by Nicole Evans M.D.

Created on: October 20, 2009   Last Updated: September 07, 2010

Headaches can be classified into two categories: primary headaches and secondary headaches. In primary headaches, the headache itself is the illness. A secondary headache on the other hand is a headache that is the result of an underlying illness. 

Tension headaches, cluster headaches, migraines and chronic daily headaches are all considered to be primary headaches. Each form of primary headache is diagnosed by the particular pattern of symptoms it creates.  And while the particular treatment for each of these  headaches differs, the methods used to prevent primary headaches can be applied to all four types of primary headaches.

The techniques and therapies that may be effective in the prevention of primary headaches include identifying and avoiding triggers as well as utilizing certain complementary and alternative therapies. Keeping a headache diary is a useful way to identify triggers.  This does require patience but the ability to prevent headaches by avoiding triggers is well worth the extra effort.  In addition, complementary and alternative medicine options may be helpful, especially biofeedback, acupuncture, clinical hypnosis, self-hypnosis and stress management.

Until an individual has discovered how to prevent their primary headache, it is essential to obtain an accurate diagnosis.  These headaches are diagnosed by symptoms.  Once the headache type is accurately diagnosed the appropriate treatment can be determined.  The diagnosis and treatment for each of the four types of primary headaches is described below.

Migraine Headache: Symptoms of a migraine headache include some or all of the following

-unilateral head pain

-pulsating pain

-nausea and vomiting

-sensitivity to light and noise

-seeing an aura approximately one hour before migraine onset

Treatment of a migraine headache includes over the counter pain relievers with or without caffeine for mild symptoms, triptan prescription medications for moderate to severe symptoms, antiemetics if needed to prevent vomiting, and Amitriptyline, Valproic Acid, Propanolol, or Topiramate daily to prevent migraine headaches if they are frequent.

Tension-type Headache: Symptoms of a tension headache include some or all of the following

-bilateral head pain

-tight or pressing pain

-sensitivity to light and noise

-head pain that may worsen through out the day and go away with sleep

Treatment of tension headaches includes over-the-counter analgesics, muscle stretching

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