Headaches and Migraines

Headache refers to pain in any part of your head and can vary greatly from mildly bothersome through to severely debilitating. Headaches are divided into two categories: primary headache or secondary headache – with this classification then informing the treatment or management plan.

Primary headaches occur when the headache is not due to any underlying medical problem. These headaches may be due to factors including:
– Lifestyle
– Stress
– Sleep
– Diet

Secondary headaches are caused by an underlying medical condition. To treat and manage this form of headache, the underlying medical problem should be treated. There are a wide variety of conditions which may contribute to headaches including:
– Conditions of the eye, ears, nose, teeth/mouth
– Sinus congestion
– Infections
– Temporomandibular joint disorder
– Head injuries, whiplash, cervical spine disorders
– Side effects to medication
– Hypertension
– Vascular conditions

Within the primary headache category there are 3 common headache types:

Migraine
– A neurological disorder which can be highly debilitating.
– Symptoms can vary but usually migraines produce pain on one side of the head, throbbing in nature and made worse by head movements.
– Other symptoms may include sensory disturbance called aura, sensitivity to light and/or sound, nausea and vomiting.

Tension-type headache
– Pain usually on both sides of the head and described as a dull ache or tightening.
– Pain felt in the forehead, back of head, neck and shoulder is common.
– Usually mild to moderate in severity and steady (not pulsing).
– Not associated with nausea or vomiting.

Cluster headache
– Pain described as a severe stabbing or burning pain on one side of the head, most commonly behind one eye.
– Pain not affected by position or activity.
– The eye may become red, droopy and watery and the nose may become congested or leak.
– Headaches occur in a cluster: multiple times per day.

Treatment and management strategies depend on the type of headache.

Some strategies you may find useful to try at home include:

Sitting in a quiet, dark room
Applying a cold pack to your head
Applying a heat pack to your neck and shoulders to relieve muscle tension
Stress or relaxation strategies
Try and improve the quality of your sleep
Review your diet and fluid intake

How physiotherapy may help:

Treatment of the underlying condition for secondary headaches. For example, treatment of the cervical spine, TMJ, whiplash disorders.
Postural exercises and stretches.
Manual therapy and soft tissue release for restricted joints and tight muscles.
Pain management strategies and stress/relaxation techniques.
Acupuncture/dry needling for pain management, improved circulation and stimulation of the central nervous system.

Anna Mickenbecker – Physiotherapist