Headaches Coventry & Birmingham

Headaches affect almost everyone at some point and they can present themselves in many different ways. Some people only experience pain in one part of their head or behind their eyes, some people experience a pounding sensation inside their head, and some people experience nausea. The pain itself may be moderate to severe, and may last anywhere from minutes to a few days. Fortunately, very few headaches have serious underlying causes, but those that do require medical attention.

Headaches can be due to a wide variety of causes, such as drug reactions, temporomandibular joint dysfunction (TMJ), tightness in the neck muscles, low blood sugar, high blood pressure, stress and fatigue. The majority of recurrent headaches are of two types: tension headaches (also called cervicogenic headaches) and migraine headaches. There is also a third type of headache, called a cluster headache; this is related to the migraine.

These three types of headaches are described in the other tabs above.

Tension Headache Coventry & Birmingham

A tension headache can affect upwards of 85% of people who suffer headaches. Most people describe tension headaches as a persistent, dull or pounding ache around the head or behind the eyes. A tension headache will usually begin slowly and gradually, and can last for minutes or days, usually beginning in the middle or late evening. A tension headache is often the result of stress or bad posture, which stresses the spine and muscles in the neck and upper back.

A tension headache, or stress headache, may last for minutes to several days. In some cases, chronic tension headaches may persist for months. Although the pain can at times be severe, tension headaches are usually not associated with other symptoms, such as nausea and dizziness.

The most common cause of a tension headache is subluxations in the upper back and the upper neck, usually in combination with active trigger points. When the top cervical vertebrae lose their normal motion, a small muscle called the rectus capitis posterior minor muscle goes into spasm. The problem is that this small muscle has a tendon which moves between the upper neck and the base of the skull and attaches to a pain sensitive tissue called the dura mater that covers the brain.

Although the brain itself has no feeling, the dura mater is very sensitive to pain. Consequently, the rectus capitis posterior minor muscle goes into spasm and its tendon pulls at the dura mater, and a headache occurs. People who do mainly desk jobs will tend to suffer from headaches for this reason.

Another cause of a tension headache comes from referred pain from trigger points in the Sternocleidomastoid (SCM) or levator muscle either side of the neck. These are much more common in people who suffer a whiplash injury due to the muscle damage in the neck.

Triggers:

• Stress or anxiety
• Poor posture
• Wear and tear on the neck
• Depression
• Social problems

Facts to note:

• Last from thirty minutes to seven days
• Feel like pressing or tightening around the head – but not pulsations
• Bring on mild to moderate pain
• Resulting pain on both sides of the head

Migraine Coventry & Birmingham

Each year, about 10% of people in the UK experience migraine headaches, about 70% are women. Migraines are intense and pounding headaches that are often associated with nausea and sensitivity to light or noise. They can last from a few hours to as long as a few days. Many of those who suffer from migraines experience visual symptoms called an "aura" just prior to an attack; this is often described as seeing flashing lights or that everything takes on a dream-like state. Migraine sufferers usually have their first attack before the age of 25 and they tend to run in families, supporting the notion that they are genetic. Some people have migraine attacks several times a month; others have one or two a year. Most people find that migraine attacks occur less frequent with age.

Migraine headaches are caused by a constriction of the blood vessels in the brain, followed by a dilation of blood vessels. During the constriction of the blood vessels there is a decrease in blood flow, which can lead to the visual symptoms that people do experience. People who do not experience the classic migraine aura still know that an attack is imminent. Once the blood vessels dilate, there is a rapid increase in blood pressure inside the head. It is this increased pressure that leads to the pounding or throbbing headache.

There are many theories about why the blood vessels constrict, but no one knows for sure. What we do know is that there are a number of things that trigger migraines, such as lack of sleep, stress, flashing lights, strong odours, a change in weather patterns and foods; especially foods that are high in an amino acid called ‘tyramine’.

Migraines are the most common type of vascular headache and are characterized by severe pain on one or both sides of the head, sometimes associated with stomach problems, and, at times, disturbed or blurred vision.

Migraine Symptoms:

There are two types of migraine headaches known as "classic" and "common." The visual symptoms called an "aura" such as bright flashing lights or differing line shapes, blurred or temporary loss of vision. Some or all of these symptoms tend to happen ten to thirty minutes before the onset of a classic migraine. There may also maybe a speech impediment, weakness may occur in the arms or legs, the face or hands may tingle, confusion may also occur. The "aura" is a characteristic of a "classic" migraine.

Migraine symptoms tend to present as intense throbbing or pounding headache which usually affects one side of the head and can spread to the other side and be accompanied by throbbing or pounding pain in the forehead, temple, ear, jaw, or around the eyes. A Common migraine is the most common kind of migraine which affects the greatest number of people.

Symptoms of "common" migraine

• Mood swings
• Lack of mental awareness
• No aura
• Fatigue
• Diarrhoea and increased urination
• Fluid retention
• Nausea and vomiting

The pain can be classified by at two or more of the following:

• Severe to moderate headache
• The headache becomes aggravated by movement
• Throbbing on one side of the head

There is also at least one of the following associated symptoms:

• Nausea
• Diarrhoea
• Vomiting
• Headache may last for between 4 and 72 hours
• Sensitivity to light which is called photophobia, or sensitivity to noise, photophobia

Migraine Long-term problems/treatments

• A classic migraine attack lasts one to two days
• Common migraine pain can last three or four hours
• Both classic and common migraine can strike as often as several times a week
• Some migraines become very predictable (if in doubt keep a diary)

Other symptoms include:

• Articulation and coordination problems
• Sensitivity to smell called osmophobia
• General feeling of being extremely unwell
• Difficulty in concentrating or confusion
• An aura which is a visual disturbance, for example: bright lights, flashing lights, zigzag lines, difficulty in focusing or blind spots
• Tingling and weakness in either legs or arms associated with pins and needles or numbness.
• Migraine does occur over many years or even decades. The frequency may vary from person to person, from a few a years to several per week.

Triggers of Migraine

Common dietary triggers include:

• Caffeine
• Missed or inadequate meals
• Citrus fruits, cheese and cultured products such as chocolate
• Wines, beers and spirits
• Monosodium glutamate (MSG)
• Dehydration

Physical and Emotional Triggers

• Lack of sleep or oversleeping
• Viral infection or cold
• Vigorous or excessive exercise
• Neck and back pain, stiff and painful muscles, especially in jaw, neck, shoulders, and upper back

Environmental Triggers

• Bright sunlight and bright or flickering lights
• Weather changes, changes in barometric pressure
• Travel and stress related
• Strong smells, e.g. Petrol, perfume, chemicals, various food odours

Hormonal triggers

• Menopause
• Ovulation
• Oral contraceptives
• Menstrual period
• Hormone replacement therapy (HRT)

Early Warning Symptoms

Migraine sufferers can experience warning symptoms up to 24 hours before an attack. These symptoms include:

• Mood changes, varying from depression and irritability to elation
• Behaviour such as being obsessional, lethargic, and hyperactive
• Nausea, changes in appetite from intense hunger to a complete lack of appetite; constipation or diarrhoea
• Neurological yawning, drowsiness, difficulty with vision
• Muscular symptoms include general aches and pains
• Light and sound will have its effect.
• Fluid retention, passing more fluid

Cervicogenic Headaches

Cervicogenic headaches are defined as headaches originating from the neck. The location is typically at the back of the head, sides and top of the head as well as around the forehead and eyes affecting one or more of the above regions at once. These headaches can be located on one or both sides of the head.

Cervicogenic headaches are usually associated with dysfunction of the upper neck which can present itself as neck pain or local tenderness, reduced neck range of motion and exacerbation of the headaches by neck movement. The past history of neck trauma is typical for this type of headaches. The cervicogenic headaches are caused by irritation of nerve endings of injured joints, ligaments, muscles and discs of the neck. The nerve endings in the injured areas send pain signals up the upper nerves of the neck to the brain causing "cross wiring" with the fibers of the trigeminal nerve (one of the nerves in the head) which is responsible for perception of the head pain thus causing the headaches.

Neck pain as well as "whiplash" (WAD) injuries and both conditions can result in headaches and all three are commonly treated by Chiropractors. The treatment is focused on the small joints in the back of the neck called facet joints that are responsible for neck pain. When these joints dysfunction but injury to the muscles he nerve fibres that innervate / act as sensors for these facet joints also serve to act as sensors to parts of the head. When these facet joints dysfunction these sensors become active, the brain cannot clearly differentiate between the facet joints and the mapping of the head and create the sensation of pain in a broader area- Headache.