Risk Factors for Headache

A risk factor is something that increases your likelihood of getting a disease or condition.

It is possible to develop headaches with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing headaches. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.

Risk Factors for Tension Headache

Specific Lifestyle Factors

Poor posture, such as holding a phone between your shoulder and ear puts stress on the muscles and can result in tension headaches.

Medical Conditions

Certain conditions are associated with tension headaches and tightening of the muscles in the neck, face, and scalp. These include:


Women are at greater risk of tension headaches than men.

Genetic Factors

Approximately 40% of individuals with tension headache have a positive family history.

Risk Factors for Migraine

Specific Lifestyle Factors

Several lifestyle factors may trigger a reaction in the blood vessels that brings on a migraine headache. These include:

  • Lack of sleep
  • Skipping meals
  • Drinking alcohol, especially red wine
  • Excessive exercise
  • Eating foods with monosodium glutamate (MSG) or nitrates (such as red wine and nuts); eating cheese or chocolate
  • Stress
  • Travel


Use of certain medications may trigger a migraine, including:

  • Birth control pills or hormone replacement therapy (There may be some relationship between female hormones and migraines.)
  • Drugs that dilate the blood vessels (They change blood flow in the brain.)
  • Headache remedies used on a daily or near daily basis


The highest incidence is in teenage years.


Migraine headaches are more common among females—with a 3:1 female to male ratio.

Genetic Factors

Migraines seem to run in families. Approximately 90% of migraine patients have a positive family history.


Migraines may be triggered by the blood vessels overreacting to a variety of factors, including:

  • Menstruation
  • Fatigue
  • Changes in altitude, weather, or time-zone
  • Glaring lights
  • Perfumes or other odors

Risk Factors for Cluster Headache

Specific Lifestyle Factors

Cluster headaches seem to occur more often in heavy smokers, shift workers, and drinkers. The reason is not understood.

Medical Conditions

Having head surgery or a head injury increases your risk of cluster headache.


Risk is greatest between 20-40 years old in men, whereas women have a later onset at age 60 and beyond.


Males are at greater risk for cluster headaches than females—with a male to female ratio of 6:1.

Risk Factors for Sinus Headache

Medical Conditions

Certain medical conditions increase nasal secretions and cause swelling in the tissues lining the nasal passages. These changes lead to nasal congestion and stuffiness. The nasal passages become blocked and normal drainage cannot occur. Secretions that are trapped in the sinuses may become infected with bacteria or, rarely, fungus. The swollen tissues or infection may create pain and pressure.

Conditions that increase sinus pressure and increase your risk of sinus headache include:


Swimming in dirty water can cause an infection leading to a sinus headache if the water enters the nasal passages.


Bigal ME, Lipton RB. Modifiable risk factors for migraine progression. Headache. 2006;46:1334-1343.

Brandes JL. The influence of estrogen on migraine: a systematic review. JAMA. 2006;295:1824-1830

Gardner KL. Genetics of migraine: an update. Headache. 2006;46:S19-24.

Headache—frequently asked questions. National Headache Foundation website. Available at: http://www.headaches.org/education/Tools_for_Sufferers/Headache_-_Frequently_Asked_Questions. Accessed September 11, 2008.

NINDS headache information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/. Updated July 2008. Accessed September 11, 2008.

Last reviewed July 2008 by Rimas Lukas, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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