Headache sufferers often feel like someone hit them in the head with a sledgehammer. But with the proper diagnosis and treatment, patients can find some much-needed relief.

Humans have been getting headaches for thousands of years. In ancient times, people went as far as to drill holes in their skulls to relieve the pressure. While we don’t yet have a cure for headaches in 2014, we certainly have better options for treating them.

Robert Beck, a neurologist at Lawrence Memorial Hospital

Just ask Robert Beck, a neurologist at Lawrence Memorial Hospital who has made it a point of his career, since his days serving in the Navy, to educate the public about headaches.

The first thing that’s important to distinguish about headaches, he says, is the two different types: primary and secondary.

In primary headaches, which make up about 95 percent of headaches, the pain is caused by the miscommunication of brain cells. These include migraine, tension and cluster headaches.

In secondary headaches, the pain is the result of something else: a brain tumor, an aneurysm, an infection. That’s why doctors often take MRIs or CT scans of headache sufferers: to make sure the pain isn’t a sign of a more serious condition.

Once that’s ruled out, the work gets harder.

“Migraine, tension and cluster headaches are caused by microscopic events within the brain. And we don’t have microscopes to look at your brain with,” Beck said.

There are genetic factors that predispose people to headaches. Women are susceptible to headaches during their menstrual cycles. But headache causes differ according to a person’s lifestyle and environment.

Further complicating things, Beck said, migraines actually start a day or two before the pain begins, with symptoms such as dizziness, irritability and fatigue. When the pain finally comes, the person might wrongly blame the meal they just ate for their headaches.

Still, certain things are known to cause or exacerbate headaches: aged meats and foods containing nitrates and MSG, weather, stress, caffeine.

The frequency and severity of headaches often determines the course of treatment, Beck noted. For instance, if you have a headache six days or less per month, you can likely get by with short-acting medications (Tylenol, Excedrin, prescription migraine meds) that you take at the onset of headache. If you have them more frequently, you may need preventive medications that you would take daily. For many people, the neurologist said, even getting headache frequency down to a manageable level (a few times per month) can be a great relief.

Beyond that, treatment options vary widely, Beck noted. Possibilities include meditation, yoga, acupuncture, chiropractic, cognitive behavioral therapy, neurofeedback, biofeedback, Botox injections and IV therapies. A low-fat vegetarian diet, an elimination diet or supplements like riboflavin and melatonin can be also options for some patients.

Even with the prevalence of headaches nowadays, it can be hard for the general public to empathize with headache sufferers.

“A majority of the population is not going to have severe headaches, so they can’t imagine what you’re dealing with,” Beck said. “When you have a severe headache, it can follow you around and you can’t really do anything. And maybe people who have it can’t necessarily find other people who feel the same way, so they get lost.”