Headaches vary greatly in terms of the location and intensity of the pain and how often they occur. Almost all people have headaches at some point in their lives, but based on the frequency and intensity, you may seek medical attention for the evaluation and management of difficult headaches. 

Types of Headaches

Headaches are broadly categorized as either primary or secondary. Primary headaches include:

  • Migraines. In migraines, symptoms other than pain occur as part of the headache. These may include nausea and vomiting, lightheadedness, sensitivity to light (photophobia) and sound (phonophobia) and other visual symptoms. Migraines also have distinct phases (premonition/prodromal, aura, headache and resolution). But, not all people have each phase. 
  • Tension headaches. These are the most common type of headache. Stress and tight muscles are often factors in tension-type headaches. Common symptoms of a tension-type headache include slow onset of the headache; pain of both sides of the head; pain is dull or feels like a band or vice around the head; pain may be in the back part of the head or neck; pain is mild to moderate, but not severe.
  • Cluster headaches. Cluster headaches usually occur in a series that may last weeks or months. Among the most common symptoms of cluster headaches are severe pain on one side of the head, usually behind one eye; the eye that is affected may be red and watery with a droopy lid and small pupil; swelling of the eyelid; runny nose or congestion; swelling of the forehead.

Secondary headaches are related to an underlying health condition such as:

  • Eye problems
  • Head or neck injury
  • Hormonal conditions
  • Sinus problems
  • Sleep interruptions


Headache care at Marshall Health begins with an assessment of a patient’s medical history, previous tests and treatments and a list of the medications ou are currently taking. Evaluations for related or underlying conditions might also be performed.

At your initial appointment, you will be asked to describe your headaches in detail. You might be asked questions like:

  • When do your headaches occur?
  • What is the location of your headache?
  • What do the headaches feel like?
  • How long do your headaches last?
  • Have there been changes in behavior or personality?
  • Do changes in position or sitting up cause the headache?
  • Do you have trouble sleeping?
  • Do you have a history of stress?
  • Do you have a history of head injury?
  • Do you have other symptoms during a headache?

Patients are also encouraged to keep a headache diary and bring it to their first appointment.


Micaela R. Owens, DO

Clinical Interests: