BACKGROUND
There are over a hundred different categories of headaches, most with their own sub categories. Ranging from serious conditions such as high blood pressure to safe headaches from muscle tension. It is important to have your headache diagnosed, especially if it’s new or if it becomes persistent or regular.
For the purpose of this blog we will stick to two of the most common and the most regularly seen in our practice.
2 COMMON HEADACHES
Cervicogenic and Tension-type Headaches are both persistent and relatively simply treated (if there are no complicating factors).
Tension-type Headache
Theses headaches are usually derived from tension build up around the head, neck and shoulders and tends to be one of the most common headaches. The pain associated with them might be rated as mild to moderate. There are three main subgroups of tension-type headache so there is no one classification, they are: Infrequent episodic, frequent episodic and chronic Tension-type headaches.
Their main symptoms include:
- Pain on both sides of the head
- A pushing/tightening sensation
- mild to moderate pain
- non-pulsating quality
- Not aggravated by routine physical activity
- No nausea or vomiting
- No more than one out of noise or light sensitivity
- Lasts 30 minutes to 7 days
Cervicogenic Headache
This headache is classified by The International Headache Society as: headache caused by a disorder of the cervical spine and its component bony, disc and/or soft tissue elements, usually but not invariably accompanied by neck pain.
Their main clinical signs and symptoms include:
- Headache near temples with onset close to a case of neck pain
- Limited movement in the neck
- Headache worsens with neck movements
Because of the involvement of the joints in the neck this is usually accompanied by neck pain with referral to the head especially the base of the skull and over the temples. Sometimes there is no one inciting incident that can be identified but a build up of micro traumas over time such as bad posture or physical work. When the upper joints of the neck are involved this usually leads to head pain while the lower joints in the neck will usually cause pain across the shoulders and along the shoulder blades.
Reg Flags
Not all headaches are created equal and that is why it is important to get your headache properly diagnosed and on the right treatment path. There are however, some headache symptoms that must not be ignored these are: a sudden excruciating headache you have never had before, a significant change in what you are used to from previous headaches, sudden onset of headaches after the age of 50 years, vision disturbances in older adults, strange neurological symptoms like (facial tingling, numbness, weakness or change in speech) and a history of glaucoma in older adults.
TAKE HOME POINTS
Nine times out of ten you will be suffering from a regular run of the mill headache and at Waterloo Chiropractic, our chiropractors are well trained in giving you the right diagnosis and getting you on the road to recovery whether that is with us or another headache professional.
Both headaches discussed can have a rapid response to treatment of the cervical structure or muscle disorder perpetuating it. The journal of Orthopaedic and Sports Physical Therapy recently put out their recommendations the mobilisation and manipulation are valid treatment options for acute, sub-acute and chronic neck pain.
REFERENCES:
1. Lancet Neurol. 2009 Oct;8(10):959-68. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests and treatment.
Bogduk N1, Govind J.
2. Spine 1990 Jun;15(6):453-7. Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers.
Dwyer A, Aprill C, Bogduk N.
3. Front Neurol. 2016 Mar 21;7:40, Mobilization and Manipulation of the Cervical Spine in Patients with Cervicogenic Headache: Any Scientific Evidence, Garcia JD, Arnold S, Tetley K, Voight K, Frank RA
4. International Headache Society Classification ICHD-II