Spine & Orthopedic Pain Centers


There are many types of headaches such as migraines, tension headaches, cluster headaches. Most are episodic and go away with conservative measures.



Tension-type Headaches (TTH)

Tension-type headache (TTH) category is defined as either episodic (frequent and infrequent) or chronic. Headache categories also are defined by whether they are associated with (facial, forehead, jaw, and scalp) or pericranial muscle disorders. 

Episodic tension headache usually is associated with a stressful event. This headache type is of moderate intensity, self-limited, and usually responsive to nonprescription drugs. Tension headaches cause somatic pain which is pain that comes from the soft tissues, skin, and muscles.

Chronic tension headache often recurs daily and is associated with contracted muscles of the neck and scalp. This type of headache is bilateral and usually at the base of the skull or over the forehead (occipitofrontal).

TTH is the most common type of chronic recurring head pain. In the past, pain etiology was presumed to be the muscular contraction of pain-sensitive structures of the skull.




Migraine headaches are a complex disorder characterized by recurrent episodes of headache, most often one-sided and in some cases associated with visual or sensory symptoms—collectively known as an aura—that arise most often before the head pain but that may occur during or afterward. Seeing spots, blurred vision, nausea, and vertigo are some of the symptoms of an aura.

Signs and symptoms of migraines include:

  • Throbbing or pulsatile headache, moderate to severe pain that intensifies with movement
  • Unilateral and localized pain in the forehead and ocular area, but the pain may be felt anywhere around the head or neck
  • Pain builds up over a period of 1–2 hours, progressing posteriorly and becoming diffuse
  • Headache lasts 4–72 hours
  • Nausea (80%) and vomiting (50%), including anorexia and food intolerance, and light-headedness
  • Sensitivity to light and sound


Cluster Headaches

Cluster headaches cause acute pain attacks in which several severe headaches occur over the course of 24 hours. They most often occur at night, but daily cluster headache attacks can continue to happen for weeks or months, after which a period of remission can occur. This remission period can last for months or even years.

Cluster headaches are different from other headaches as they can be very severe and often require medical management. On a pain scale, they are often rated a 10 out of 10.

Common cluster headache symptoms include:

  • Severe headache pain that starts behind the eye or on one side of the face
  • Headache that begins suddenly without any warning, often waking you in the night
  • Several severe headaches that cause acute pain can last between 15 minutes to 3 hours, within a 24-hour period
  • Headaches that start at the same time each day or the same time every year
  • Eye redness and tearing on the side of your face where your headache is
  • Runny or stuffy nose on one side
  • Swelling of the eyes or face
  • Drooping or constricted pupil on the side where you have pain
  • Numbness or tingling on one side of your face or in your arms or fingers
  • Restlessness or agitation
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