Four Headache Locations and What They Mean

There are many different types of headaches, and there's a lot of overlap in where they cause pain. However, there are subtle differences in headache location that can help distinguish one type of pain from another. Knowing what type of headache you're dealing with is crucial so you can get the right treatment—fast.

Here's a guide to what the location of your headache pain might mean.

If the Pain Is Around Your Eyes

According to Johns Hopkins Medicine, head pain in and around your eyes can be a classic sign of a cluster headache. Cluster headaches get their name because these headaches tend to occur in groups or clusters, with the pain lasting up to three hours. When these groups of headaches occur, they may happen multiple times a day or days apart. Once the episode is over, you may not experience another cluster headache for weeks or even years.

According to Johns Hopkins Medicine, the pain from a cluster headache is intense and often concentrated behind one eye. It typically peaks within 10-15 minutes, and there may be eyelid drooping or swelling on the side of the eye pain. In addition, restlessness and agitation can develop as well as sweating. You may also develop a stuffy or runny nose. Cluster headaches are one of the most painful types of headaches but also one of the rarest, with males more commonly affected by them than females.

"They are very painful, like a hot poker in the eye," said Mark W. Green, MD, a spokesperson for the National Headache Foundation and the director of headache and pain medicine at the Icahn School of Medicine at Mount Sinai in New York City.

After a cluster headache has happened, there are treatments that may help, including sumatriptan, a prescription medication often used for migraines, and oxygen therapy. It's thought that the action sumatriptan has on constricting blood vessels in the brain helps to alleviate the pain caused by cluster headaches, according to Johns Hopkins Medicine.

Other medications, taken regularly, may help prevent the attacks before they happen. These include corticosteroids such as prednisone, calcium channel blockers such as verapamil, and lithium carbonate. Prednisone is thought to help by reducing inflammation, verapamil relaxes blood vessels, and lithium carbonate helps regulate brain chemistry.

If you experience cluster headaches or think you may be experiencing them, talk with your healthcare provider about preventive therapies and treatments.

If the Pain Is in Your Neck

Neck pain may not be the first thing you think about when it comes to migraines, but they are a common feature of the condition.

"About 75% of people with migraines get neck pain, which is something many people don't realize," said Dr. Green.

According to Medline Plus, individuals with migraines may experience four phases during their migraine episode, each with different symptoms. The first phase is called the prodrome and can begin a day before the actual headache. Symptoms may vary, including mood swings, fluid retention, extra urination, food cravings, and uncontrollable yawning.

The aura, part of the headache itself, is the next phase. Not everyone experiences migraines with a visible aura. But if you do, you may see flashing lights or zigzags. Auras can happen right before or during a migraine headache.

Migraine headaches tend to have a gradual onset, building into severe pain that is typically throbbing on one side of the head. You may experience increased sensory sensitivity, such as increased sensitivity to lights and sounds. You may also experience increased pain with movement, nausea, and vomiting. And as Dr. Green said, you may experience neck pain. It is also possible to have these symptoms without classic head pain.

The last phase is the postdrome, which happens after the pain. A period of exhaustion, it typically lasts a day.

Some people can avoid migraines by staying away from migraine triggers, such as stress, alcohol, and certain foods, according to MedlinePlus. Also, medications such as beta-blockers, antidepressants, and anti-seizure drugs may help prevent migraines before they happen, the American Migraine Foundation advised. One is Aimovig (erenumab-aooe), which the Food and Drug Administration (FDA) approved in 2018. During an active episode, analgesics such as Tylenol (acetaminophen) or Motrin (ibuprofen) and a class of medications called triptans may lessen symptoms.

Prevention is probably the most attractive option if you're prone to migraines. However, if you get them only once in a while, you can turn to several medications for treatment. Your healthcare provider can help you determine which medicines are right for you.

If the Pain Is on Your Scalp

Most of us expect a headache to affect our scalp, head, and neck. Unlike migraines and cluster headaches, tension headaches usually cause pain on both sides of your head, mainly your forehead, temples, the back of your head, and sometimes your neck and shoulders. The pain usually feels like pressure, said Dr. Green.

When tension headaches occur, there is often muscle tightness in these areas, which can cause discomfort, according to Medline Plus. Also, stress, depression, anxiety, and head injury may lead to tension headaches. Other common triggers include eye strain, dental issues, and sinus infections. You may try over-the-counter pain relievers for everyday tension headaches, but talk with your healthcare provider if they become chronic.

If the Pain Is in Your Sinuses

Many "sinus headaches" are actually tension headaches or migraines, the first and second most common types of headaches, respectively. In fact, a true "sinus headache" probably doesn't really exist, said Dr. Green. "Most headaches are referred to the sinus region."

Sinus infections and colds can trigger tension headaches. And tension headaches can occur with migraines, according to Medline Plus.

Also, acute sinus disease can cause headaches, said Dr. Green, often with accompanying fever and a discharge of pus from your nose.

Whichever kind of headache you experience, it is important to talk with your healthcare provider if your pain becomes chronic or disabling, if headaches feel different from how they used to feel, if they come on suddenly, or if they're accompanied by a fever, confusion, stiff neck, double vision, or seizures.