HEADACHES...
Can be defined as any type of discomfort in the head or face and they make up the second most common complaint for doctor visits. Although headaches can be extremely painful, an extremely small amount are due to serious illnesses. Headaches can have a wide range of causes, locations, and associated symptoms. This is why they are classified into many different types including migraines (common and classic), cervicogenic headaches, tension headaches, cluster headaches, and many types of secondary headaches.
Secondary headaches can be caused by many different things like sinusitis, jaw dysfunction, and muscle pain. However, with secondary headaches it is important to rule out the possibility of serious underlying illnesses such as bleeding, infection, tumor, and other blood vessel or neurological causes. Symptoms of secondary headaches that may warrant further evaluation include fever or sign of whole body infection, neurological symptoms, a sudden onset of extreme headache, a new headache in older individuals, headache after trauma, and any pattern changes to an old headache.
Before I go over the different kinds of headaches and natural managements it is important to understand that any new headache should be evaluated by a health care provider and self-diagnosis is not recommended. This article is meant to be an overview of the different kinds of headaches, their features, and a review of research on conservative treatments.
Migraines
BACKGROUND
Migraine headaches are painful, recurrent headaches that usually last around 1-3 days. The pain from migraines is usually described as throbbing. Migraines have a genetic predisposition and are more common in females. They may be triggered by many factors including stress and intake of caffeine, alcohol, chocolates, and cheese. Hormonal changes in women can also be a common trigger in the onset of migraines. Visual disturbances and presence of a visual aura is what distinguishes the two categories of migraines which are common migraines and classic migraines. People experiencing classic migraines have a one-sided headache that is followed by visual disturbances and an aura. With classic migraines it is common to also experience nausea and vomiting. Common migraines are very similar in nature and also have a unilateral location but do not have the visual disturbances and aura.
TREATMENT OPTIONS
1. Removal of Triggers: Common triggers to consider removing from the diet include any foods that contain tyramine (cheese and wine), MSG, chocolate, sodium nitrate (hot dogs and lunch meats), bananas, nuts, caffeine, and aspartame. Stress can be a major trigger of migraines and stress relieving activities such as mindfulness meditation, yoga, massage, and exercise may also help reduce symptoms. Another trigger is altered sleep habits and not getting enough sleep. Adequate sleep is important andavoiding blue light from TV, cell phone, and computer screens at night can help improve your quality of sleep and reduce migraine frequency or severity.
2. Supplementation: Non-prescriptive strategies with different supplements have some evidence to help decrease migraine occurrence and severity. Here are some supplements that have been shown to help with migraines.
- Magnesium
- 600 mg/day
- Vitamin B2 AKA Riboflavin
- 400 mg/day
- Butterbur Extract
- 75 mg/2x per day
- Coenzyme Q10
- 300 mg/day
- Riboflavin
- 400 mg/day
3. Acupuncture: Acupuncture involves the placement of very small needles into specific points in the skin. It has been shown to be effective in relieving pain and preventing migraine relapse.
4. Chiropractic Spinal Manipulation: There is some evidence that spinal manipulation performed by a chiropractor can help reduce symptoms in migraine sufferers. This improvement in symptoms is possibly due to stress reduction in the patient leading to the elimination of a common trigger.
Cervicogenic Headaches
BACKGROUND
Cervicogenic headaches usually refer pain to the forehead, behind the eyes, and the temples. They are caused by tight and tender neck muscles from overuse. Poor neck muscle coordination and abnormal posture can also lead to cervicogenic headaches. Limitation of neck movement, abnormal tenderness of neck muscles, and changes in muscle tone of the neck after stretching can all be signs that your headache is a cervicogenic headache. Treatment for cervicogenic headaches is fairly simple and focuses on relaxing the muscles of the neck.
TREATMENT OPTIONS
1. Chiropractic Spinal Manipulation: Spinal manipulation by chiropractors has been shown to be effective for reducing symptoms of cervicogenic headaches. This alleviation of symptoms is likely due to the manipulation having a relaxing effect on the musculature of the neck.
2. Physiotherapy: Exercise and other muscular therapy options such as trigger point, ultrasound, e-stim, and more are performed by physical therapists as well as chiropractors. Physiotherapy has also been shown to be effective for treatment of cervicogenic headaches.
3. Massage Therapy: Massage therapy can be effective in reducing symptoms of cervicogenic headaches by relaxing the surrounding musculature of the neck. Although massage therapy has been shown help, research shows that mobilization (chiropractic manipulation) has more clinical benefits for spinal pain.
Tension Headaches
BACKGROUND
Tension headaches are usually described as a dull pain in a tight squeezing fashion that wraps around both sides of the head usually reoccurring over long periods of time. Pain from tension headaches is commonly worse in the afternoon or evening, are mild to moderate intensity, and are not accompanied by nausea or visual disturbances. It is thought that tension headaches are related to muscle tension and stress. Common triggers include depression, fatigue, over exertion, clenching or grinding teeth, medications, and previous head or neck injury
TREATMENTS
1. Acupuncture: Acupuncture has been shown to improve symptoms of tension headaches, and the benefits of the acupuncture treatment may still be seen after 6 months.
2. Lifestyle Changes: Lifestyle changes to improve overall health and avoid triggers can help with pain and recurrence of tension headaches. These include:
3. Manual Therapy: Manual therapy includes mobilization, manipulation, and muscle therapies. These treatments all have shown to be more effective for tension headaches than general practitioner care and likely work better in combination. Mobilization and muscle therapy are commonly performed by physical therapists and all three may also be performed by a good chiropractor.
Cluster Headaches
BACKGROUND
Cluster headaches are extremely severe headaches that occur as an excruciating stabbing-like pain through one eye. They typically last for 15-180 minutes per episode with episodes occurring for 4-8 weeks. Triggers for cluster headaches may be alcohol, smoking, pressure changes, napping in the afternoon, and nervous system fight-or-flight response impairment. Symptoms that are commonly seen with cluster headache are all on one side of the head and include droopy eyelid, red eye, constricted pupil, tearing, and nasal congestion.
TREATMENTS
Cluster headaches are extremely severe and may be managed with a headache specialist or neurologist. One non-prescriptive treatment option for cluster headaches that was found to be preventative was melatonin supplementation. In a small study (n=20), supplementation of 10mg of melatonin at night has been shown to reduce cluster headache frequency over placebo.
OVERALL..
Headaches can be extremely difficult to deal with and manage. An important step in management is identifying what type of headache you are experiencing and avoiding the triggers that set them off. It is also important that your headache is evaluated by a health care professional that can identify the type and rule out serious illness. Once you diagnosis is determined, there are many steps that you can take to naturally improve the severity, duration, and frequency of your headaches.