A headache or cephalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the pain-sensitive structures around the brain. Nine areas of the head and neck have these pain-sensitive structures, which are the cranium (the periosteum of the skull), muscles, nerves, arteries and veins, subcutaneous tissues, eyes, ears, sinuses and mucous membranes.
Headaches are generally classified into two main types: primary headaches and secondary headaches.
A migraine, which is a disabling, recurring headache that frequently occurs only on one side of the head. A Migraine is one type of primary headache. A migraine is a chronic headache in which blood vessels constrict and dilate, releasing inflammatory substances that cause painful pulsations. The mild to severe pain can last from four hours up to a week, two to four times a month and often results in other symptoms.
Other primary headaches include cluster and tension headaches. Tension-type headaches are the most common headache, and are often experienced as mild, dull pressure without other accompanying symptoms. Cluster headaches, which are less common than migraines or tension headaches, usually bring severe pain (sometimes described as “stabbing” pain) behind one eye, and may be accompanied by redness and nasal congestion.
The other main type of headache is called a secondary headache. These headaches, while relatively rare, are more serious than primary headaches. That’s because they are often caused by other serious health problems or underlying conditions, such as brain aneurysms or tumors, dysfunctions of the spinal fluid, or inflammatory diseases. In order to treat secondary headaches, a doctor must first diagnose and treat the underlying condition that’s caused the headache.
NB: If you suspect you might be suffering from a secondary headache, it is advisable to seek immediate medical attention!
Causes of Primary Headaches
There is little research to confirm the exact cause of Primary headaches. Primary headaches occur because of physical or emotional stress placed on the body.
For example, these stressors can cause the muscles surrounding the skull to clench the teeth and go into spasm. Physical stressors include difficult and prolonged manual labour, or sitting at a desk or computer for long periods of time concentrating. Emotional stress also may cause tension headaches by causing the muscles surrounding the skull to contract.
Tension headaches are commonly attributed to the following factors:
- Clenching one’s jaw
- Diet – a poor diet and lifestyle could cause headaches.
- Excessive consumption of alcohol, sugar and caffeine could result in primary headaches.
- Musculoskeletal dysfunction
- Physiological dysfunction
- Bad posture
- Staying in one position for a long time
- Working in an awkward position for a long time
- Food allergies – In some people, certain foods and drinks — or components they contain — can trigger a migraine/headache. One well-accepted migraine trigger is tyramine.
Primary headaches include Migraine Headaches, Tensions Headaches and Cluster Headaches. The symptoms of each are discussed below.
Symptoms of a Migraine Headache
A migraine headache can range from moderate to severe, causing intense pulsing, throbbing or pounding sensations in your head. Usually one side of the head is affected, however in some cases both sides may be affected. Other distressing symptoms include:
- Sensitivity to light, noise or odors
- Blurred vision
- Nausea or vomiting, upset stomach, abdominal pain
- Loss of appetite
- Sensations of being very warm or cold
- Fever (rare)
- Bright flashing dots or lights, blind spots, wavy or jagged lines (aura)
Symptoms of a Tension Headache
Tension (Muscle contraction) headaches – also known as myogenic headaches, are caused by the tightening/tensing of facial and neck muscles, these account for nearly 90% of all headaches. Researchers at the University of Copenhagen reported in the Journal of Clinical Epidemiology that 3% of the population has chronic tension-type headaches.
Common presentation of tension headaches includes the following:
- Pain that begins in the back of the head and upper neck and is described as a band-like tightness or pressure. It may spread to encircle the head.
- The most intense pressure may be felt at the temples or over the eyebrows.
- The pain can vary in intensity but usually is not disabling, meaning that the sufferer may continue with daily activities. The pain usually is bilateral (affecting both sides of the head).
- The pain is not associated with an aura (see below), nausea, vomiting, or sensitivity to light and sound.
- The pain occurs sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people.
- The pain allows most people to function normally, despite the headache.
Symptoms of a Cluster Headache
Cluster headaches are headaches that come in groups (clusters) separated by pain-free periods of months or years. A patient may experience a headache on a daily basis for weeks or months and then be pain free for years. This type of headache affects males more frequently and often begins in adolescence but can extend to those in middle age.
- During the period in which the cluster headaches occur, pain typically occurs once or twice daily, but some patients may experience pain more than twice daily.
- Each episode of pain lasts from 30 to 90 minutes.
- Attacks tend to occur at about the same time every day and often awaken the patient at night from a sound sleep.
- The pain typically is excruciating and located around or behind one eye.
- Some patients describe the pain as feeling like a hot poker in the eye. The affected eye may become red, inflamed, and watery.
- The nose on the affected side may become congested and runny.
The key to making the diagnosis of any headache is the history given by the patient. The health care professional will ask questions about the headache to try to help make the diagnosis. The questions are designed to provide insight into the quality, quantity, and duration of the pain.
Guidelines have been set out to evaluate and manage adult patients who have a non-traumatic headache of acute onset.
Statistically, headaches are most likely to be primary (non serious and self-limiting). Certain specific secondary headache symptoms may demand specific treatment or may be warning signals of more serious disorders. Differentiating between primary and secondary headaches can sometimes be difficult.
As it is often difficult for patients to recall the precise details regarding each headache, it is often useful for the sufferer to fill-out a “headache diary” detailing the characteristics of the headache.
The diagnosis by the health care professional will establish whether the headache is a primary or secondary headache. Secondary headaches are generally distinguished by neurological symptoms that accompany a very severe headache—your doctor can give you a neurological examination to rule out a secondary headache.
If in doubt about the type of head pain you are dealing with, consult your doctor.
Treatment of Headaches
The ideal treatment for tension headaches depends on many factors, including the patient’s overall physical and mental health and lifestyle.
The Allopathic approach to the treatment of Headaches can include the following:
- Painkillers – such as aspirin, acetaminophen (paracetamol, Tylenol), naproxen and ibuprofen. Prescription drugs are also available for more severe symptoms, including naproxen, indomethacin and ketorolac.
- Patients with severe migraine or headache who are hospitalised may benefit from intravenous medications.
- Combination drugs – aspirin or acetaminophen may be combined with a sedative or caffeine.
- Triptans and opiates – for sufferers of both migraines and tension headaches. Triptans are effective in relieving the symptoms of both tension headaches and migraines. With opiates there is a risk of dependency and unpleasant side effects.
Scientists at The University of Adelaide in Australia reported on a study that found that frequent and large doses of codeine can result in greater sensitivity to pain.
Other Treatment/Management Options
Hot or cold showers – some people find that taking a shower helps. While one person may benefit from a hot shower, others may find a cold one gives better results.
Lifestyle – some simple changes in lifestyle may reduce, and sometimes completely eliminate the recurrence of headaches. Getting enough sleep, doing plenty of exercise, stretching the neck and back muscles regularly may be all you need.
Diet – are you eating properly? A good diet with plenty of fruit, vegetables, minerals and fiber will help you stay in good health and might help reduce the intensity and frequency of your headaches.
Depression – if the tension headache is chronic (long-term), there is a chance you could be suffering from depression.
Stretching and strengthening modalities – Yoga and Pilates create flexibility and strength throughout the body. Helping to release tension and engage core muscles which improve balance and posture as well as create mobility throughout the body. This will help reduce the risk of musculoskeletal and physiological dysfunction which catalyses the onset of the headache.
A headache diary – if you keep a diary it may help you identify your headache triggers. When a headache starts write down when it started, include notes of what you drank and ate during the previous 24 hours. Note down how long you had slept, whether it was a good night’s sleep, when you slept. Record in your diary what was happening in your life immediately prior to the onset of your headache – were you under unusual stress? Write down how long the headache lasted, and if you can, what made it stop.
Bowen Therapy Headache/Migraine Treatment
Bowen Therapy is a holistic healing modality. This means that no ailment is treated in isolation – the entire body is addressed as a whole. This is particularly effective in the treatment of headaches and migraines, which may have multiple potential causes.
Allopathic treatments are largely focused on the symptoms (such as the throbbing pain in your head) as opposed to the cause – which may originate from one or more underlying musculoskeletal and/or physiological dysfunctions.
Bowen Therapy offers an effective alternative treatment for both acute and chronic primary headaches, including migraines, tension headaches, cluster headaches, etc. Bowen Therapy is a natural, holistic approach to healing, using precise, targeted stimuli to activate the central nervous system – addressing dysfunctions within the body and activating the body’s natural ability for self-regulation and healing – thus restoring balance. This is referred to as homeostasis.
Please see the What is Bowen Therapy section for more information.
Secondary headaches require immediate medical attention, as they are attributed to potentially life-threatening ailments, which may require chronic medication and/or surgical intervention. Bowen Therapy does, however offer alternative/complementary post-treatment options. Bowen Therapy can work alongside allopathic treatments to support the healing process, improve overall health and well-being and strengthen the immune system.
For more information regarding Bowen Therapy, and how this treatment can assist you, please do not hesitate to contact us.