Headaches are one of the more common, and complex, conditions that we treat at SSPC. There are over 300 different types of headaches listed in the medical literature, making this the longest list in medicine of subcategories of one condition. The two most commonly known headache types are Migraines and Tension Type Headaches (TTH) which people mainly relate to stress and tension. There are however, other common forms of headaches, and having your headaches accurately diagnosed is one of the keys to treatment. There are also some critical warning symptoms with some headaches that may indicate a more serious, and at times life threatening, condition that needs urgent attention.
Migrains
True migraines are at the most severe end of the headache spectrum. Whilst many people may think they have a migraine, in many cases it is just a severe form of tension headache. 20% of migraine sufferers will have an aura which precedes the headache, and this aura may involve sensitivity to light or sound, or even episodes of vomiting. Migraine headaches are usually only felt on one side of the head, and are often pulsating in nature.
It is generally accepted that migraines are a disorder of the vascular (or blood flow) system within the body – either a constriction or dilation of the blood vessels that supply the brain. Recent research tends to question this theory, as changes in blood flow to the brain are thought to be a consequence of the migraine, not the cause! It is now thought that migraines may be caused more by abnormal activation of nerves in the neck in combination with a change in a chemical called Serotonin, which is produced within the body. Serotonin is known as the “happiness hormone” as it plays a major role in our feeling of well being. Serotonin also controls pain levels in the nucleus of nerves in the neck, so if there happens to be inhibition of Serotonin (very related to estrogen production), plus over stimulation of the nerves in the neck (posture, injury, stress, etc), the nerve nucleus becomes over stimulated, with minimal dampening effect from Serotonin, possibly resulting in a migraine.
Tension Type Headaches (TTH)
These types of headaches tend to radiate to both sides of the neck and head and lack the pulsating feeling and nausea that often comes with migraines. These headaches can be brought on by exercise, or more commonly emotional stress, anxiety and depression. TTH’s can occur as a result of an acute episode, or can be chronic and occur regularly. One of the ways of differentiating between TTH’s and migraines is that you can often in some way or another control a TTH, whereas a migraine controls you. TTH’s may inhibit, but don’t prohibit, activities, whereas migraines bring a complete stop to everything.
Cervical Headaches
There is a wealth of evidence that the neck, or cervical spine, is a common cause of headaches. Cervical headaches often occur to one side predominantly, as it is less likely to have both sides of the neck with pressure or pathology. Neck pain and/or stiffness often precedes these headache types and there is a reduction in neck range of movement, which is not often seen with migraines or TTH. The upper three cervical nerves converge into the same nucleus that controls the sensation in the facial muscles – so if a painful neck is sensitising the nucleus, the brain can misinterpret where the sensation is coming from, and perceive the pain as coming from the facial area, explaining why a painful neck can result in a headache!
As well as the above factors, jaw pain and pathology also contribute extensively to neck pain and headaches. People who clench or grind their teeth, or have jaw pathology are very likely to have associated neck pain and headaches.
Symptoms To Be Wary Of!
Anyone with a headache and fever who is also experiencing drowsiness and confusion needs immediate medical attention. Other symptoms that also warrant an urgent medical assessment include blurry or double vision; weakness, tingling or pins and needles down an arm; difficulty maintaining balance or control of walking; speech difficulty; and new headaches you have never experienced before with serious symptoms like those listed above.
All of our SSPC physiotherapists have completed a recent in-house Headache Seminar, conducted by a Physiotherapist with extensive international headache education and treatment experience. If you would like further advice regarding headaches you are suffering, we would be happy to assist.
