I am queen of the hypochondriacs. I have gone to the ER on multiple occasions and have actually uttered the words “I think I’m dying.” And though my health isn’t perfect (far from it, judging by the bag of Nachitas I started … and polished off last night), I am happy to report that most of the time, my hunches are wrong.

So what exactly is a headache anyway? It’s not actually your brain that’s hurting, though it may feel like it after an all-nighter before a big exam. According to the National Institute of Neurological Disorders and Stroke, there are four types of headaches — vascular (relating to your blood vessels), muscular, traction and inflammatory. A migraine or a headache caused by a fever is vascular, while the more common tension headache is muscular. Traction headaches are caused by pulling, pushing and stretching of the head’s pain-sensitive areas, and inflammatory headaches are caused by — you guessed it — an inflammation somewhere in your head, such as a sinus infection.

Tension headaches tend to happen again and again and are often caused by — you guessed it — tension, whether it be actual muscle tension or tension from emotional stress in your life. These headaches are often characterized by a constant (not throbbing) pain on both sides of your head (not only one side, which is more characteristic of a migraine headache). Usually, they can be treated with an over-the-counter painkiller like acetaminophen or ibuprofen, but if you’re getting them often, experts suggest you keep a headache log to see when the headaches usually occur to see if you can pinpoint a cause. For example, if you always seem to get them after a long day hunched at your desk at work, your posture could be to blame. (Or, if you always get them when your boss comes by your desk, maybe you should switch jobs.)

So when is a headache actually a symptom of a brain tumor? Well, not every headache is that dire, but you should definitely call your doctor if the headache comes on suddenly, is nothing like you’ve ever experienced before, is worse when you wake up, or is accompanied with nausea, vomiting or dizziness. When in doubt, check it out — that’s my motto. After all, as this boy and his family know all too well, you never can be too careful.

For more on different kinds of headaches, check out our headache guide. And for those of you migraine sufferers out there, check out a new herbal remedy that may help relieve your pain.

When is a tension headache a sign of a more serious medical condition?
I get bad headaches all the time that really prevents me from functioning. Is there any way I can tell for sure what causes it?