Health – Not all headaches are created equal

Headaches are one of the leading causes of disability and time off work in the Western world. Despite this, it is not very well known that there are multiple types of headaches, causes and different ways to manage or treat them.

In a deep dive on the medical literature, there are a myriad of different types of headaches. For the purposes of this column, I felt the most useful thing would be to go into the most common types of headaches that we would see in a physiotherapy clinic. There are some key differences as to how these headaches present and knowing these can help a health professional support you in managing these frustrating conditions.

Migraine Probably the most infamous of all headaches, a migraine is classed as a neurovascular headache, which means it includes both circulatory systems, and our nervous system. These tend to occur most around puberty, menopause or later in life, with a slight bias towards women. Migraines typically present with an aura or ‘warning sign’ that is usually visual – being blurred or wavy vision in one or both eyes. There is then a delay before the primary migraine headache sets in. Migraines are often accompanied with light sensitivity, nausea, vomiting and a severe whole-head, vice like headache. For some there can be latent headaches that last upwards of two to three days.

Tension type headache A tension type headache is one of the most common types, typically caused by muscle spasm and tightness in the neck, shoulders and upper back muscles. This headache tends to be felt across the front of the temple or sides of the head. Posture has a big part to play with these headaches, particularly a ‘forward head’ position that is frequently adopted when working on a computer, driving or using a phone.

Cervicogenic (neck-related) headache Though similar to the tension-type headache, a cervicogenic headache is caused by one or more of the spinal joints in the neck as opposed to the muscles. This headache tends to start at the base of the skull on one side of the head, wrapping around the side of the head behind the ear and into the back of one eye.  It can be caused by direct trauma such as whiplash or concussion. Wear and tear of the neck joints can also contribute to these. 

Cluster headaches These are a particularly disabling type of headache with repeated, severe headaches usually on one side of the head behind or above the eye. They can also cause eye weeping, nasal congestion and even swelling of the face. The headache can last 15 minutes to three hours and can occur in bursts up to eight times per day. This can repeat daily for weeks or even months at a time. 

Managing and treating headaches is very complicated, but part of the diagnostic battle can be won by understanding the triggers, onset and pattern with your headache. Treatment options vary from physiotherapy, acupuncture or specific drugs made for certain headache types.  If you are struggling with persistent headaches then make a ‘diary’ of those details and have a chat with your local health professional.