I am not sure which article to use in the following context:

  • She has been suffering from a headache.
  • She has been suffering from the headache.

Please clear up my doubt.


Peter Shor hit on something very pertinent in his comment to Barrie England; when discussing maladies, sometimes English uses the, sometimes a, and sometimes no article at all:

Andy caught the flu.
Randy suffered from the mumps.
Candy had the measles.

Fred had a headache.
Ned had a sprained ankle.
Ed had a cold.

Fran has arthritis.
Ann has thyroid cancer.
Dan has depression.

Sure, the variants abound:

Candy had measles last summer.
Ed caught the common cold.
Dan had a bout of depression.

I would think that, in the context provided by the O.P.:

She has been suffering from a headache.

would be more common than:

She has been suffering from the headache.

but that doesn't mean the article the would never be used:

Last night, she had the headache of her life.
This medication will help alleviate pain from the headache.

(although, in that last example, I'd might be more apt to use alleviate headache pain, depending on the context).

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    And Ngrams shows that you used to suffer from the gout and from headache, rather than from gout and from a headache. So we were inconsistent in the past, and we're differently inconsistent now. – Peter Shor Oct 21 '12 at 17:25
  • 'Had a flu' once existed - in fact, an Ngram shows a slight increase in its use in the last 40 years, which surprises me. – Edwin Ashworth Oct 21 '12 at 22:11

In sentences such as your examples, The headache was used in the past, but it's now ususal to speak of a headache.

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    But we still suffer from the flu, the measles, and the blues. So this usage hasn't vanished for all ailments. – Peter Shor Oct 21 '12 at 12:20

J.R provides a great list of examples of article use in various diseases and conditions. His examples seem to suggest a vague pattern.

Chronic diseases and conditions - (arthritis, thyroid cancer, depression) usually take no article. They are not discrete but an ongoing state. Simiarly, tuberculosis, Lyme disease. There are exceptions. I have heart disease. However, I have a heart condition.

Diseases and conditions that you get many times - (headache, backache, cold) often are preceded by a when you aren't trying to distinguish this bout from a different episode. I had a cold last winter; but The cold I had last winter was a killer. There are numerous exceptions. I had the flu and I suffered from hay fever all summer.

Diseases and conditions that you get only once - (mumps, measles) when these take an article, often take the. But they sometimes do not take an article (chicken pox, rubella). And they may take a if proceeded by bout. I had a bout of measles.

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"The" refers to a specific headache while "a" is any headache. If the writer has already mentioned the subject as having a headache, then use "the" to show it is the same headache and "a" if it is a new one. If it is the first mention, use "a."

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In English, the definite article is used to refer to a specific, individual object. So to use the, the thing referred to must be already known to the listener/reader or have been identified in a previous sentence or be identified specifically in the same sentence.

I have a headache. I cannot move because of the headache.


I could not move because of the headache that had begun as soon as I thought about returning to work.

Here's one I couldn't resist, sorry...

We didn't have sex last night. She had the headache.

To use the definite article to refer to an unidentified object is to create for the listener/reader an expectation of significance yet to be explained. This can be used for powerful literary effect....

The man was there again; she would have to find another way home.

or, in a third person narrative, can simply indicate that the object is familiar to the protagonist (and is too commonplace to require explanation).

Anyway, to answer your question directly; "a headache" is the appropriate article in your example unless she regularly has a particular kind of headache in particular circumstances and this is known to the person with whom you are communicating.

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  • I know that in some other languages, Spanish being an example, the definite article is used when referring to one's own body parts. Maybe there's a bit of the old Latin coming through. – Alan Gee Oct 21 '12 at 10:10

Well, this is a good example of why learning English as a second language is difficult.

'She has a headache' is the normal way to speak, and 'She has the headache' would be used only to compare, if there is someone else who might have a headache. Otherwise, 'the headache' would definitely be a mistake, and point to the speaker as likely coming from European languages such as French which emphasize the definite article.

J.R. has a good set of examples, so maybe we can understand a little as to why these may occur — thus to try to put a little sense into a language mixed from others.

  1. To not use an article at all, is to take a British custom. It wouldn't be done in American English, which may still be considered the most common International English.

  2. Most of the time in American English we say 'a condition'. When 'the condition' is used, as in 'the gout', that's usually because the condition is a bit unusual or perhaps a bit socially undesirable, which seems to trigger the use of an archaic language form to distance it. Gout is after all a bit historic, and also associates (not at all necessarily fairly) to eating too many rich foods or gluttony.

These are indeed anecdotal and opinions, but based on having lived in the U.S., Britain, and Europe each for considerable time.

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    'The headache' could also mean that you're reading a 19th century novel and/or an author who wants to sound like he's writing in the 19th century. – Marthaª Oct 21 '12 at 20:06
  • @Martha: From Ngrams, 19th century writers might have said "she has headache", but probably wouldn't have said "she has the headache". But maybe "she has the headache" has more verisimilitude. – Peter Shor Oct 21 '12 at 22:08
  • Ah, good point about clarifying who has the headache. Thinking about it, that's potentially another case of the item under discussion having already been identified (Somebody has a headache; which is the woman with the headache?). – itsbruce Oct 22 '12 at 9:16

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