There are many different types of headaches. The one thing that we all know about headaches is that their causes tend to be complex.
Headaches can be caused by various factors such as high blood pressure, side effects of medication, 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. Today, treatment of these headaches 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 direct therapy to treat the needs of the patient.
There are two types of headaches that people most commonly suffer from; Tension Type and Migraine headaches. At Senior Physical Medicine, our team approach has been successful in aiding patients in the relief of chronic headaches through the use of trigger point injections and chiropractic adjustments.
More About Headaches
Migraine headaches occur less often than tension-type headaches, however they are usually much more severe. They are also found to be 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 have been shown to play a role, since 70% of migraine victims have at least one close relative with the problem. New research also points to dysfunction in the spine as a common factor in many migraine sufferers.
Although a migraine can come on without warning, it is most usually always triggered by something. 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 the most common. These may include halos, sparkles or flashing lights, wavy lines, and even temporary loss of vision. The aura may also produce a numbness or tingling to one side of the body, especially the face or hand. Some patients develop aura like symptoms without getting headaches; and they often think they are experiencing a stroke, not a migraine.
While the aura can be seen in extreme cases, the majority of migraines develop without an aura. In typical cases, pain arises 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 has been described as a throbbing or pulsating feeling. Nausea is common, and many migraine patients experience a watering eye, a runny 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 physical 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. Joint dysfunction in the spine is common in these patients and palpation of the joints and muscles in their neck is generally uncomfortable. Muscular Trigger Points are also commonly found in predictably common locations, and can at times reproduce the pattern of pain that the patient is experiencing upon palmpation.
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 symptoms of a dull, squeezing pain on both sides of the head. People with strong tension headaches have described feeling like their head is in a vise; the shoulders and neck can also ache. Some tension headaches are triggered by fatigue or emotional stress, and most can last for 20 minutes to several hours.
Experts today understand that people who suffer from ongoing Tension-type headaches are “primed” to do so. 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.
It has been shown that most individuals who suffer from recurrent tension-type headaches have had some form of injury that has affected their neck in some way. These injuries may have come from many different sources including a slip and fall, an automotive accident, or even the result of a traumatic birth. The patient generally has a loss or reversal of the normal curvature in their neck with an associated predictable pattern of muscle tension and imbalance.
Each of these factors can in itself be the direct cause of headache pain. However, these factors in combination create a well-laid foundation for recurrent painful episodes of the Tension-Type Headache. By having these
issues addressed and corrected, the individual moves further away from the threshold of these painful events occurring.
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.