So You Have a Coin-Shaped Headache that won’t go away…

As bizarre as it may sound to someone who has never had one, there is such a thing as a “coin-shaped” headache – very small and localized, but still painful.

Coin-shaped headache is actually an older term for what we now call nummular headache. Nummular is just one of those fancy medical terms – it comes from the Latin for “little coin”.

The “little coin” headache may actually be little, but it’s often larger than a coin – up to 6cm (about 2 1/3 inches). But it has a definite shape – either round or sometimes more of an oval. It can come and go, but it’s always a specific shape.

Nummular headaches are often on the top/upper back of the head (more rarely there may be more than one “coin” – but always a very localized area). The pain is usually somewhere between mild or moderate, although it can be severe.

But even though it’s usually not as severe as some other headaches, it finds other ways to make life difficult. Although the pain may last only for minutes or days, most often it becomes chronic, lasting for months. Worse pain may flare up at various times.

And it is often accompanied by other symptoms besides pain. For example, the skin may feel strange – numb, perhaps. Or may more sensitive than normal – a feeling of “pins and needles” or burning, or pressure, or just painful to a slight touch.

A new trial will be studying the connection of nummular headache to migraine. Do patients with nummular headache have migraine-like symptoms? If you have chronic nummular headache, you may want to keep an eye on this study: Observational Prospective Study on the Presence of Typical Migraine Features in Nummular Headache Patients: The Numamig Study

If you have a coin-like headache, it’s very important to get it checked out. As you might guess, there are other things that can cause similar kinds of pain. Rashes, such as shingles. Or other diseases, such as cancers.

If the pain is not severe, nummular headache may not be treated at all. It’s enough to know from your doctor that it’s nothing that’s likely to become more serious (such as cancer, of course).

The fact is that common headache treatments simply may not work in this case. However, some treatments have been tried – you can read a summary of some of them here. The most important thing is to rule out other causes, and then talk to your doctor about the best treatment for you.

For more information on nummular headache:

• Nummular headache (The International Classification of Headache Disorders 3rd edition)
• Nummular headache: diagnosis and treatment.