now Rx, you can complete an online assessment and receive prescription treatment if appropriate.