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Headaches slowing you down: Which type do you suffer from?

If you suffer from headaches, it is important to identify which type of headache you experience as this will dictate the plan of management. Each type of headache has unique features and treatment will vary accordingly. Below are the types of headaches and some common features of each.
Tension Headache
Tension headaches are the most common type of headache. They tend appear intermittently and feel like a constant ache, “squeezing” or “pressure” sensation around both sides of the head, particularly over the temples, front or back of the head, similar to the feeling of wearing a tight band. The pain is typically even, not throbbing and will not cause nausea, visual changes (aura), sensitivity to light or sensitivity to sound. Potential causes include general stress, lack of sleep or rest, muscular stress, postural imbalance, and jaw dysfunction. Tension headaches are not typically aggravated by physical activity. Management includes massage therapy, physical therapy, chiropractic, stress management, nutrition, acupuncture, medication, and self-care lifestyle modifications.
Cervicogenic Headache

Cervicogenic headaches originate from dysfunction of the joints and muscles of the neck. Pain is typically one-sided but may be found on both sides. The pain is localized to the neck or back of the head and may radiate to the forehead, temples, or eye region. Symptoms tend to appear gradually and are often described as a dull ache and stiffness. Decreased or limited neck range of motion is not uncommon and particular movements will aggravate the pain. Management includes chiropractic, massage therapy, physical therapy, stress management, nutrition, acupuncture, medication, and self-care lifestyle modifications.


Cluster Headache
Cluster headaches are recurring headaches that occur in groups or cycles. They appear suddenly and are characterized by severe, “debilitating”, “excruciating” or “piercing” pain on one side of the head, and are often accompanied by a watery eye, nasal congestion or a runny nose on the same side of the face. During an attack, people often feel restless and are unable to get comfortable; they are unlikely to lie down, as someone with a migraine might. The exact mechanism of cluster headaches are unknown  however, potential causes include genetic predisposition, hormonal influences due to hypothalamus dysfunction, disorders of serotonin metabolism, histamine irregularity, and disrupted regulation of arteries of the brain. Potential triggers may include stress, glare or bright lights, allergies alcohol and tobacco and extreme temperatures. Management includes massage therapy, physical therapy, chiropractic, stress management, nutrition, acupuncture, medication and self-care lifestyle modifications.

Sinus Headache
Sinuses are air-filled spaces located in your forehead, cheekbones, and behind the bridge of your nose. The sinuses drain through channels in the nose. When a sinus becomes inflamed, often due to an infection, tumour or allergic reaction, the inflammation causes swelling and increased mucus production, which results in an increased pressure leading to pain. Symptoms of a sinus headache feel like a deep and constant pain in the cheekbones, forehead or bridge of the nose. The pain is usually accompanied by other symptoms such as nasal discharge, feeling of fullness in the ears, fever and facial swelling. Headaches due to sinus infection can be treated with antibiotics, as well as antihistamines or decongestants.

Rebound Headache

Ironically, rebound headaches are caused by regular, long-term use or abuse of medication used to treat headaches. These medications include Aspirin, Acetaminophen (Tylenol), or Ibuprofen (Motrin, Advil), as well as prescription drugs. The mechanism of this is explained by two theories: 1) Excessive medication use can cause the brain to shift into an excited state that triggers more headaches, and 2) Rebound headaches are a result of withdrawal as the level of medication drops after dependency has been established. Symptoms of rebound headache vary from person to person  and typically range between a tension headache and a migraine headache, sometimes with severe exacerbations. They are often relieved by retaking the involved medication and worsen rapidly as the medication wears off. Management includes gradual decrease of medication use, though the headache will typically worsen before it improves as the body adjusts to this change.


Migraine Headache
Migraine headaches result in intense throbbing or pulsating sensation typically over one side of the head, localized to the temple and frontal regions, though the location may vary. Symptoms are often accompanied with nausea, vomiting, and sensitivity to light or sound. Some migraines are preceded by sensory “warning” signs (“aura”) such as flashes of light, blind spots, or tingling and numbness in the arm or leg. The pain and associated symptoms may last hours to days and are frequently described as debilitating. Migraines are still poorly understood though links have been made to familial predisposition, stress, imbalances in the brain (particularly serotonin), hormonal changes in women (fluctuations in estrogen), pregnancy, menopause, oral contraceptives, foods (aged cheeses, salty or processed foods), skipping meals, food additives (aspartame and monosodium glutamate), drinks (wine, caffeine), bright lights, changes in wake-sleep cycle, changes in barometric pressure and certain medications. Management of migraine headaches include stress management, chiropractic, relaxation techniques, massage therapy, hydrotherapy, sleep, nutrition (feverfew, omega-3 oils, calcium, vitamin D, riboflavinoids, magnesium, vitamin B2 and B6), acupuncture and prescription medication.

Warning Signs for Pathological Headaches:
  • abrupt onset or very severe (especially if no previous history)
  • new headache in an older individual
  • headache due to trauma
  • tingling or numbness
  • disturbed vision or pressure behind the eye
  • cognitive changes / altered consciousness
  • seizures, vomiting
  • persistent, progressive headache
  • marked neck stiffness
  • persistent or severe headache in a child
  • known cancer 
If you or a loved one experiences any one of these types of headaches, schedule a chiropractic and medical check-up as soon as possible to have an assessment and to determine the appropriate plan of management. Should you or a loved one experience any warning signs for pathological headaches, visit a medical doctor or emergency physician as soon as possible. Don’t let headaches slow you down!