Changing the Way We Talk About Headache

Lately I’ve been thinking about that phrase we all love to hate. “It’s just a headache” has to be one of the most hated phrases in the migraine community. We have fought back, countering with a long list of miserable symptoms and shouting “It’s not just a headache!” at the top of our collective lungs. We’ve complained that society views “headache” as a trivial inconvenience. Not wanting to be associated with that stereotype, we have insisted on using the term “migraine attack” to describe our experiences. Slowly our message is being heard.

There’s just one problem.

Have you ever looked at the complete list of headache disorders in the International Classification of Headache Disorders (ICHD-3)? There are over 200, most of which are not migraine. I would not want any of them. They all sound awful. “Headache” is not trivial. It is not an inconvenience. In fact, “headache” is a symptom of many serious illnesses and diseases, none of which are trivial or inconvenient.

Yes, headache is merely one symptom of migraine.

No, not everyone with migraine will even experience a headache.

That doesn’t make “headache” trivial.

Some of the worst headaches I’ve ever experienced have not been migraine symptoms at all. I’ve had dozens of ER visits because of “headaches” that have nothing to do with migraine. I’ve lost more productive days to “headaches” than I’ve ever lost to migraine.

I used to think that migraine was the worst “headache” possible until I learned the hard way that there are headache disorders that are so much worse. All headache disorders are serious. All can become disabling.

There is nothing trivial about any headache disorder.

Each one deserves proper diagnosis and treatment from a qualified headache specialist. If left untreated, any headache disorder can spin out of control, creating daily suffering and permanent disability.

We must exercise caution when trying to separate migraine from all other headache disorders. There is a risk that we will perpetuate the myth that “headache” is not a serious problem. Like it or not, the various migraine diagnoses are listed as “headache disorders” and treated by “headache” specialists". We are part of the larger “headache” community. To separate ourselves from that community is to risk alienating our brothers and sisters who suffer from non-migraine headache disorders.

There is already too much division within the headache community. Why add to it?

I’m not suggesting we stop educating others that migraine isn’t “just a headache” because it’s not. Instead, I propose that we begin to challenge the notion that headaches are not serious. Headaches of any kind should be taken seriously.

Defining “headache”

I recently looked up the word “headache” in both a dictionary and thesaurus.

“Headache” has two definitions

  1. A pain located in the head, over the eyes, at the temples, or at the base of the skull
  2. An annoying or bothersome person, situation, or activity

Unfortunately, the second definition is the one more commonly accepted. This is evident by the sheer number of synonyms:

  • Aggravation
  • Annoyance
  • Bane
  • Bother
  • Difficulty
  • Dilemma
  • Frustration
  • Hassle
  • Hindrance
  • Inconvenience
  • Irritation
  • Nuisance
  • Pain in the neck
  • Pest
  • Predicament
  • Problem
  • Quagmire
  • Trouble
  • Vexation
  • Worry

The words disease, illness, affliction, and suffering were not listed as synonyms for “headache.” The language we use to describe “headache” needs to change. We need to make a conscious effort to only use the word “headache” when describing one of the 200+ headache disorder diagnoses found in the ICHD-3. We must also commit to never using the word “headache” to describe anything other than a true headache disorder.

There is no such thing as “just a headache.”

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