Record each day
- when the headache started and how long it lasted;
- location, quality and severity;
- nausea, light, sound, eye or nasal symptoms;
- menstruation, sleep or other notable circumstances;
- which medication you used and on how many days.
Conditions & symptoms
Headache and facial pain
Not every headache is the same. Location, duration, accompanying symptoms and the pattern together tell you more than the pain score alone.
This page helps you compare, not diagnose yourself. A new, sudden or clearly changed headache needs medical assessment.
The headache family
Which route best matches your question?
People can have more than one type of headache. A headache diary and a conversation with a doctor can help separate overlapping patterns.
MigraineOften attacks with nausea, sensitivity to light or sound, or sometimes aura.
Tension-type headacheUsually pressing or tightening, often on both sides.
Cluster headacheExtremely severe one-sided attacks around the eye, often with restlessness.
Medication overuseHeadache becomes more frequent with frequent use of acute medication.
Facial painBrief electric shocks or other pain in the face, jaw or nerve area.
Direction, not a self-test
The main differences side by side
A diagnosis is never based on one feature alone. These patterns are simplified and can overlap in one person.
| Pattern | Location and feeling | Duration | What else may occur? |
|---|---|---|---|
| Tension-type headache | Often on both sides, pressing or tightening | 30 minutes to several days | Usually no nausea; routine movement does not clearly worsen it |
| Migraine | Often one-sided and throbbing, but not always | Hours to several days | Nausea, sensitivity to light or sound, sometimes aura; movement may worsen it |
| Cluster headache | One-sided around the eye or temple, extremely severe | 15 minutes to 3 hours, repeated in clusters | Red or watery eye, nasal symptoms, drooping eyelid and marked restlessness |
| Medication-overuse headache | Features may become less distinct; often many headache days | At least 15 days per month | Pre-existing migraine or tension-type headache becomes more frequent and medication helps less |
| Trigeminal neuralgia | Usually one-sided, electric shock-like facial pain | A fraction of a second to about 2 minutes | May be triggered by touch, talking, chewing, brushing teeth or cold air |
Facial pain is not simply “headache in the face”
Jaw problems, dental causes, nerve pain, cluster headache and other conditions can all cause pain in or around the face. Their assessment and treatment differ.
Make patterns visible
A headache diary can tell you more than memory alone
Do not search for one perfect trigger
A diary is mainly for discussing frequency, patterns, medication use and treatment response. It does not prove that one meal, stressful moment or weather change caused an attack.
An important side route
Count medication days, not just tablets
Medication overuse is mainly about the number of days acute medication is used. The threshold for paracetamol and NSAIDs differs from the threshold for triptans, opioids or combination medicines.
Paracetamol or NSAIDs
Use on 15 or more days per month for more than 3 months can fit medication-overuse headache in someone with a pre-existing headache disorder.
Triptans, opioids or combinations
For these medicines, the classification threshold is use on 10 or more days per month for more than 3 months.
Make a withdrawal plan with your doctor
Especially with opioids such as tramadol, oxycodone, fentanyl or morphine, do not stop on your own. Discuss support and treatment of the underlying headache.
Safety
When should a headache be assessed quickly?
Seek urgent medical advice for a new, extremely severe headache
Urgent assessment is also important with weakness or other neurological loss, drowsiness, neck stiffness or fever, after a serious head injury, during pregnancy or shortly after giving birth, or when someone appears seriously ill. Call the local emergency number if life is in danger.
Make an appointment
For recurring, increasing or changing headaches, frequent medication use, a new headache later in life, or when work, school, sleep or everyday life is being disrupted.
Do not let an existing label explain everything
Someone with migraine or tension-type headache can still develop a new pattern. A clear change should not be dismissed as “just your usual headache”.
More control
Questions for your appointment
- Which headache type fits best, and which features support that?
- Could I have more than one headache type?
- How many medication days per month are appropriate in my situation?
- Would a diagnostic or treatment diary be useful?
- Which change should make me contact you again?
- When is referral to a neurologist or headache centre appropriate?
- Is the goal fewer attacks, fewer headache days or better functioning?
- Who keeps an overview when several treatments or specialists are involved?
Experiences wanted
Where did your headache care get stuck?
Was your headache attributed to stress too quickly, did recognition take a long time, or did care become fragmented? Share your experience through the general Zorgfuik form.
Share your experienceSources
Reliable explanations and guidance
- NICE guideline: Headaches in over 12s — assessment, headache patterns, diary use, red flags and medication overuse.
- ICHD-3 headache classification — international classification and diagnostic criteria from the International Headache Society.
- Dutch GP guideline on headache — the primary-care context used for the Dutch source page.
- Dutch specialist headache guideline — specialist guidance on migraine and other headache disorders.