The Sievert Clinic - Conditions- Headaches

This is the most common type of headache. It is caused by muscle strain, or contraction. The pain is usually located on the forehead or the back of the head and neck. When muscles are held tight for a long period of time, they begin to ache. The same thing would happen if you clenched your fist tightly and held it for many minutes-eventually your hand muscles would become tired and sore. When this happens in your head muscles, the pain is usually described as a dull ache, or a bandlike sensation surrounding your head as if you were wearing a tight bathing cap.

Usually, these headaches begin gradually and then last from a few hours to several weeks. Factors that may trigger them include stress, diet, fatigue, and poor posture.

MIGRAINE HEADACHES

Migraine headaches may take many forms. About 70 percent of people with migraine headaches have a genetic predisposition. They are more common in females than males and usually begin during the teenage years. The headache pain occurs when the blood vessels of the head dilate (expand) and press on sensitive nerve endings. The nerve endings transmit pain sensations to the brain, though the brain itself does not actually feel pain. Blood vessel expansion is thought to be controlled by changes in blood chemistry. Conditions that may trigger migraine headaches include stress, certain foods, fatigue, and the menstrual cycle.

The most common type of migraine is called a common migraine. These are frequently described as "sick headaches" because they are often accompanied by nausea, vomiting, and sensitivity to light and sound. The pain is typically very severe and is described as deep and throbbing. The headache is usually located on one side of the head but may involve both sides. It may last from 2 to 4 days. Minor analgesics (aspirin) are generally ineffective in relieving the pain.

Another type of migraine headache is known as a classic migraine. These headaches are often preceded by an "aura" (unusual visual sensations, such as blotches or sparkles) or by sensations of weakness, numbness, or tingling. The victim may also experience nausea, vomiting, cold hands and feet, and a feeling of soreness or exhaustion afterward. Though these headaches are just as severe as the common migraine, they generally do not last as long (24 hours or less).

CLUSTER HEADACHES

Cluster headaches are sometimes classified as migraines because the pain is caused by dilation of the blood vessels. The name "cluster" describes the way the headaches come in distinct clustered episodes. In other words, you may have a bout of headaches for a week or two and then not experience them again for some time. Attacks usually last 15 to 30 minutes and occur in violent, punishing repetition. More men than women suffer from these headaches, and most sufferers are over 40 years old. Alcohol is a common trigger.

HEADACHES OF CERVICAL (NECK) ORIGIN

These headaches are most common among elderly people with arthritis of the neck or people who have suffered an acute injury to the neck or back. The pain is often located on the back of the head and is typically described as either a dull ache or sharp "jabs." The pain is usually caused by injury or inflammation of the muscles or ligaments in the head, neck, or upper back. Usually, stiffness or pain in the neck occurs with, or precedes, the headache. Along with stress and diet, these headaches can be triggered by poor posture.

HEADACHES OF DENTAL ORIGIN

Dental headaches can be caused by a malocclusion ("bad bite"), which places strain on the muscles of the face, head, and neck. This may also pull the joints that attach your jaw to your skull (temporomandibular joints) out of alignment. When these muscles are out of alignment, they may refer pain to the head in the form of a headache. Referred pain is when a pain originates in a part of the body that is different than the area where it is felt. Even a single tooth can refer pain to the head. Though of different origin, these are essentially muscle tension headaches. Sufferers may also experience pain behind the eyes, soreness of the jaw muscles, and grinding of the teeth.

OTHER TYPES OF HEADACHES

To list and describe all the many types of headaches would fill an entire book. Some other types of headaches include those due to eye disorders, allergies, and sinuses. Two very serious, though much less common, causes of headaches are brain tumors and inflammation of the membranes covering the brain. This is why it is very important to have a thorough examination to determine the type and source of headache pain.

A VICIOUS CYCLE

All of these various types of headaches share a common thread: they produce pain. The severity and frequency of pain vary from person to person and often from episode to episode.

Pain experienced in the face and head has a great deal of emotional significance. Pain around the face and head is frightening because it seems closely tied to your brain and vital control centers. The face is also tied closely to your self-concept; therefore, discomfort or physical distortion in this area is especially anxiety provoking.

Emotional anxiety and stress almost always go hand in hand with muscle tension. One feeds the other. Muscle spasm causes pain, and the pain makes you feel anxious and uptight. Anxiety itself can initiate muscle tension, which then turns into pain. This in turn aggravates the pain. Effective treatment breaks this cycle. The mind and body are interwoven, and both the physical and emotional aspects of your headache pain must be considered.

Causes of Headaches

If you suffer with headaches, do not let anyone tell you they are "normal." Headaches are pains, and pains are your body's way of telling you that there is a problem somewhere. That pain, in a sense, is begging for correction.

Although popping a pill may seem to be an easy answer, it is not. It merely masks the hurt; the problem goes on. As you become immune to the drug, you will require higher doses, which will not stop the pain.

If you are a headache sufferer, the best thing you can do is seek professional help immediately. Unfortunately, some patients have suffered many years, visited many types of health specialists, and tried many remedies without relief before seeking out chiropractic care. Doctors of chiropractic have been particularly successful at finding the source of health problems that cause headaches and treating them effectively.

Headaches can, of course, result from many conditions. But research has revealed that a common cause of headaches can be traced to the area of cervical vertebrae (spinal bones of the neck).

Because the neck is extremely mobile, there is constant danger of displacement of one or more of these vertebrae, which may compress and irritate the cervical nerves.

Some headaches have simple explanations, such as being the "morning after" result of an overindulgence in food or drink. With these types, the pain usually goes away as soon as its cause, a stressed digestive or eliminative tract, has been relieved. Intermediate causes of headache include digestive, eliminative, kidney and heart problems; eye problems (chiefly eye strain); infected tonsils; nerve pressure from spinal conditions involving cervical and other areas of the structural system; and sometimes, though very rare, brain problems. In women, disorders of the reproductive system are often the cause of headaches.

Determining Headache Patterns

THE INTERVIEW

The first step in any headache treatment program is the interview. Your physician or therapist will ask you questions to try to understand your condition. Questions will be asked about your current symptoms-where and when they occur, how often they occur, and when they began. Questions about your medical history will include previous physicians and treatments you have tried for this problem as well as medications you have taken and those you are currently taking. Another important area to explore is the impact your headaches have on your life style. In what ways have your headaches affected your family or work situations? If you were to become totally pain free, how would this affect your life? Many times, people who experience chronic headaches begin to feel out of control of their life, which makes them feel depressed. These are some of the issues that are explored during the interview.

HEADACHE DIARY

A common strategy in dealing with pain is to ignore it or try to forget it. Although this may be a useful pain management strategy for some people, it usually makes you a terrible historian when asked to recall relevant information about your headache. Consequently, it is useful to keep a headache diary for several weeks. Included in the diary should be items such as the frequency and severity of your headaches, description and location of the pain, and any events surrounding pain episodes (such as unusual movements, family- or work-related stress, etc.).

This information is helpful to both you and your physician. Identifying patterns might help uncover the cause. Also, you may discover that there are particular environmental factors that start your headaches. Although many people simply have an inborn tendency toward headaches (migraines are especially linked to heredity), there are often additional factors, such as diet and stress, that bring out headaches at particular times. By understanding what triggers your headaches, you may learn ways to avoid them altogether or lessen the headache pain.

PHYSICAL EXAMINATION

With some headache conditions, it is useful to identify the location and pattern of the headache pain. Some headache sufferers can put their finger right over the problem. When the headache results from muscle spasm of the head, neck, or shoulders, the particular muscles involved often become tender to the touch. Treatment, such as massage or heat, directed at these tender areas may help relieve the pain. However, sometimes it is not so easy to point to the source of the problem. Even when muscle spasm accounts for the headache, you may not be able to put your finger on the origin of the pain. When muscles are very tense, they may develop "weak points" that are especially sensitive to either physical or emotional stress. Eventually, nodules called trigger points form within the muscle itself. Trigger points can cause what is known as referred pain-this is when you feel pain in a different place than where it originates. For instance, a trigger point in your cheek muscle may refer pain to your ear, so that pressing on the cheek actually causes your ear to hurt! The effects can be far-reaching. A trigger point in the neck, for instance, may cause pain in the scalp, face, ears, shoulders, arms, hands, fingers, or even the chest. Successful treatment depends on identifying and treating the trigger point itself-since it is the actual origin of the pain.

If trigger points are suspected, the physician must first find out exactly where you hurt to get a clear understanding of pain patterns. He or she may ask you to point to the painful areas or diagram the areas on a "pain picture." The physician or therapist may also palpate, or press, different muscles commonly involved with headaches to identify tender trigger points. Once identified, various treatments such as hot or cold packs, deep massage, or stretching exercises may be used to relieve the trigger point spasm.