Headache

We’ve all had headaches. They might be triggered by illness, stress, dehydration, or working on the computer. But when chronic headaches disrupt your life—taking you down for days or weeks every month—it’s time to get help from a specialist.

MedStar Health headache experts are board-certified in neurology and headache. We will hear you, and we will bring the expertise to give you more headache-free days, with a custom treatment plan based on your individual needs.

Specialized headache care

MedStar Health’s headache specialists, including those at MedStar Georgetown University Hospital Headache Center can give you a precise diagnosis and a personalized treatment plan to manage your headache condition. In our care, you’ll be surrounded by experts who rally behind you to reclaim a healthier, happier life.

Types of headache disorders

You might be surprised to learn that researchers have identified hundreds of different types of headaches. In fact, the International Headache Society has developed a classification system with three main categories and 14 sub-categories.

Primary headaches
A headache is classified as primary if the head or neck pain itself is causing the symptoms.

Tension headaches are by far the most common type. The pain is mild to moderate, short-lived, and easily treatable.

Cluster headaches involve a sudden, sharp pain on one side of your head, along with the distinctive symptoms of a watery eye, drooping eyelid, and nasal congestion. While the symptoms can last for several hours, the pain will eventually ebb with no lingering side effects. Cluster headaches typically occur in a noticeable pattern.

Migraine is a chronic disorder that causes debilitating pain along with symptoms that can include nausea, dizziness, vision changes, and extreme sensitivity to light and noise. Your headaches may be diagnosed as migraine if the pain is throbbing or pulsating and lasts for more than four hours.
Secondary headaches
Your doctor may determine your headache is secondary if the pain is linked to another condition or disorder. These might include:

Allergies and allergic reactions

Infections

Menstruation, menopause, or other hormonal changes

Excessive caffeine consumption or withdrawal

High blood pressure

Head or neck trauma

Substance use or withdrawal
Neuropathies and facial pains

Some headaches are caused by nerve damage to the face or neck. This might happen if a lesion develops on the nerve or surrounding tissue. Trigeminal neuralgia is an example of this kind of condition.

Advocating for your health

Migraine and other chronic headache disorders are sometimes called invisible conditions because symptoms can’t readily be seen by others. Many patients try to power through symptoms or mask them with over-the-counter medications to minimize the impact on daily life.

If that sounds familiar, you don’t have to suffer in silence or hide away in a cold, dark room. You deserve to be heard. Self-advocating is especially important for people whose pain has been ignored or dismissed by providers in the past.

Potential causes and risk factors

Some headache risk factors, such as diet and hydration, are straightforward to control. Others require partnering with specialists to get the best, safest outcome. Some of the more complex risk factors include:

Diabetes
High blood pressure
Immunocompromising conditions, such as lupus, cancer, or HIV/AIDS

If you have a history of headaches and notice a change in the pattern or frequency—or if headaches are accompanied by fever, weight loss, or confusion—see a doctor to rule out other diagnoses. For adults over 50, new and severe onset of headaches could be a sign of a more serious condition.

Diagnosing headache disorders

Assessing your symptoms and level of discomfort is key to pinpointing your type of headache pain. Your care team will ask you to describe the details of your headache episodes:

How would you rate your pain level?
How long do your headaches last?
Do you have other symptoms at the same time?
Where is the pain located?
Does the pain disappear quickly or linger?
Have you noticed any triggers?

Your doctor may ask you to keep a headache diary to identify patterns in the intensity and duration of your episodes. This information can help you learn to avoid triggers and give us details to customize your care plan.

Self-care remedies

If you get mild or gradual onset headaches frequently that do not get worse over time, try these natural and topical treatments:

Apply an ice pack, heat pack, or mentholated cream or balm to the affected area
Drink chilled water and stay hydrated
Remove yourself from a stressful situation by taking a break or going for a walk
Sleep or rest, if you’re able to do so
Take deep breaths for relaxation
Use a diffuser with lavender essential oil

Pediatric Headache Care

A young girl holds her head in pain while talking to a doctor. Headaches are very common in children and adolescents, with more than half experiencing headache at some point in their lifetime. The division of Pediatric Neurology at MedStar Health offers comprehensive, expert headache care tailored to each child’s unique symptoms and needs.

Frequently asked questions:

What is a headache?
A headache is discomfort or pain in the head or face. Headaches can be frequent and persistent, or few and far between. Headaches can be primary or secondary in nature. A thorough medical history is required to help determine headache type, as well as evaluation and treatment that may be needed.

Primary headaches are recurrent headaches that are not caused by an underlying medical condition. Some of the most common types of primary headache include migraine headache, tension headache, and cluster headache

Secondary headaches are caused by an underlying medical condition, and while some may be benign, others may require more urgent evaluation. Causes can include medication overuse, sinus disease, trauma, bleeding, infection, or tumor.

What are the signs and symptoms of headache?
Common signs and symptoms of headache include:

Nausea and/or vomiting
Light and/or sound sensitivity
Changes in vision, such as blurry or double vision
Changes in sensation, such as numbness or tingling
Lightheadedness or dizziness
Trouble with walking or balance
Changes in speech

Signs that should prompt an immediate visit the emergency department include:

One sided weakness of the face or body
Slurred speech
Loss of consciousness
Memory loss, confusion, or disorientation
Persistent vomiting
Feeling sleepy or having trouble staying awake

Who is at risk for headache?

Children, adolescents, and adults alike are all at risk for headache.
On average, children experience headaches starting around age 7 years, with headaches becoming more common as children grow older.
Headaches tend to be more common in males before puberty, and in females after puberty.
Headaches can commonly occur in children with other medical conditions, such as anxiety, depression, ADHD, sleep difficulties, and epilepsy.

How are headaches diagnosed?
A through medical history and physical exam are usually all that are needed to help diagnose and treat headache. However, depending on your child’s symptoms, additional testing, such as brain imaging (such as an MRI) or spinal tap (lumbar puncture) may be recommended. Your child may also benefit from evaluation by other pediatric specialists.

How are headaches treated?
A multidisciplinary approach is the best way to provide a comprehensive headache treatment plan. Treatment for your child’s headache can include a variety of recommendations, such as:

Vitamins and supplements
Medications
Lifestyle modifications, including adjustments in sleep, diet, hydration, and exercise
Therapy, including physical therapy and talk therapy (such as with a psychologist)
Devices, which can be worn on the head or other parts of the body to help acutely treat or prevent headaches
Procedures, such as injections

What services do we offer at the division of pediatric neurology?
We offer a targeted and tailored approach to treatment of your child’s headache. After a thorough evaluation, our team will determine which treatment options are the best fit for your child, discuss whether referrals to additional specialists are recommended, and determine if further testing is needed.

To schedule an appointment with one of our pediatric neurologists, please call our Pediatric Neurology Clinic at 202-295-0547.

When to see an expert

If self-treatment is no longer enough, talk with your primary care doctor about more targeted therapies. Disclose all the medications and treatments you are using to avoid unexpected drug side effects.

Depending on the frequency and severity of your headaches, your doctor may refer you to a neurologist or other specialist. The experts at MedStar Health’s Headache Center will listen closely to understand your symptoms and the impact on your daily life.