A: A headache happens when tissues in and around the head that are sensitive to pain become irritated or pushed out of balance. While the brain tissue itself doesn’t feel pain, structures nearby such as blood vessels in the coverings around the brain (the meninges), nerves that carry sensation from the face and scalp, muscles in the neck and jaw, and the sinuses do. When these tissues are stretched, inflamed, squeezed or chemically ‘activated’ in some way, they send signals to the brainstem and higher brain areas, which interpret them as pain.
Different headaches start in different ways. In tension headaches, prolonged muscle tension and stress-related changes in pain processing can make the scalp and neck feel sore and tight. In migraines, the nervous system becomes unusually sensitive: brain networks that regulate sensory input, blood vessel tone, and pain can shift into a hyper-responsive state. This can trigger a cascade involving inflammatory molecules around nerves and changes in brainstem circuits, producing throbbing pain, nausea, and sensitivity to light or sound. (Scientists have unearthed many clues about why the sensitivity increases but they haven’t determined a single cause yet.)
Dehydration, missed meals, poor sleep, alcohol, infections, and bright light can all be triggers for headaches because they alter hydration, blood sugar, hormones and/or immune signals.
Finally, while most headaches are not dangerous, a sudden and really bad headache, a headache with fever and stiff neck, weakness, confusion or one after a head injury deserves urgent medical attention.
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