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Updated February 19, 2015.

You have a headache smack dab on your forehead. Ouch! Does it feel like sinus congestion? Or maybe it's a migraine because you have a throbbing sensation? There are lots of possibilities for a frontal headache. Let's review the common primary headache disorders that can trigger forehead pain. Remember, primary headache disorders exist on their own, and are NOT caused by another medical condition.

Tension Headache


A tension headache is the most common type of primary headache disorder. It's characterized by a dull tightening or pressure on both sides of the head, like a band. It typically starts at the forehead and radiates around to the back of the head. Unlike a migraine, a tension-type headache is not associated with nausea or vomiting or with an aura. Sufferers do sometimes report a loss of appetite and may report photophobia (sensitivity to light) or phonophobia (sensitivity to sound).
 
Cluster Headache

A cluster headache is an extremely painful and disabling headache that is one-sided and occurs around the eye, temple, or forehead. It is often described as intensely sharp, burning, or piercing. Cluster headache attacks are accompanied by at least one autonomic symptom on the same side of the head pain. These autonomic symptoms include: nasal discharge, tearing of the eye, miosis (pupil constriction), and facial swelling. Most individuals suffering from cluster headaches are agitated and unable to lie down.

Migraine

A migraine is a debilitating, neurological condition that occurs usually on one side of the head, causes a throbbing sensation, lasts 4-72 hours, and is commonly accompanied with nausea, photophobia, phonophobia, and sometimes a migraine aura. While a tension headache may be annoying, the pain is generally mild. A migraine, on the other hand, has a moderate to severe intensity of pain leading to a greater impairment in your daily functioning.

Sinus Headache

Sinus headaches are often confused with migraines because both commonly cause head pain in the forehead. Also, you may get a congested or runny nose with a migraine. In the vast majority of cases, people (and their doctors!) think they are suffering from a sinus infection, when they are really having a migraine.

Clues that you have a frontal sinus infection include:

• fever and/or chills
• nasal discharge that is thick, colored, and ample

To distinguish from other types of frontal headaches, an otolaryngologist (ENT doctor) can perform a nasal endoscopy and possibly a CT scan of your sinus to see if you have a buildup of mucous in your frontal sinus. It can be tricky though because sometimes the CT scan will show a mucous buildup, but the cause of your headache is still NOT sinus disease. This is just the reality of medicine and why the diagnosis of your headaches can be a tedious process.

Hemicrania Contiua

Hemicrania continua is a painful, one-sided headache that occurs all the time on a daily basis without relief. It is a rare cause of headache but occurs on the forehead, as well as the temples, around the eyes, or the back of the head. It is accompanied by at least one autonomic symptom like: nasal discharge, tearing of the eye, miosis. This headache type is responsive to indomethacin, an NSAID.

Quick Note

There are also secondary headaches--headaches caused by a separate medical condition--that may be causing your frontal headache like:

• Giant Cell Arteritis
• Brain Tumor
• Cervicogenic Headache

These are rare causes though and will be discussed in Part 2: Frontal Headaches.

Take Home Message

There are a number of primary headaches that may be causing your frontal headache. Be proactive in your health and talk with your doctor. Getting the right diagnosis is critical to formulating an effective treatment plan.
 
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DISCLAIMER: The information in this site is for informational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for advice, diagnosis, and treatment of any concerning symptoms or medical condition.