The Complete Guide to Headache Types, Causes and Treatments

Did you know that millions of dollars go towards pain medication every year to help ease headaches? Actually the International Headache Society has classified over 200 different types of headaches.

Studies have shown that approximately two-thirds of the worldwide population suffer from headaches and unfortunately for about one-fifth of the population, these headaches can be both extremely painful and recurrent.

 

What is a headache?

Headache causes in townsville

A Headache is defined as pain coming from the head or upper neck. The pain can vary from being sharp, dull, throbbing, or intermittent,

Within the brain itself there are no pain fibres at all. This means that the brain actually doesn’t feel pain at all.

The pain that you feel actually comes from the tissues that surround, cover and supply the brain.

So Actually What Causes Headaches?

Headache causes range from a simple biomechanical issues which will respond excellently when spinal function is restored to  life-threatening condition that require emergency care.

Understanding the many causes of headaches and their differences is essential to gaining an accurate diagnosis and treatment for your headaches.

There Are two major categories of headache:

  1. Primary headaches;
  2. Secondary headaches;

Primary headaches

A primary headache is caused by problems involving

  • Headache treatment townsville chiropractorthe functioning of your cervical spine
  • the muscles of your head and neck spasming
  • the chemical activity in your brain,
  • The functioning of the nerves and blood vessels around your brain

Most of these headaches are mild, infrequent and resolve relatively quickly. Unfortunately, in very severe cases, they can  be very debilitating and severely reduce your quality of life.

 

Unfortunately X-rays, CT-scans and MRI’s will not help diagnose nearly all of the primary headaches. While problems such as spinal degeneration can be detected, you can suffer headaches with or without some abnormal findings on X-rays or scans. Likewise, having abnormalities detected on a scan do not guarantee that you will have headaches.

Sometimes you can suffer from more than one type of primary headache or migraine and they can overlap. For example, a neck headache can cause increases in muscular tension and blood pressure giving you both neck tension headaches and a migraine at the same time.

The most important thing is that they are not a symptom of an underlying disease. Other life threatening conditions such as stroke can easily be misdiagnosed as a primary headache which is why an accurate diagnosis is so important.

The most common primary headaches types are:

Neck (vertebrogenic) headaches
These are one of the most common form of headache. They originate the structures in the neck and the pain is generally described as a dull, constant ache on one or both sides of their head.

The pain will often start in the upper neck and spread to the top or side of the head and behind the eyes. These headaches usually last anywhere from a couple of hours to days or weeks.

The major cause of these headaches is a loss of normal functioning of the spine leading spinal joint dysfunction and irritation of the nerves and other tissues in the neck. These changes are often associated with traumas such as Whiplash, poor posture or physical stresses such as a poor work environment. 

This type of headache responds exceptionally well to chiropractic care.

Tension headaches
Tension headaches are a very common type of headache. According to the World Health Organization 1 in 20 people in the developed world suffer with a daily tension headache. Tension headaches can be difficult to distinguish from migraines in some cases.

They are described as a mild to moderate pain pressure or tightness across the forehead, behind the eyes and into the temples. The pain can occur infrequently however it can be daily for some people. It is aggravated by certain postures or neck movements and is eased by applying pressure to the base of the skull.

These headaches most commonly originate from spasming or tight neck muscles due to poor posture or restricted vertebral movement. Other common causes include emotional stress, depression, alcohol use, skipping meals and eyestrain.

Tension headaches respond excellently to chiropractic care that involves  a combination of restoring normal spinal function stretching and strengthening exercises and lifestyle changes.

Migraine
A migraine can be severe disabling pain that lasts for hours or days. It is described as a severe throbbing pain and is usually accompanied by other symptoms such as nausea, vomiting, and extreme sensitivity to light and sound.

Visual disturbances, known as auras, are often experienced before a migraine. Another symptom of an impending migraine is a tingling sensation on one side of your face, arm or leg.

There are many triggers for migraines such as hormonal issues, cheeses, chemicals, alcohol and stress. The actual causes of migraines aren’t known however if parents suffer migraines there is a 70% chance that their children will get them as well.

Cluster headaches
Cluster headaches are a very painful type of headache often described as excruciating pain on one side of the head and behind one eye.  They usually occur at night and last from 15 minutes to three hours. This rare headache usually lasts over a few weeks with long periods in between episodes and affects less than one person in every 1,000.

It is believed that the hypothalamus (the part of the brain regulating our sleeping) activates the trigeminal nerve causing these headaches, however that is yet to be proven.

The symptoms of cluster headaches are as a constant piercing or burning pain behind one eye or in the region surrounding it, swollen eyes and nasal congestion.

Cranial Neuralgia
These headaches are caused by inflammation in the upper part of the neck and the cranial nerves. The most common nerve affected is the trigeminal nerve. This sensory nerve supplies sensation to the face and can cause intense facial pain when inflamed. This is called trigeminal neuralgia.

Other cranial nerves that can be affected are the glossopharyngeal nerves which can cause pain in the throat, tonsils, tongue and ears and the occipital nerve which causes chronic pain at the base of the skull and in the upper neck.

Chiropractic, acupuncture and massage have all been found to help with this condition and should be the first treatment considered. Drugs are available that aim to suppress or block the nerves. There are some surgical procedures that can be considered however due to risks involved should be considered last.

Exercise headaches
These types of headaches occur during or after sustained, strenuous activity such as running, swimming, lifting weights or even sexual intercourse. It is described as an explosive pain that and can last from 5 minutes up to 48 hours and is located on both sides of the head.

Clinically these headaches respond very well to chiropractic care.  Restoring the normal function to the spine and is often found to relieve or stop these headaches.

Exercise headaches are usually self-limiting, however, they can indicate an underlying pathology. In older people it is important to look for any hidden underlying disease processes.

Secondary headaches

A secondary headache is one where a condition somewhere in the body is causing the pain in the head. These causes can vary from very minor to life threatening such as aneurysm, stroke, coronary disease or Inflammation.

The most common secondary headaches are:

Eyestrain
Eyestrain headaches can occur when you use your eyes to perform certain activities such as reading, working with computers and driving long distances. Headaches that accompany eyestrain are usually mild and dull in nature. The headaches a person feels when their eyes are tired and overworked, and are felt on both sides of the head, around the temple area.

Massaging both temples,  taking a break and altering the room’s lighting condition can give you relief from these headaches. Wearing prescription glasses or contact lens to correct your eye conditions can also prevent eyestrain headaches.

Headaches related to eyestrain can also be caused by underlying eye conditions that need to be investigated by an optometrist.

Menstrual and Hormonal Headaches
These headaches are believed to be related to changes in the level of the hormones estrogen and progesterone and can be brought on by hormone treatments, including birth control pills or other hormonal contraceptives.

Hormonal headaches are described as pain in one or both sides of the head that lasts for a few hours to a few days. They are often accompanied by nausea, vomiting, dizziness and blurred vision which can all be confused with migraines.

Many women find that regular chiropractic care can lead to a reduction in both the intensity and frequency of hormonal headaches. Whether this is the effect of improved spinal function or influencing hormonal levels has not been tested or proven yet.

Dehydration
Dehydration occurs usually when you don’t drink enough water, especially in hot weather. Severe diarrhoea, vomiting  or a fever can also cause it. Mild to moderate dehydration is easily reversed by drinking more fluid. In severe cases an IV drip may be needed.
Caffeine Headaches
The symptoms of a caffeine headache are a pounding headache and also fatigue and having difficulty concentrating. They affect people trying to reduce or eliminate their caffeine intake and are cause by a caffeine withdrawal. The good news is that the pain will go, however it can take a few days or weeks.

Caffeine acts like a stimulant on the brain. Quitting cold turkey is the fastest way to remove caffeine addiction however it can cause the most severe withdrawal symptoms.

Taking caffeine-free pain relievers and abstaining from alcohol for the duration of the withdrawal period helps alleviate the pain.

Sinusitis
The cavities in our skull above the eyes, forehead, cheekbones, and the bridge of our nose are called our sinuses. Sinus headaches are caused by inflammation, congestion or an allergic reaction increasing the pressure in these areas.

Sinusitis usually occurs after a viral infection or cold and includes thick, discoloured nasal mucus and pain in one or both cheeks. The pain is usually worse when bending forward. Other symptoms of sinusitis are pain in the upper teeth and a feeling of swelling or fullness in the face.

These headaches can be confusing as they share a number of similar symptoms with tension and migraine headaches.

Home remedies to relieve sinus pain include nasal irrigation, breathing moist air using a steam vaporizer or a humidifier. Alternating hot and cold compresses on the congested areas can also help.

Concussion
Concussion occurs after a traumatic brain injury that can occur after an impact to the head or after a whiplash-type injury. Sometimes the symptoms are not immediately obvious and can last for days or weeks.

The common symptoms of concussion are headaches, loss of memory, dizziness, balance problems, confusion, nausea, vomiting and slurred speech.

A concussion can occur without any loss of consciousness so often patients won’t realize they have concussion. It is not usually life-threatening and the effects are temporary, it can however cause serious symptoms that require medical treatment.

Rebound headaches
Rebound headaches occur when pain relief medications are overused for a prolonged period of time. They usually stop once all the medication has been stopped. They typically improve with more pain relief medication but then return as the medication wears off.

Rebound headaches occur almost every day on waking up in the morning. They will improve with your usual pain relief medication but then return as the medication wears off. You may also experience nausea, difficulty concentrating, memory problems and irritability.

Hangover Headaches
Hangover headaches are caused by excessive alcohol consumption however some people can experience this after light to moderate drinking and is described as a splitting headache. Remember that alcohol is a migraine trigger which means headaches could be an undiagnosed migraine.

Alcohol acts as a diuretic (it removes fluids from the body) so drinking water during your night out and before you go to bed is a great help. Dehydration causes many of your hangover symptoms.

There are no proven cures for a hangover. Some suggested cures are sweet drinks, ginger or peppermint tea and asparagus. We don’t recommend having all of these in the same glass.

Influenza
Influenza is a viral infection that affects your nose, throat and lungs. The symptoms of influenza are a temperature over 38 degrees aching muscles, chills, sweats persistent cough, fatigue, sore throat and nasal congestion. It usually resolves on its own however its complications can be very serious and even deadly.

A fever and headaches at the same time can also be a sign that there’s something much more serious that is causing the symptoms such as bacterial meningitis and encephalitis.

Relieving symptoms will not help to cure the underlying illness but will make you feel better and more comfortable. For this reason medications that can lower a person’s temperature and relieve headaches can be useful.

TMJ Headaches
Temporomandibular joint (TMJ) headaches caused by dysfunction of the temporomandibular joint are easily confused with migraines or sinus issues.

TMJ headaches are described as a dull, aching pain located around and inside the ear which can radiate toward the temple and neck area. It can be aggravated by talking excessively and chewing. When there is a structural issue with the TMJ you can feel a click in the joint on movement and have difficulty opening the moth wide.

Functional changes in the TMJ joint are often found to be caused by spinal problems and in these cases respond excellently to chiropractic care. When the joint is damaged a dentist trained in neuromuscular dentistry may help.

High Blood Pressure
Headaches can be caused by high blood pressure and dangerously some patients can have no other obvious signs or symptoms of the problem. Indeed the high blood pressure is often found when investigating the headache.

The best treatment for mild hypertension is lifestyle change such as exercise and a very healthy diet. In severe cases medication can be extremely important in controlling the hypertension and stopping other potential problems such as stroke.

Stroke
A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Early medical intervention can minimize brain damage and potential complications.

The most common symptoms of a stroke are a sudden dizziness, slurred speech confusion, severe headache, blurred vision, loss of balance or coordination, numbness of the face, arm or leg.

If you suspect a stroke seek urgent medical attention.

Brain Aneurysm
Brain Aneurysm is the bulging of one of the arteries in the brain, which can often lead to a stroke. An aneurysm will often not cause any symptoms until it ruptures and are often only found during tests for other conditions

The symptoms of are a ruptured aneurysm are a sudden, extremely severe headache, nausea and vomiting, visual disturbances, confusion, severe light sensitivity. The headache is often described as “the worst headache I have ever had.”  This is a life-threatening condition that requires immediate medical treatment.

Brain Tumours
There are two different types of brain tumors, benign (noncancerous) and malignant (cancerous). They can start in your brain (primary brain tumors), or they can spread to your brain from other parts of your body (secondary or metastatic brain tumours).  The most common causes of metastatic brain tumors are breast, colon, kidney and lung cancer.

The most common symptoms of a brain tumor are headaches that are new, different and usually, more severe headaches, nausea or vomiting, visual problems, loss of balance, speech difficulties, confusion behavioural changes and seizures. These vary greatly depending on the size, location and the rate of growth of the tumor.

Encephalitis & Meningitis (brain inflammation)
The most common cause of the encephalitis and meningitis is a viral infection. The symptoms of this can be a sudden high fever, stiff neck, severe headache, light sensitivity, confused thinking, skin rash, seizures or changes in vision and speech.

Both encephalitis or meningitis require immediate medical attention.

Hematoma
An intracranial hematoma occurs when a blood vessel ruptures in or around your brain. The hematoma compresses your brain tissue, and is usually caused by trauma to the brain. Hematoma is potentially life-threatening and often requires surgery to remove the blood.

The symptoms of an intracranial hematoma may be immediate or may develop with time. As the pressure on the brain from the bleeding increases symptoms will develop such as a progressive worse headache, vomiting, progressive loss of consciousness, confusion, slurred speech seizures and unconsciousness.

How do you find out what is causing your headaches?

HISTORY

To diagnose what is causing your headaches the first step is to get a complete history of your problems. You will be asked about your symptoms, how often the headaches happen, what makes them worse, and what helps you feel better.

Sometimes it’s helpful to keep a headache diary to record the frequency, severity and triggers of your headaches.

EXAM

Once the history is completed a physical examination will be performed to find any underlying causes of your headaches. This will consist of neurologic, orthopaedic and functional examinations. With primary headaches the neurological and orthopaedic examination will be essentially normal however the functional testing will help differentiate if chiropractic care can help you. Any abnormality on neurologic or orthopaedic examination will need to be investigated further.

Testing

What tests are performed depends on which specific disease, illness or injury are suspected to be causing the headaches.

The most common tests include:

  • blood tests
  • x-rays
  • Computer Tomography (CT scan) of the neck
  • Magnetic Resonance Imaging (MRI) scans of the head
  • Lumbar puncture

How Are Headaches Treated?

The best treatment of any headache is always based on getting an accurate diagnosis of what is actually causing the pain. Regardless of whether you are seeing a chiropractor, doctor or masseur for your headaches the cause should be found before any treatment is started.

Most of the primary headaches discussed above will respond well to improving the functioning of your spine and implementing lifestyle changes. A specific treatment plan should be designed for each patient allowing for their specific headache type and their individual circumstances. Occasionally medication may be necessary to help reduce headache symptoms.

The secondary headaches discussed above also need to have a specific treatment program designed for each individual patient. This can be anything from a collaborative effort between chiropractors, doctors and specialists to the urgent intervention of surgeons. That is why the diagnosis is so important.

Which health care professional should I see for my headaches?

Each of the health care professions can play an important yet different role in correcting your headaches. Indeed sometimes they will just use different points of intervention to create the same outcome.

Chiropractors

Chiropractors specialise in restoring normal movement and balance to the spine and surrounding structures. They have a wide range of techniques that involve spinal manipulation (where you may hear a clicking in your spine) to low force techniques using very gentle drop piece and activator instruments. They will also use non manipulation techniques such as mobilisation.

Chirorpactors will choose the best technique that is most suitable for you and combine this with specific stetching and strengthening exercises and lifestyle changes to reduce or stop both the frequency and severity of your headaches.

Doctors

Your doctor has one of the most important roles in headache treatment. They help provide the accurate diagnosis that is vital in the treatment of your headache. Indeed, when some of life threatening secondary tumors are involved, early intervention can be the difference between a good and a catastrophic outcome and in some cases an early death.

They will organise the relevant testing, provide prescription medication where necessary and arrange opinions from a wide variety of specialists such as neurologists, neurosurgeons, cancer specialists and many more to diagnose and treat your headaches.

 

Massage Therapists
Massage Therapists help headache sufferers by relaxing the muscles in the neck and shoulders which can be very effective. Sometimes you find that massage is giving you headache relief however the pain will return after a few days. This usually indicates that there is an underlying spinal problem that is causing the muscle tightness. In this case the headaches will keep returning until the spinal problem is corrected.

Massage Therapists get good results with some primary headaches and also provide some relief to some of the secondary headache types.

Physiotherapists
Physios aim to relieve headaches through relaxation of muscles in the neck. They may also use acupuncture/dry needling, massage and TENS, IFC (Interferential Current) or EMS (Electrical Muscle Stimulation). They will use the same exercises as the chiropractors: specific stretching and strengthening exercises.

They get good results with some primary headaches types and also play a vital role in some of the secondary headache types such as stroke where long periods of rehabilitation are involved.

Specialists
Specialists There are a wide variety of specialists such as neurosurgeons, radiologists or rheumatologists who may be involved with your headache treatment. Initially they will be involved at the level of ruling out many of the secondary headache types that can be life threatening such as stokes, tumors and infections.

When necessary they will also play a vital role in the treatment of the underlying condition that is causing your headaches.

Pain Management
Unfortunately some patients suffer from headaches where the cause is not completely treatable and they are left with chronic look term pain. A pain management clinic can provide a multidisciplinary approach to help people  manage their pain.

These clinics can include doctors of different specialties as well psychologists, chiropractors, physiotherapists, acupuncturists or massage therapists.

Their treatment can involve medications for pain control councilling and advice on lifestyle changes

DRUG TREATMENT FOR HEADACHES
Some people don’t need medical intervention at all and respond well to improving their spinal function with chiropractic care combined with lifestyle and diet changes. Others require occasional over the counter (OTC) medications such as aspirin and iboprofun and stress management.  For those with long term severe, pain medication may be required to manage their pain and symptoms.

There many drugs that are used for the treatment for headaches including analgesics such as aspirin and paracetamol based drugs, nonsteroidal anti-inflammatory drugs (NSAIDS).

Liniments that are usually made with components of natural medicines and herbs can also help relieve headaches. They are usually available without prescription.

It is important to remember that OTC medications can have both side effects and potential interactions with other prescription medications. This should be checked with your medical practitioner.

With some headaches such as severe migranes or with some of the secondary headches types, prescription medications may be needed to control the symptoms when necessary. Corticosteroids, opiod based drugs, muscle relaxants and antidepressant drugs may be recommended  in these cases.

It is often helpful to keep a headache diary can help you note any patterns or changes in how you feel. stick to healthy habits that will keep you feeling good, like regular exercise, enough sleep, and a healthy diet. Also, make your scheduled follow-up appointments so your doctor can see how you’re doing and make changes in the treatment program if you need them.

What you can do at home to relieve headaches

  • Apply a hot or cold compress to your head
  • have long, hot shower stretching the head and neck under hot water
  • get some rest and staying well hydrated
  • massaging your temples and the muscles in your neck
  • Improve your posture while standing & sitting
  • Sit/stand up straight
  • Stretches should done several times throughout the day
  • Keep hydrated!

Seek emergency care

You need to seek immediate medical care if you experience any of the following:

  • Headaches that you feel are the “worst headache of your life.”
  • Headaches that start suddenly, occur more often or are more severe than usual
  • Headaches that are getting progressively worse
  • Headaches that are associated with fever or stiff neck
  • Headaches that are associated with recent head trauma or a fall
  • headache after cough or sneeze, exercise, coitus or head turning
  • Confusion or trouble understanding speech
  • Fainting
  • High fever, greater than 38C
  • Numbness, weakness or paralysis on one side of your body
  • Trouble with seeing, speaking, behaviour or walking
  • Nausea or vomiting
  • Sudden weight loss
  • A headache after a head injury,
  • High fever
  • Sudden or severe headache – “thunderclap” type headache.
  • A previous history of cancer.

For more information about headaches that are potentially life threatening see our blog:

Fatal Headaches – 7 symptoms you must not ignore

Copyright Ansell Chiropractic ©2016

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