FAQs on Headaches – Info from a Phoenix Headache Specialist

A headache is one of the most common complaints heard in doctors’ offices. The pain associated with a headache can be disabling, interfering with school, work, and social functions. Called cephalgia, headaches are either primary or secondary in nature.

What is the difference between a primary headache and a secondary headache?

A primary headache is the cause of the pain. A secondary headache is a symptom of another disorder, disease, or injury. More often, a secondary headache is caused by another disorder, but the condition is not typically serious.

How common are headaches?

Approximately 5% of adults report frequent headaches. Every year, more than 10 million people seek medical care related to complaints of headache. Headaches account for more than 127 million missed days from work each year. The most common type of headache is tension-type, with around two-thirds of people experiencing this during life.

What are the signs and symptoms related to headaches?

The symptoms of a headache depend on the type. The most common types include:

Tension-type headaches – These are usually felt on both side of the head. The pain associated with tension-type headache is described as pressure, tightness around the head (like a band), and heaviness.

Sinus headache – This type of headache produces pain under both eyes, the forehead, or the cheeks. Caused by sinus pressure and swelling, the headache is often accompanied by fever and soreness.

Migraine headache – This is a throbbing, aching pain, usually felt on one side of the head. Migraine headaches are often associated with nausea, vomiting, and sensitivity to light and sound.

Cluster headache – This type of pain develops around or behind one eye. Most patients have associated tearing, nasal blockage/drainage, and eye redness on the side of the headache. These headaches last for 15-90 minutes, and can occur daily or in groups for weeks at a time.

How are headaches treated?

Depending on the cause, various treatment options are available for headaches. These include:

Stress reduction techniques – Because stress brings on many types of headaches, stress reduction is a good way to prevent and treat headaches. Measures include deep breathing, yoga, meditation, and regular sleep.


Medications – For tension headaches, a mild analgesic is used, such as paracetamol or aspirin. Tricyclic antidepressants are used for some patients who experience chronic daily headaches. For frequent migraine attacks, abortive agents are used, such as ergotamine and sumatriptan. For severe pain, the pain management specialist will prescribe narcotic analgesics.


Occipital nerve block (ONB) – With this procedure, the doctor injects a long-acting anesthetic near the occipital nerves of the back of the head. A recent clinical study found that ONB produced a 50% reduction in headache pain and was effective for long-term treatment.


Radiofrequency denervation – For certain types of pain related to the cervical (neck) spine, the doctor destroy a portion of the nerve root with radiofrequency energy. To introduce the radiofrequency energy, small needles are inserted into the tiny facet joints along the back of the neck. Research studies found this procedure to have a 75% efficacy rate.


Botox – As a neurotoxin, botulinum A is used for the prevention of migraine headache. The doctor will inject the forehead, temples, jaw, and back of neck with Botox to alleviate muscle tension. A recent study found this procedure to be useful for reducing migraine severity and frequency.


Acupuncture – To alleviate pain in the back of the neck, this ancient Chinese technique involves insertion of tiny needles. This dry needling restores body energy flow and stimulates the brain to release neurotransmitters called endorphins. In a research study of more than 18,000 headache patients, acupuncture was found to be more effective than placebo.