Headaches are common. They are the single most commonly reported illness and they have a tendency to be frequent in those prone to them, so the burden of illness is often significant. They can come at great social, occupational and financial cost to chronic sufferers.
It is important to understand that not all headaches are the same, there are many different types, with different causes and different treatments. This is by no means an exhaustive list but it covers the ones we see most commonly. Before we get into specifics, it’s also worth noting that we often categorise these different headache types as either primary or secondary headaches depending upon whether the headaches is actually the result of some other illness or pathology (think sinus infection, strokes or tumours).
Tension type headaches are the most commonly occurring type of headache but like most other headaches, the exact mechanisms underlying them are unknown. Typical symptoms include bilateral headache, lasting minutes to days. Episodes are typically less frequent and though bothersome; the pain is not usually as intense or debilitating as some other headaches. Pain is often described as pressure and though it may be associated with sensitivity to light or noise, it does not involve any visual disturbance, nausea or vomiting as a migraine might.
A migraine is a typically a unilateral headache, they are relatively common in Australia, affecting about 12% of women and 6% of men. The increased occurrence in women may relate to hormonal changes or be ‘menstrual migraine’. There is no clear consensus on the cause of migraines (likely because there are several causes); but vascular, neurological and other mechanisms have been proposed causes.
Migraines are broadly divided into two subgroups, those with and without a prodromal aura;
- Migraine without aura – Most migraines (about 80%) occur without a preceding or prodromal aura. These are often recurrent headaches that manifest as repeated episodes of severe headache and maybe pounding in nature.
- Migraine with aura – The remaining 20% of migraines are associated with an aura, meaning they present with associated neurological symptoms that occur before or during the onset of the migraine. These symptoms often begin over a period of 5-20 minutes and last up to an hour. The headache may also begin during this time or it may begin shortly after the aura subsides. These migraines are also typically recurrent.
Cluster headaches are severe headaches that tend to be excruciating, the patient can be totally incapacitated that occur in succession or in a ‘cluster’. The cluster period may be weeks to months, with a complete remission between episodes. For reasons unknown, cluster headaches affect men 3-4 times more often than women.
Cluster episodes may chop and change sides and other symptoms can classically accompany the headache. These symptoms might include nasal congestion, facial sweating or eyelid swelling; these would all occur on the same side as the head pain.
Headaches originating from other structures
In much the same way we know that the heart can refer pain to the shoulder, arm or neck, musculoskeletal structures can also refer pain. So, it is well established that structures in the neck, jaw, oral and sinus cavities can refer headaches.
This is due to the considerable overlap in the spinal cord between the nerves that provide sensation to the head, neck and face. If these nerves are irritated by stiff joints and muscles in the neck or jaw, they can cause pain anywhere in the head.
A visit to one of our friendly osteopaths will provide you with a completely individualised assessment and treatment plan, and expert advice on ways you can help strengthen and support your body to limit headache frequency and intensity.
For more information or to find out how we can help you recover from headaches, call us on 03 8370 3044.