Acute headaches

What are acute headaches?

A headache, or cephalgia, is pain that occurs anywhere on the head or neck. Acute headaches are considered primary and benign; these types of headaches include migraines, tension, and cluster. Less common versions include cold-stimulus, benign cough and benign exertion headaches.

What causes acute headaches?

Acute headaches have many causes, including daily stress. They may also be the result of referred pain — pain from a neck strain, upper back issue or tired eyes. Headaches have also been linked to hormonal fluctuations, depression, sinus infections, reactions to food and perhaps the most common cause — lack of sleep.

Typical diagnosis

When examined, a pain physician will ask many questions about the nature, duration, and type of pain caused by the headaches to determine the ultimate source. Specifically, the physician will ask about the worst headache experienced and review the patient’s age. The onset of acute headaches in those age 50 and older can be a sign of temporal arteritis or mass lesion.


Tension headache pain

Tension headache is the most common type of headache. These headaches typically occur in the late afternoon and go away by evening. The pain is usually mild or moderate. You may have problems tolerating bright light or loud noise. The pain is usually across the forehead or in the back of the head, often only on one side. These headaches may occur every day.

Migraine headache pain

Migraine headaches cause moderate or severe pain. The headache generally lasts from 1 to 3 days and tends to come back. Pain is usually on only one side, but it may change sides. Migraines often occur in the temple, the back of the head, or behind the eye. The pain may throb or be sharp and steady.

A migraine with aura means you see or feel something before a migraine. You may see a small spot surrounded by bright zigzag lines. Other signs or symptoms may follow the aura.

Cluster headache pain

Cluster headache pain is usually only on one side. It often causes severe pain and can last for 30 minutes to 2 hours. These headaches may occur 1 or 2 times each day, more often at night.

Symptoms (cont.)

While serious causes of headaches are not common, regular acute headaches may be a sign of a more serious disorder. A pain physician should be consulted if a patient has sudden, severe headaches — especially if they are ever in tandem with a stiff neck, fever, loss of consciousness or pain in the eye or ear.


Therapeutic treatments

Therapeutic options for headaches include a review of diet, occipital nerve stimulation, botox injections, cervical facet injections, cervical epidural steroid injections, occipital nerve blocks, sphenopalatine ganglion blocks, supratrochlear nerve blocks, spur/infraorbital nerve blocks and radiofrequency ablation.

Other treatments to consider include cognitive behavioral therapy and biofeedback. Both help teach symptom reduction or coping skills.


Treatment for acute headaches is two-fold: abortive and preventive. Abortive treatments stop headaches that have already started, while preventive measures come from identifying and eliminating headache triggers.

Procedures / Surgeries

Various procedures are available for the treatment of acute headaches.


There are pharmaceuticals designed for both treatments. Non-steroidal anti-inflammatory drugs (NSAIDs) are an immediate relief in many patients. Also commonly prescribed to headache patients are serotonin-binding ergot alkaloids and triptans; these have effective vessel-constricting qualities. Other medications used to control headache includes: antidepressants, antiepileptics, beta-blockers and calcium channel antagonists.

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