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We all have headaches, but treating one can be a real pain! Where did it come from? What does it mean? How do you get rid of it? Often, they are more complex than we realize, and understanding the difference between a primary vs secondary headache is the first step towards recognizing your symptoms and regaining a clear head!

Primary vs Secondary Headache Explained

You may have heard the terms primary vs secondary headache being mentioned, and wonder which it is that you are experiencing. Perhaps one is more serious than the other? Each kind is unique, with a distinctive set of symptoms, and a different set of treatments. Read through our guide which explains the terms and types to you.

What is a Primary Headache?

With a primary headache, the pain in your head is the condition. This means that it has not been triggered by external causes such as allergies or illnesses. There are three main types of primary headaches; migraines, tensions, and clusters.

Primary headaches can be either episodic or chronic. Episodic headaches occur every now and then, and usually last for any time between half an hour to several hours.

On the other hand, chronic headaches tend to be more consistent. This means they are likely to occur most or any days out of the month. They also last longer than episodic headaches, sometimes for several days. If you suspect that you are suffering from chronic headaches, a trip to the doctor is necessary to sort out a pain management plan that will reduce suffering.


This particular type of primary headache is characterized by a throbbing, pounding pain or intense pulsing that seems to come from deep within your head. It is usually one-sided, on either the left or right half of your brain. They can occur several times a month (usually any time between once and four times). They tend to last longer than the other types of primary headaches, typically any time from 4 hours to 3 days.

The first sign of a migraine in some cases, is the appearance of visual disturbances. This usually occurs in one in five people before the condition begins, and it is known as an aura. An aura can consist of stars, blind spots, flashing lights, zig-zag lines, and shimmering lights.

In some cases, an aura may include a tingle on one side of the face or down one arm, as well as difficulty speaking or communicating. This means that the preceding symptoms of a migraine can sometimes mimic a stroke! With this in mind, if anything feels unfamiliar, obtaining medical attention immediately is strongly recommended.

When suffering from a migraine, it is common to feel particularly sensitive to light, smells, and sounds. Vomiting and nausea are other common issues, that are usually accompanied by a stomach ache or upset tummy. As a result, many sufferers lose their appetite when experiencing a migraine headache.

What Causes Them?

A combination of your genes and your environment will affect the likelihood of experiencing a migraine. For example, women are three times more likely to suffer from migraines than men. That being said, susceptibility to the condition can also run in the family, for example, if connected to a nervous system disorder.

Those suffering from Post Traumatic Stress Disorder (PTSD) are also likely to fall victim to the ailment. This is the result of an environment that someone is experiencing. Other environmental factors might include hormone fluctuations, sleep disruption, exposure to certain chemicals, dehydration, skipped meals, and certain foods.

In terms of prevention, there are many different options out there. It’s all about finding the one that’s right for you! Your doctor will help with this and is likely to recommend over the counter pain relievers initially. If this fails to reduce your pain during an attack, then you may try triptans instead.

Triptans work to reduce brain inflammation, as well as alter the blood flow. Common examples of these include sumatriptan (Imitrex), rizatriptan (Maxalt), and almotriptan (Axert). They are usually administered via nasal sprays, injections, or pills.

As well as medication to treat or reduce the pain of these ailments, there is also preventative medication. This can include amitriptyline, propranolol (Inderal), metoprolol (Toprol), and topiramate (Topamax). These are hugely under prescribed! It is thought that up to 38% of sufferers might need them when only 3-13% actually use them.


Tension headaches are the most common types, regardless of whether you are a teen or an adult! They are typically triggered by stress and tend to come and go over time. Most people experience one of these at some point in their life.

They are characterized by a dull but not throbbing, aching sensation all over the head. It can also spread to include a feeling of sensitivity or tenderness in your scalp, forehead, neck, or shoulder muscles. Usually, there are no other symptoms, but someone can experience mild to moderate pain.

Luckily, most over the counter pain relievers are enough to reduce your symptoms! Look out for aspirin, ibuprofen (Advil), naproxen (Aleve), and acetaminophen, and caffeine for effective pain relief. If this fails to sort your problems, take a trip to your doctor. They may be able to provide you prescribed medications to provide relief. Prescriptions may include ketorolac, meloxicam (Mobic), and indomethacin.

However, if even this fails to address your symptoms, it may be that your tension headaches are chronic. If this is the case, the correct course of action would be to identify the underlying cause.


Clusters are usually quite severe, and of the primary vs secondary headache classification, they too fall under primary. Victims usually experience an intense burning or piercing pain that is throbbing or constant, in or around one eye. Flushing, redness, swelling, nasal congestion and sweating can stem from this.

Often the pain is so intense that individuals struggle to continue with daily life, even waking people from sleep. It is difficult to sit still, so victims may find themselves pacing during an attack. On the side of the pain, the pupil may begin to shrink, the eyelid may droop, and the eyes may begin to make tears.

Predictably, cluster headaches tend to occur in groups. They can happen up to four times a day, and each episode can last between 15 minutes and three hours. This is usually around the same time each day, and as soon as one recovers, another soon follows. This can occur daily, for any time from two weeks up to several months.

Spring and Autumn tend to be the most common seasons for experiencing cluster headaches. Also, men are three to four times more susceptible to them than women. However, individuals tend to be symptom-free in the months between experiencing them.

Should the condition completely disappear for a few months or years, it is known as remission. They may, however, come back later. In which case it would be wise to engage in a prevention plan.

Doctors are unable to pinpoint exactly what causes clusters. However, there are still methods of prevention, as well as ways to reduce symptoms. For example, calcium channel blockers, melatonin, topiramate (Topamax), and corticosteroids can put your clusters into a period of remission. In the meantime, a local anesthetic (lidocaine), sumatriptan (Imitrex), and oxygen therapy can assist with pain relief.

What is a Secondary Headache?

Now we will move on to consider the other half of primary vs secondary headache ailments.

In the case of the secondary headache, there are six main types to consider. These include sinus, medication overuse, illness-related, post-traumatic, spinal, and a cervicogenic headache. If you are wondering which of the primary vs secondary headache conditions you are experiencing, there is more information under this category to consider.

Sinus Headaches

Also known as an allergy headache as it most frequently stems from an allergic reaction. The pain is most prominently felt in the sinuses and front of the brain. This should end once a course of antibiotics is finished. If you suffer from chronic seasonal allergies or sinusitis, then you are particularly susceptible.

Migraines are commonly misdiagnosed as a sinus headache due to the similarity of symptoms. So much so that nearly 90% of the conditions are in fact migraines. Therefore, it is important to seek medical attention if you are unsure.

Medication Overuse

New or existing medication that has increased in dosage can provoke a negative reaction in your body as you adjust. Unfortunately, the only way to prevent the ailment is to identify the medication that is being overused. Once it has been discontinued, by definition, these should stop

From Illnesses

When suffering from an illness, your body can overexert itself when attempting to fight it off. This exhaustion can manifest itself as a headache, for example during meningitis.


These can develop after a head injury of any kind. They feel physically similar to a migraine or tension-type headache, potentially lasting for six to twelve months afterward. Pain relievers are the best-known way to tackle these. The most commonly prescribed medications are sumatriptan (Imitrex), beta-blockers, triptans, and amitriptyline.

Unfortunately, they can become chronic, so it is important to monitor their length and severity.

Spinal Headaches

These are nothing to worry about too much! They are normal after an epidural is given, for example when a woman receives pain relief once she has entered labor.

Cervicogenic Headaches

Predictably, a cervicogenic headache is directly related to an underlying neck issue. Such a condition might include degenerative disc disease of the cervical vertebrae.

Final Thoughts

Now that you know more around the subject of primary vs secondary headache conditions, it should be easier to identify and find out how to treat the pain that you experience. Remember that it is best to consult a medical professional if you feel anything is out of the norm.