Synonyms in the broader sense

Headache, migraine

Medical: Cephalgia

English: headache


Overall, headaches are one of the most common complaints ever. Causes of such pain can be very different.

Nevertheless, it must still be said today that the exact processes that cause the individual forms of headaches in many cases, he suspects, because can be proven.

Occurrence in the population


About 30% of Germans (that's almost 25 million) have at least occasional headaches. Nearly 12% of them are children (mostly of school age) and over 20% of them suffer from migraine.

Headache patients worldwide consume almost 13, 000 tons of aspirin (acetylsalicylic acid) alone. These tremendous amounts of analgesics consumed by patients are, in most cases, freely available. On the one hand, this entails the danger of developing drug dependence / addiction on the other, but also of massive organ damage.
It is known that almost 10% of today's dialysis patients have massively damaged their kidneys with the regular intake of painkillers.


The division is made according to the International Headache Society (International Headache League). An experienced doctor will usually be able to do the correct classification after a specific survey.

Basically one differentiates the headache without external influences (primary headache) from the headache by external influences.

Primary headache

Primary headache:

  1. Tension headache
    • episodic (the pain comes and goes)
    • chronic (permanent pain)
  2. migraine
    • without aura
    • with aura
  3. Cluster headache and chronic paroxysmal hemicrania
  4. Various headaches without damage to the head or its organs

Secondary headache

Secondary headache

  • Headache after brain injury (trauma)
  • Headache in vascular diseases
  • Headache in other brain diseases
  • Headache in case of substance abuse or withdrawal
  • Headaches from infections that do not affect the brain
  • Headache in metabolic disorders
  • Headache from pain in nerves (facial neuralgia eg trigeminal neuralgia)
  • Headache caused by diseases of the skull, eyes, nose, ears, sinuses, teeth or mouth
  • Very often, especially in people over the age of 40, the headache, which is caused by hypertension.

Headache after localization

Headache in the area of ​​the forehead

Headaches are particularly common in the forehead.
The pain can be both one-sided and bilateral. Migraine sufferers also typically experience headache in the forehead area. The headache is usually one-sided, pulsating and strong.

In addition, many migraine sufferers also suffer from nausea ( possibly with vomiting ), photophobia and a kind of flicker in front of the eyes. This phenomenon is also called an aura and heralds the coming migraine headache in many patients.
Headache in the forehead, however, does not always indicate a migraine headache.

When the headache stretches from the forehead to the temples, the origin may lie in the temporomandibular joint. By unconscious stress-induced teeth grinding, the temporomandibular joint and the masticatory muscles are over-stimulated and damaged. Remedy relaxation techniques and wearing a crunch bar.

Even typical tension headaches can manifest in the forehead area. The pain is then often bilateral, permanent and pulling. Due to stress, too little sleep and general inner tension, this headache is favored.
Eye problems also often cause headache in the forehead area. If a person suffers from a vision defect that is not corrected by glasses or contact lenses, the eyes must constantly strive to correct the fuzzy image on the retina. In the long run that overloads the eyes and the view of the affected person becomes increasingly blurred.
The brain no longer receives clear visual information. Headaches can be the result.
For frequent headache should therefore be thought of an ophthalmological clarification.

The frontal sinuses also run along the frontal area - air-filled cavities in the bone. Respiratory infections can spread to the paranasal sinuses and sinuses, causing an inflammatory response.
This is often very painful and the affected patients feel a feeling of pressure in the forehead area, which increases in particular when the head is tilted downwards, for example when tying shoes.

Excessive alcohol consumption the day before is also a possible cause of headache in the forehead. This phenomenon is colloquially referred to as "hangover" and improves usually by itself during the following day.

Of course, the pain can also be used in a direct trauma, such as a blow or fall on the head. In case of severe violence or temporary unconsciousness of the patient, a hospital should always be consulted to clarify serious injuries (cerebral hemorrhages, skull fractures).
Rarer causes of pain in the forehead are malignant diseases or nerve damage.

Headache on the back of the head

Hinterkopfschmerzen can have different causes.

Very often, they are triggered by muscle tension in the neck and shoulder region ( see: strained neck). The neck muscles pull from the lower part of the back of the head towards the shoulders, so that a tension can lead to a cramping of this whole area.
Neck tensions are favored by poor posture, which today often result from predominantly sedentary occupational activities and general physical inactivity.

Keeping the head in one position for many hours a day, such as working on the computer for a long time, can cause neck tension and back pain. Another cause of back pain is the teeth grinding ( bruxism ) that many people do while sleeping without realizing it.
It also causes neck and back pain and morning pain in the masticatory muscles.

In the neck area there are several nerves that can be irritated for various reasons, for example due to tensions, inflammation, wear and tear or infections.
When the nerves are irritated, it comes to stinging, episodic pain that can radiate from the neck into other areas of the head. This condition is also called occipital neuralgia .

More serious causes of pain in the back of the head are circulatory disorders of the brain, for example in the context of a stroke. The pain is often massive and occur quite suddenly. Accompanying this is often nausea, vomiting and neck stiffness - if there is a bleeding in the area between the meninges (subarachnoid hemorrhage).

Last but not least, there can also be a malignant disease behind persistent pain in the back of the head, such as a brain tumor or metastasis of another tumor that has appeared in the body.
In the case of long-lasting and / or severe symptoms, which show no improvement, a doctor should be consulted to clarify serious causes of the pain.

Symptoms and therapy



In this type of pain, both halves of the head are affected. the pain moves from the back of the head to the forehead. Mostly it is described as oppressive. Patients often feel like their skull is in a screw clamp. Not infrequently, there is a permanent (chronic) course.

It occurs at all ages and is often accompanied by dizziness in the head and vomiting. Headaches with nausea are also common.

Women are typically more affected than men. The chances of complete healing and freedom from pain are generally poor with pure medical therapy. With regular exercise, eg in endurance sports, you can achieve quite good and long painless episodes.

The focus must be on a good relationship between doctor and patient. Special attention must be paid to responding to the patient's anxiety about a serious, life-threatening condition. Tension headache is very tormenting, but not life threatening.

Medication starts with a (tricyclic) antidepressant drug (eg amitriptyline, Doneurin, Imipramine) if there are more than 9 days of pain per month. Painkillers should be used sparingly and not more than 500mg aspirin a day.

Furthermore, it has been shown that progressive muscle relaxation can be very helpful.


In addition, 10 behavioral recommendations of the German migraine league are listed here.
More about headache at our partner

6 Steps to Relieve a Headache (July 2020).

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