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Headaches may be a primary disorder (i.e. migraine, tension, or cluster headaches) or a secondary symptom of other disorders such as head injury, severe hypertension, dehydration, intracranial infection or tumour or infections of the eyes, nose or ears.
Types of Headaches:
Types of Headache
TENSION/STRESS Tension or stress headaches are the most common type of headache. They are frequently described as dull, diffuse, nondescript headaches usually occurring in a band like sensation around the head, which is not associated with nausea or vomiting. They can be infrequent, episodic or chronic. The exact mechanisms of these headaches are unclear, however, popular theory suggests they result from sustained tension of the muscles of the scalp, neck and/or oromandibular (face and jaw) dysfunction. Anxiety, stress, depression, general muscular stress, and overuse of caffeine and lack of hydration or analgesics all contribute to the development of these particular headaches.
MIGRAINE Migraines occur more frequently in women than men and tend to run in families (inherited trait). They are more common in adults but may also occur in children. The mechanisms of migraine are poorly understood, however, some evidence suggests a neurogenic basis in part due to the frequent presence of focal neurologic disturbances in many sufferers. Changes in brain and scalp arterial blood flow occur, however, whether vasodilation or vasoconstriction, are a cause or an effect of migraine is unclear. Hormonal variation (especially cycling oestrogen levels) barometric pressure change and chemicals in some dietary substances (e.g. monosodium glutamate, chocolate and cheese) also factor in the pattern of migraine attacks. There are two categories.
Migraine without aura: A pulsatile, throbbing, unilateral headache that typically lasts 1 – 2 days, usually aggravated by routine physical activity. This type of headache can also be accompanied by, nausea, vomiting, and sensitivity to light and sound. Visual disturbances occur quite commonly and consist of visual hallucinations such as stars, sparks or flashes of light. Many sufferers may experience symptoms such as fatigue, depression and irritability preceding an attack by hours or days.
Migraine with aura: Similar symptoms for migraine without aura, but with the addition of visual and neurologic symptoms that precede the headache which are known as an “aura”. The aura usually develops over a period of 5 – 20 minutes and lasts less than an hour.
CLUSTER Cluster headaches are headaches that tend to occur in clusters over weeks or months followed by a long remission period. They tend to affect men more than women. The pain is typically described as severe, unilateral and of rapid onset lasting for 15 minutes to 3 hours. Symptoms include, retro-orbital, temporal, supra-orbital and infraorbital pain frequently associated with conjunctival redness, lacrimation, nasal congestion, rhinorrhea, facial sweating and eyelid oedema. Due to their location and associated symptoms, cluster headaches are often misdiagnosed as being sinus infections or dental problems. Vasodilation and irritation of the trigeminovascular system (i.e. innervation to the temple, cheek and gum) are thought to play a role in the pathogenesis of cluster headaches.
TEMPOROMANDIBULAR JOINT PAIN (TMJ)
TMJ syndrome is one of the more common causes of headaches. Poor bite, teeth grinding, and inflammation, trauma or degenerative changes all contribute to an imbalance in joint movement. The pain is almost always referred presenting as facial pain, head, neck or earache. The movement of the jaw often aggravates the pain. TMJ syndrome can affect both children and adults and can often be the source of chronic pain.
Cervicogenic headache is a syndrome characterised by chronic hemicranial pain that is referred to the head from either bony structures or soft tissues of the neck. The trigeminocervical nucleus is a region of the upper cervical spinal cord where sensory nerve fibres in the descending tract of the trigeminal nerve (trigeminal nucleus caudalis) are believed to interact with sensory fibres from the upper cervical roots. This functional convergence of upper cervical and trigeminal sensory pathways allows the bidirectional referral of painful sensations between the neck and trigeminal sensory receptive fields of the face and head. A functional convergence of sensorimotor fibres in the spinal accessory nerve (CN XI) and upper cervical nerve roots ultimately converge with the descending tract of the trigeminal nerve and might also be responsible for the referral of cervical pain to the head.
Trigger points in the cervical, head and facial muscles can also cause this pain.
There are a multitude of more serious conditions that can have the same symptoms as headaches. If you suspect something of a more serious nature or if you are having persistent headaches then seek medical advice.
Possible alternative causes of headaches:
· Brain Tumour – The increased cranial pressure will cause pain.
· Dehydration – lack of water can lead to headaches
· Concussion – a recent blow to the head may have caused some internal bruising of the brain leading to headache symptoms.
· Poor diet – too much sugar and caffeine are common triggers of headaches.
· Drug withdrawal
· Temporal Arteritis - inflammation and damage to blood vessels that supply the head, particularly the large or medium arteries that branch from the neck and supply the temporal area. This can be very serious and without immediate treatment can lead to permanent blindness.
Treatment of headaches will focus on releasing muscles of the head, neck, jaw, upper back and chest as well as bringing awareness to client’s poor postural habits.
Benefit from gentle traction, myofascial release (MFR) trigger point therapy and/or soft tissue manipulation should occur because of the release of pressure upon nerve roots thus decreasing severity of referred pain.