Most common headaches are not life threatening and can be treated successfully with conservative care such as chiropractic care. These common headaches include: migraine headache, tension headache, cervicogenic headache, and cluster headache. Any one of these headaches can dramatically ruin the quality of a person’s life; it is the job of the chiropractor to ask you the right series of questions in order to diagnose the correct headache and give you the most effective treatment and advice.
Migraine Headache
There are two general types of migraine headaches, migraine with aura and migraine without aura. Examples of auras include: zig-zag lines, flickering lights, or vision loss. A classic migraine presents with an aura before the headache sets in. This aura will typically last for 10-20 minutes and usually does not last longer than an hour. The headache usually follows the aura; however, it can happen simultaneously with the aura. The quality of the migraine with/without the aura is usually pulsating in nature and can be moderate to severe in terms of pain. The pain is usually so intense that it forces the person to avoid any and all activity such as walking or jogging. In fact, any movement will typically aggravate the headache. The person will often feel nauseous and will avoid bright lights or loud sounds (photophobia/phonophobia respectively).
Signs and Symptoms
- Visual Disturbances
- Pulsating/throbbing quality- moderate to severe
- One side of head
- Avoidance of bright lights/sounds
- Nausea
- Activity avoidance
- Associated neck pain
- Tearing
- Nasal congestion
- Family History1
Common Triggers
Keep in mind that there are many triggers of a migraine which include the following:
- Change of weather
- Stress
- Lack of sleep or fatigue
- Alcohol
- Food triggers (including but not limited to chocolate, fried foods, dairy products, and nitrates in cured meats and fish)1
Tension Headache
This common headache is usually mild to moderate in severity. It tends to get better with exercise, which is one way of ruling out a migraine. In addition, unlike a migraine, tension headaches tend to occur on both sides of the head, usually at the base of the skull. Many people with this common headache report feeling a band of tightness around their head. It is non-throbbing type of headache. There is also no nausea or vomiting; there is no avoidance of bright lights or loud sounds either.
SIgns and Symptoms
- Pressing and tightening band
- Both sides of head
- Better with exercise
- No nausea or vomiting
- No avoidance of bright lights/loud sounds
- Non-throbbing
Common Triggers
- Stress
- Caffeine withdrawal
- Tension/Prolonged posture (sitting at a desk for several hours)
- Poor posture
Cervicogenic Headache
This common headache has combination of symptoms found in migraine and tension headache. The classic presentation is mild to moderate pain on one side of the head/neck. The pain can be dull-achy or sharp. The pain often travels from the base of the skull, over the ear, to the eye. Many people with this common headache report neck tightness and restricted neck movement. Prolonged head positions or stress can trigger the headache. Person may have migraine-like associated symptoms of nausea, vomiting, and sensitivity to light.1
Signs and Symptoms
- Dull-achy pain or sharp pain
- Pain on one side of head, over ear, to eye
- Neck tightness and pain
- Signs of joint degeneration in neck on x-ray
- Possible nausea, vomiting, and sensitivity to light
Common Triggers
- Maintained neck positions (staring at the computer for too long)
- Stress
- Whiplash/trauma
Cluster Headache
This headache, although not very common, is actually more common in men than woman. The pain is an extremely intense, sharp pain behind the eye. The headache will typically last for 30 minutes at a time and be described as the worst pain the person has ever felt. The headache will come in cycles where it is off and on for days/weeks and then won’t reoccur for months to years. The headache tends to last for weeks followed by no headache for months to years. The headache tends to occur at night. It is often associated with at least one of the following: runny nose, teary eyes, constriction of the pupils (small pupils), nasal congestion, drooping of the eyelids, forehead/facial sweating, or swelling around the eyes1 . Many people with this headache have a history of smoking and/or alcohol abuse.
Signs and Symptoms
- Severe headache: sharp and stabbing
- Pain behind the eye
Person will also present with at least one of the following:
- Runny nose
- Teary eyes
- Constricted pupils
- Nasal congestion
- Drooping of eyelids
- Forehead/facial sweating
- Swelling around eyes
Common Triggers
- Alcohol
- Smoking
- Some foods
Source 1: Integrative Orthopedics; Alex Vasquez