There are many different types of headaches. The one thing that is well understood about headaches is that their causes tend to be complex.The most common headaches that people suffer from are Tension Type and Migraine headaches. However, headaches can be caused by other factors like high blood pressure, medication side effects, sinusitis, exercise, and dental issues.
The conventional approach to treatment has been limited primarily to utilizing medications. The results of this approach have been less than optimal and involve unwanted side effects.
The trend today is moving toward a multidisciplinary approach to the diagnosis and treatment of many headache disorders. Using a team of medical specialties allows for a more thorough understanding of the needs of that specific patient.
Migraine and Tension Headaches
Migraines often begin in the evening or during sleep. In some people, the attacks are preceded by several hours of fatigue, depression, and sluggishness or by irritability and restlessness. Because migraine symptoms vary widely, at least half of all migraine sufferers think they have sinus or tension headaches, not migraines.
Migraines occur less often than tension-type headaches, but they are usually much more severe. They are two to three times more common in women than men. Neurologists believe that migraines are caused by changes in the brain’s blood flow and nerve cell activity. Genetics play a role since 70% of migraine victims have at least one close relative with the problem. New research is also pointing to spinal dysfunction as a common factor in many migraine sufferers.
Although a migraine can come on without warning, it is often set off by a trigger. The things that set off a migraine vary from person to person, but a migraine sufferer usually remains sensitive to the same triggers.
About 20% of migraines begin with one or more neurological symptoms called an aura. Visual complaints are most common. They may include halos, sparkles or flashing lights, wavy lines, and even temporary loss of vision. The aura may also produce numbness or tingling on one side of the body, especially the face or hand. Some patients develop aura symptoms without getting headaches; they often think they are having a stroke, not a migraine.
The majority of migraines develop without an aura. In typical cases, the pain is on one side of the head, often beginning around the eye and temple before spreading to the back of the head. The pain is frequently severe and is described as throbbing or pulsating. Nausea is common, and many migraine patients have a watering eye, a running nose, or congestion. If these symptoms are prominent, they may lead to a misdiagnosis of sinus headaches.
Just like with Tension-type headaches, many migraine sufferers have certain examination findings in common. The patient usually has a loss or reversal of the normal curvature in their neck with an associated predictable pattern of muscle tension and imbalance. Spinal joint dysfunction is common in these patients and palpation of the joints and muscles in their neck is painful. Muscular Trigger Points are also commonly found in predictable locations and can at times reproduce the pattern of pain that the patient is experiencing.
Recently, scientists have begun to understand that mechanical dysfunction of the cervical spine can have a direct effect on the trigeminal nerve. This nerve supplies sensation to the crown of the head, the face, and the jaw. The body of the nerve, called the nucleus, descends down the brainstem to the level of the 2nd vertebrae in the neck. Due to the convergence of nerves of the nucleus and the spinal nerves at that level, painful or noxious stimuli can have a direct effect on the nucleus. This in turn causes pain in the head and face.
When the issues that are causing that stimulation are addressed and corrected, the pain resolves. This convergence is also the reason that migraine sufferers without cervical spine issues often feel associated neck pain.
The typical tension headache produces a dull, squeezing pain on both sides of the head. People with strong tension headaches may feel like their head is in a vise. The shoulders and neck can also ache. Some tension headaches are triggered by fatigue or emotional stress. Most last for 20 minutes to several hours.
Experts today understand that people who suffer from ongoing Tension-type headaches are “primed” to do so. This is also true for many who suffer from Migraine headaches. What this means is that although certain things like stress, fatigue, foods, etc. can “trigger” the headache event, that individual was already much closer to that painful threshold than most. The reasons why are many and should be sought out for each patient, but there are some commonalities.
Most individuals who suffer from recurrent tension-type headaches have had some form of injury that has previously affected their neck. These injuries could have come from many different sources including a slip and fall, a car accident, or a traumatic birth. The patient usually has a loss or reversal of the normal curvature in their neck with an associated predictable pattern of muscle tension and imbalance.
Spinal joint dysfunction is the rule rather than the exception in these patients and palpation of the joints and muscles in their neck is painful. Muscular Trigger Points are also commonly found in predictable locations based on the pattern of pain that the patient is experiencing.
Each of these factors could in itself be a cause of headache pain. However, these factors in combination create a well-laid foundation for recurrent painful episodes. When these issues are addressed and corrected, the individual moves much further away from the threshold of these painful events.
Many patients who had been suffering from frequent painful episodes can again begin to enjoy a pain free life. The success lies in correcting the cause and not just treating the symptoms.