The Complete Guide to Headache Types, Causes and Treatments
What causes your headache?
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.
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.
What is a headache?
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. 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.
What Actually 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:
- Primary headaches;
- Secondary headaches;
A primary headache is caused by problems involving
- the 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 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.
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 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.
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.
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.
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:
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
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.
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 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.
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 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.
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.
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 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
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.
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.
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.
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)
Both encephalitis or meningitis require immediate medical attention.
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?
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.
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.
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
- 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 aim to restore 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.
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 get good results with some primary headaches and also provide some relief to some of the secondary headache types.
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.
When necessary they will also play a vital role in the treatment of the underlying condition that is causing your headaches.
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
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
- 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:
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