Headaches – Literally a pain in the head!

by (Osteopath & Clinical Pilates Instructor)

If you have never suffered from a headache – then consider yourself one of the lucky Australian’s! Headaches are one of the most common problems to affect us, and date back as far as 1500BC!  According the Australian Bureau Of Statistics in 1995 approximately 15%[1] of the population were taking medication for headaches. So you are not alone! But the good news is you do not have to suffer in silence. In this article we will look at a few of the more common headaches, what causes them, potential triggers and a few tips and techniques which will hopefully reduce the frustration and pain caused by these pains in the head!!

So what is a Headache?

A headache is any pain or irritation to the nerves, muscles, joints, ligaments, blood vessels and other pain sensitive structures around the head, neck, face or in the skull. For those who need to brush up on their head and neck anatomy here is a picture..but trust me… thats’ a lot of different structures which could potentially causes headaches! [2]

So now we know what a headache is, what are the different types of headaches? Dehydration headache, hunger headache, sinus, migraine, rebound… there are a vast number of different headaches – you’d give yourself a headache trying to think of them all. To make things a little easier we generally subdivide headaches into categories : vascular, neurological, inflammatory tension etc. But to keep things as simple as possible we will focus on a few of the Primary headaches.

A Primary headache is one which is not associated with a pre-existing or underlying medical condition. Headaches which are caused by medical conditions such as a tumour, high blood pressure or stroke are known as Secondary headaches. Treatment (where possible) of the underlying pathology is needed to resolve these headaches, as the headache is a symptom of the pathology.

The more common, day to day headaches we see are:

Classic Migraine with an Aura

This is generally quite a severe pain that is associated with or without an aura.  An Aura is a common precursor to a migraine whereby the individual is pre warned about the onset of a migraine. This aura can take the form of motor or speech problems or as a visual disturbance such as flashing lights, blind spots or a halo around objects. It is thought that these symptoms are caused by the constriction of blood vessels and the resultant reduced blood flow to the brain and surrounding structures. Note- not all migraine will be associated with an aura (classified as Migraine – No Aura). The pain may be described as throbbing or pounding around the forehead, eyes, back of head or temples. It may remain on one side of the head or swap side’s for each attack and may be associated with nausea, vomiting and the individual experiencing a sensitivity to light and sound. The frequency and severity of these headaches will differ for each individual. We are still unsure as to what causes these attacks- but we are aware of a number of various “triggers.” More about these later!

Tension Headache:

These types of headaches are some of the most common and will have the majority of us reaching for a Panadol when they strike. Often described as being a tightness at the back of the head or neck and the feeling of tension around your head as if it is in a “vice”, or as if you were wearing a headband that was too tight. We further subdivide these types of headaches into Episodic and Chronic. If your symptoms are sporadic and eased with medication, stretching or a quiet dark room – you most likely fall into the episodic category. But if you are taking medication on a daily basis with minimal relief and the pain persistent and frequent – you find yourself falling into the chronic category. These headaches can be associated with an increase in stress levels, anxiety, fatigue or anger.  And just like the Migraine, their intensity and severity differ for each individual.  It is important to note that the severity of a headache is NOT a good indication of his potential dangers. Low grade persistent headaches can be as dangerous as the sudden and severe type and should be investigated fully.

Cluster Headaches:

Generally considered the most painful of any headache or any pain at all – Cluster headaches as their name suggests come in groups of headaches. They are characterised by periods in which they attack. Each attack can last minutes to hours, with the patient experiencing 1-4 per day. They can often experience these daily excruciating headaches lasting weeks to months, but then enjoy periods of complete remission.  The onset of pain is quick, and provides no warning to the patient. This pain is almost always one sided and often described as a searing stabbing and piercing pain, or like the feeling of a hot poker in the eye or through the head. So you can see why they have aptly been nicknamed Suicide headaches[3].

So what can be done to treat headaches? The first step in treating your headaches is a correct diagnosis. It is essential to define the type of headache a patient is suffering from and rule out an underlying pathology – if one exists. Far too often headaches are misdiagnosed resulting in poor and ineffective treatment, which leave the patient frustrated and suffering for longer than necessary. Identifying causative factors is the next step, but what is it that causes headaches? Well this is the million dollar question!! We spoke earlier about “Triggers”. Triggers are anything that result in the patient experiencing a headache. Food triggers for example (Chocolate, Aged cheese, alcohol red or white wine, citrus products, preservatives) will bring about the onset of a headache if consumed, an increase in stress, certain scents, exercise, muscle tension, joint pain, fatigue or even exercise may trigger an attack. And just as each individuals headache is unique to the sufferer, so will each trigger. It is learning to identify what triggers your headache, and avoiding this trigger if possible, that may help in reducing your headaches.

Common Triggers to consider:

Water: Are you drinking 2 Litres per day?

Food: Are there any foods that trigger headaches or that you are sensitive to? Keeping a headache diary which documents all the food you have eaten to identify if there is a common link (Chocolate, cheese, alcohol, salicylates,  etc)

Posture: This is a vital factor – having good posture especially upper back and neck posture is essential in dealing with headaches – poor posture leads to joint irritation, muscular spasm and tightness and possibly headaches. Sleeping posture – is your pillowing and mattress giving your head neck and shoulders the support it needs? Sitting posture in your car – are your mirrors in the correct spot? Desk posture – is your desk ergonomically set up for you? Your posture while undertaking a gym program – do you have good technique? These are all questions you should be asking yourself when assessing your headaches.

Eyes: Having regular eye check-ups (yearly) to determine if you require glasses, may be another causative factor in ongoing headaches.

Stress: How do you manage your stress and where is it coming from? Stress causes the release of adrenaline or cortisol and may play a part in your headaches.

Jaw: grinding your teeth, or having mal-alignment issues may be an underlying factor in your headaches.

Exercise: is the program you are participating in specifically tailored for you?

Seeking help from your manual therapist be it Osteopath, Physiotherapist or massage therapist should be part of your combined approach when addressing your headaches. Your manual therapist should be able to help address the musculoskeletal component of your headaches. Reducing muscular spasm, improving joint range of motion as well as addressing your posture are all aspects which will give you the best chance at effectively treating your symptoms. Your therapist should also work in conjunction with your Personal trainer to ensure you are undertaking your training program safely and effectively and not contributing to your pain with poor technique or over training. Pain medication or anti inflammatories may also help reduce your symptoms. But this should only be taken in conjunction with medical advice and your general practitioner.

So as you can see headaches are a complex condition, requiring a combined approach to get effective pain relief. But the good news is, you are not alone and there is plenty we can do help you manage your symptoms.

And if you’ve got a headache from reading this article, I apologize!

 

[1] Australian Bureau of Statistics.

[2] Source – University of Maryland Medical Centre – online

 

by (Osteopath & Clinical Pilates Instructor) on 26th August 2014 |

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