Headaches - it’s all in your head

Headaches are a real pain. They can cause you to be unclear in your thinking and can significantly impact on your attitude and enjoyment-factor towards your everyday life.

There are a number of different types of headaches however, in clinic the headaches which present the most include:

• Tension-type headache

• Migraine

• Cervicogenic headache

Take note that there may be an overlap in the diagnosis of these headaches.

When presenting with a headache, many factors need to be taken into consideration including:

• How long have the headaches been present for?

• Where do you feel the pain? (eg. temples, base of the skull, across the forehead).

• What is the nature of the headaches (eg. gripping / vice-like, throbbing, constant, pulsating etc)

• Are there any associated symptoms including visual changes, gut symptoms, ringing in the ears etc?

• How often are the headaches occurring?

• Are there any triggers to the onset of a headache?

• What can you do (if anything) to relieve the headache?

	Migraine	Tension-Type	Cervicogenic
Location	One-sided (in the temple)	Both sides - across the forehead & temples	Base of the skull radiating over the skull to the forehead (generally one-sided)
Type of pain	Throbbing	Gripping, vice-like	Radiating, constant. May become exacerbated with certain movement or positioning of the head & neck
Symptoms	Can present with or without an aura Nausea Dizziness Vertigo	Blurry vision Pain / tension / stiffness in neck, shoulders and/or jaw Nausea	Pain / tension / stiffness in neck, shoulders and/or jaw Nausea
Triggers	Food (chocolate, wine) Stress Hormonal changes	Stress	Neck dysfunction Jaw dysfunction (potentially related to disc, joint, muscles)
Treatment	Avoid triggers Some medications may help Manual therapy can assist	Manage stress Relief from manual therapy & management interventions (eg identifying stress triggers) Analgesics	Generally responds well to manual therapy & management interventions Analgesics

According to Beran (2012), symptoms related to headaches requiring further investigation include:

• Headaches which are exacerbated by sneezing, coughing or bearing down

• Headaches exacerbated by postural changes (stooping or bending over)

• Headaches associated with eye movement or blurry vision

• Significant changes in the quality, site and nature of the headaches

• Headaches which are not responding to appropriate treatment

• Headaches associated with a stiff neck, symptoms of infection, generalised aches and pains, and skin rash (need not have all of these symptoms)

Being guided by an health-practitioner is an important aspect in the management of any headache presentation. They will be able to interpret your presentation and guide you towards the best treatment and management for that specific type of headache.

These headaches as outlined above tend to respond brilliantly to manual therapy where the focus is on restoring the quality of movement in the neck, upper back and ribs, in addition to decreasing muscle tension in these areas. The jaw is also assessed to determine whether this could be a contributing factor to the presentation.

Management techniques range anywhere from breathing exercises & neck stretches, to desk and car ergonomics. Implementation of a management plan follows a thorough history. The history will help to identify potential triggers for these headaches which can help to identify an ‘easy solution’ to a very painful problem!

We LOVE treating headaches. If this is something you would like help with, click HERE to book and appointment or call the clinic on (03) 9052 4220.

REFERENCES

(Headache Australia, 2018) Headache Types. Retrieved from: https://headacheaustralia.org.au/types-of-headaches/

Beran, Roy G. (2012). Neurology for General Practitioners. NSW, Australia: Sophie Kaliniecki