What is causing your headache?

Did you know that it is thought that headaches are the most common complaint of mankind? 

There is much confusion about the cause of headaches and therefore the best way to manage them. I am often asked 'how do I treat my headache?' and in my opinion, the correct and most helpful answer cannot be given without thorough assessment.

The majority of headaches do not actually require medical management, as you would know with almost all of us having had several in our lifetimes. A few paracetamol does the trick. However, persistent or acute headaches, accompanied by any of the following symptoms really should be checked out:

• Headaches with a stiff neck
• Headaches with neurological signs such as drowsiness, dizziness, numbness of the limbs, weakness
• Headaches that increase over a few days
• Sudden and abrupt headache onset
• Headaches that wake the sufferer from sleep

Headaches can have many a varied cause, from dehydration to common ailments and viruses, to sinusitis, drug or medicine-induced and injury or trauma such as concussion. Today I will explain the difference between the often confused vascular headaches (migraines) and cervical headaches (originating and referring from the neck). Both types present to physios and doctors with similar presenting symptoms, so confusion regarding the actual cause can sometimes be quite common. 

Vascular headaches.

Migraines usually occur episodically and are often associated with a warning sign such as visual or sensory symptoms (the 'aura'). Nausea and vomiting are common also and often follow the headache onset. Migraines have a finite duration, when cervical headaches last for days or more. Migraines can have any associated neck tenderness, pain or stiffness, but neck movements do not typically make the headache worse. Migraines 'throb' and the pain is often felt at the front or temporal sides of the head. Sleep and anti- migrainous drugs are the only things that relieve the pain.

Migraines are generally not understood that well and are also under-diagnosed. They first afflict people from 10-40 years in age and 75% of all diagnosed migraine sufferers are women. It is thought that migraines occur from a complex reaction in the brain between the nerve pathways and the blood vessels, causing a change in the brain's chemical balance. Neural pathways in some parts of the nervous system and brain are over sensitised, causing the associated visual disturbances, nausea and sensitivity to light and noise.

Physiotherapy, massage, postural exercise, correction and awareness such as with Pilates don't really make a difference to these kinds of headaches. 

Cervical headaches.

These headaches can be just as severe as vascular headaches but there are a few differing definers. These headaches are usually slow in onset, building over days. They can last for days to weeks and neck movements or tender points on the neck can really irritate the headache. There is rarely any associated visual or sensory disturbances and infrequently any vomiting. Any or all of dizziness, neck stiffness and symptoms such as numbness, tingling or pain down the arms can be present. The headaches are usually felt on one side of the head – the same side as the neck stiffness and tenderness.

Cervical headaches are caused by pain that is referred to the head from the neck region. This can include from one or more muscular, nerve, bony, upper spinal joint, or vascular structures in the neck. Common causes for these headaches are accidents such as falls, head knocks, whiplash injuries, or postural causes such as poke chinned and slumped postures.

Physiotherapy, massage and exercises to strengthen and support the spinal posture work amazing well for both treatment and prevention of these types of headaches. 

Headaches at a glance.

Remember that your physio or doctor know how best to diagnose your headache and its cause. And diagnosing the correct cause will allow for the best treatment.