Headaches

Advice from HEALTH DIRECT

*If you have a sudden, severe headache or if you have a headache with vomiting, confusion, neck stiffness or changes in your vision, call triple zero (000) and ask for an ambulance.

Facts:

  • Headache disorders, characterised by recurrent headaches, are among the most common disorders of the nervous system.
  • A headache is a painful and disabling feature of primary headache disorders, namely migraine, tension-type headache and cluster headache.
  • Headaches can also be caused by or occur secondarily to a long list of other conditions, the most common of which is medication-overuse headache. Headaches, particularly migraine, can also affect children and adolescents but can affect them in different ways. Children’s migraines often affect both sides of their head and are usually shorter in duration. But, similar to adults, migraines in childhood and adolescence can result in missing school, sports and other activities.

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Facts:

  • Headache disorders, characterised by recurrent headaches, are among the most common disorders of the nervous system.
  • A headache is a painful and disabling feature of primary headache disorders, namely migraine, tension-type headache and cluster headache.
  • Headaches can also be caused by or occur secondarily to a long list of other conditions, the most common of which is medication-overuse headache. Headaches, particularly migraine, can also affect children and adolescents but can affect them in different ways. Children’s migraines often affect both sides of their head and are usually shorter in duration. But, similar to adults, migraines in childhood and adolescence can result in missing school, sports and other activities.

Prevalence

Globally, headache disorders affect approximately 40% of the population, or 3.1 billion people in 2021, and are more common in females compared to males. They are among the top three most common neurological conditions for most age groups, starting with age 5 and remaining in the top three until the age of 80. Despite some regional variations, headache disorders are a worldwide problem, affecting people of all races, income levels and geographical areas (1).

Not only is a headache painful, but it is also disabling. According to Global Health Estimates 2019, headache disorders were found to be the third highest cause of disability-adjusted life years (DALYs) worldwide, after stroke and dementia.

Headache disorders impose a burden on individuals that can include substantial personal suffering, impaired quality of life and financial cost. Repeated headache attacks, and often the constant fear of the next one, damage family life, social life and employment. The long-term effort of coping with a chronic headache disorder may also predispose the individual to other illnesses. For example, anxiety and depression are significantly more common in people who experience migraines than in healthy individuals.

Types of headache disorders

Migraines, tension-type headaches and medication-overuse headaches are of public health importance since they are responsible for high population levels of disability and ill health.

Migraine

Migraine is a primary headache disorder, in most cases episodic, that usually lasts 4–72 hours, accompanied by nausea, vomiting and/or photophobia and phonophobia. It is sometimes preceded by a short-lasting aura of unilateral, reversible visual, sensory or other symptoms.

Migraine most often begins at puberty and generally affects those aged between 35 and 45 years. It is more common in women, possibly because of hormonal influences. Children typically experience migraines that last a shorter duration, and abdominal symptoms are usually more prominent.

The exact cause of migraine is currently unknown, but it is thought to result from the release of pain-producing inflammatory substances around the nerves and blood vessels of the head. It can be triggered by alcohol and certain foods.

Migraine is characterised by recurring attacks and is often life-long.

Attacks typically include:

  • Headache, which is of moderate or severe intensity
  • One-sided or behind the eye
  • Pulsating in quality
  • Sggravated by routine physical activity
  • A duration of hours to 2–3 days;
  • Sensitivity to light and sounds; and
  • Nausea.

Tension-type headache

Tension-type headaches (TTH) are described as pressure or tightness, often like a band around the head, sometimes spreading into or from the neck. They may be stress-related or associated with musculoskeletal problems in the neck. They often begin during the teenage years and affect 50% more women than men.

Episodic TTH, occurring on fewer than 15 days per month, is reported by more than 70% of some populations. Episodic TTH attacks usually last a few hours but can persist for several days.

Chronic TTH can be unremitting and is more disabling than episodic TTH.

Cluster headache

Cluster headache (CH) is a primary headache disorder characterized by frequently recurring (up to several times a day), brief but extremely severe headache, usually focused in or around one eye, with tearing and redness of the eye. The nose often runs or is blocked on the affected side, and the eyelids may droop.

CH is relatively uncommon, affecting fewer than 1 in 1000 adults, affecting six men to each woman. Most people developing CH are in their 20s or older. CH has episodic and chronic forms.

Medication-overuse headache

Medication-overuse headaches (MOH) are caused by chronic and excessive use of medication to treat headaches. MOH is the most common secondary headache disorder.

It may affect up to 5% of some populations, women more than men. MOH occurs, by definition, on more days than not and is oppressive, persistent, and often at its worst when awakening.

Social and economic burden

Migraines and other headaches can affect people’s ability to work through decreased productivity and interpersonal relationships. Often, people continue to try to work despite the debilitating symptoms that can occur. Headache-related productivity loss may affect people’s careers and/or security, financial situation, relationships, and mental health. It also causes economic loss to companies and society.

Treatment

Many of those troubled by headaches do not receive effective diagnosis and care. Appropriate treatment of headache disorders requires training of health professionals, accurate diagnosis and recognition of the conditions, appropriate treatment with cost-effective medications, simple lifestyle modifications and patient education. The main classes of drugs to treat headache disorders include analgesics, anti-emetics, specific anti-migraine medications and prophylactic medications. For migraine treatment, analgesics need to be taken at the first sign of symptoms (such as visual aura) to prevent the associated headache. Simple interventions to educate people on medication overuse headaches, migraine triggers and lifestyle modifications are highly effective. Restricting or eliminating alcohol, regular sleep and exercise schedules, healthy diets, staying hydrated and using a headache calendar to identify other triggers are often all that is needed to provide relief.

Barriers to effective care

Lack of knowledge among health care providers is the principal clinical barrier. Many people with headache disorders are not diagnosed and treated. In many countries, medications, such as sumatriptan for migraines, are not available.

Poor awareness extends to the general public. Headache disorders are not perceived by the public as serious since they are mostly episodic, do not cause death and are not contagious. The low consultation rates in developed countries may indicate that many affected people are unaware that effective treatments exist. Half of people with headache disorders are estimated to be self-treating.

Many governments seeking to constrain health care costs do not acknowledge the substantial burden of headaches on society. They might not recognise that the direct costs of treating headaches are small in comparison with the huge indirect cost savings that might be made (e.g., by reducing lost working days) if resources were allocated to treat headache disorders appropriately.

WHO response

These evident burdens call for action. WHO recognizes this and partners with multiple non-governmental organizations to address headaches. WHO published the Atlas of Headache Disorders in 2011, describing the burden due to headache disorders and the resources available to reduce them.

In May 2022, the World Health Assembly endorsed the Intersectoral global action plan on epilepsy and other neurological disorders 2022–2031. The action plan addresses the challenges and gaps in providing care and services for people with epilepsy and other neurological disorders, such as headache disorders, that exist worldwide and ensures a comprehensive, coordinated response across sectors. This includes raising policy prioritizsation and strengthening governance, providing effective, timely and responsive diagnosis, treatment and care, implementing strategies for promotion and prevention, fostering research and innovation and strengthening information systems.

WHO’s position paper on optimizing brain health across the life course is a technical complement to the global action plan. The position paper provides a conceptual framework for brain health and how brain health can be optimized throughout life with actions across the following clusters of determinants: physical health, healthy environments, safety and security, learning and social connection, and access to quality services.

8 common types of headaches and how to treat them (a complete guide)

If you get headaches, know that you’re not alone. According to the World Health Organization, nearly half of all adults have had at least one headache within the last year.1

While there are more than 200 types of headaches2, only a few are very common such as cervicogenic headaches, tension headaches and migraines.

The good news? Most of the time, headaches are not a symptom of severe illness and can be managed by avoiding triggers, using appropriate medications or seeking physical treatment.

At Rasura Chiropractic Centres, we help patients get relief from headaches every day. In this article, we will walk you through the 8 types of headaches that we see most frequently, what causes them and how to treat them so you can get back to living your life.

Let’s get to it.

1. Cervicogenic Headaches

A cervicogenic headache (CGH) is a common and recurrent type of headache that originates from your neck and affects one or more regions of your head. It typically begins after a neck movement and often reduces your range of motion in the neck.

This type of headache is commonly misdiagnosed, and its symptoms can be mistaken for migraines, tension headaches, or other primary headache syndromes.

What They Feel Like

  • Pain originating from the neck and radiating along the temple and forehead
  • Reduced flexibility of the neck

Causes

  • Problems with your neck, such as vertebra alignment, irritated joints, or muscle spasms
  • A fall, injury, or whiplash (which is common after a car accident)
  • Arthritis, degeneration or tumours/cancers

Treatment

  • Physical therapies such as spinal manipulation through chiropractic care and remedial massage therapy can effectively alleviate and reduce the frequency of cervicogenic headaches by relaxing your neck muscles and improving your range of motion.
  • Complementing physical therapy with an ongoing exercise regimen often yields the best outcomes. Your chiropractor can design a personalised exercise and stretching program.
  • Relaxation techniques, such as deep breathing or yoga, can also be beneficial.
  • Deep dry needling (which we perform at Rasura Chiropractic Centres) or acupuncture can be effective.
  • If necessary, pain relief medication can be prescribed by your GP.
  • In severe cases, a nerve block procedure may be considered, or surgery can be recommended to alleviate nerve compression.

2. Tension Headaches

Tension headaches are the most common type of headache. They often result from tight muscles in the neck and head, stress, lack of sleep, or poor posture.

What They Feel Like

  • A dull, achy pain with a feeling of pressure around your head can extend to muscles in your scalp, neck, and shoulders.

Causes

  • Tight muscles in the neck and head
  • Stress
  • Lack of sleep
  • Poor posture

Treatment

  • Massaging the head, neck, and shoulders to release tension
  • Having your body adjusted by your chiropractor can be effective
  • Over-the-counter painkillers can provide temporary relief
  • Getting enough sleep
  • Improving your sitting and standing posture
  • Practicing regular exercise and stretching exercises like yoga or swimming
  • Consider having an eye test if eye strain is contributing to your headaches
  • Managing stress, anxiety, or depression with appropriate techniques (such as Bowen therapy, reiki or meditation) or with professional help
  • Having a hot bath or a sauna can help soothe muscle tension
  • Consider acupuncture

3. Migraines

If left untreated, migraines can last between 4 and 72 hours or longer, significantly impacting daily routines. They may be associated with genetic factors or other nervous system conditions.

What They Feel Like

  • Throbbing pain on one side of the head, often accompanied by nausea and vomiting.
  • Sometimes, you experience sensory disturbances called auras, including flashes of light, blind spots, other vision changes, or tingling in your hand or face.
  • Movement, light, and sound may worsen the pain.

Causes

  • Stress and anxiety
  • Sleep disruption
  • Dehydration
  • Skipping meals
  • Hormonal changes
  • Certain foods and medications
  • Bright lights and loud noise

Treatment

  • Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) and triptans, can help ease pain (consult your doctor).
  • Having a chiropractor adjust your neck can help minimise the duration of your migraine.
  • Antiemetics can help manage nausea and vomiting (consult your doctor).
  • Resting in a dark, quiet environment.
  • Apply an ice pack or cold cloth to your forehead.
  • Staying hydrated by drinking 2 to 3 litres of water daily.
  • Neurostimulation techniques, like transcranial magnetic stimulation, may be considered.

4. Cluster Headaches

Cluster headaches are very painful and come in cycles. They often wake people up in the middle of the night with intense pain around the eye on one side of the head.

These headaches happen at the same time every day, almost like clockwork (which is the other name for this type of headache). They can last from 15 minutes to 3 hours, and people may have multiple headaches in a row. Each cycle might last for weeks or months.

What They Feel Like

  • Swelling, redness, flushing, and sweating on the side affected by the headache.
  • Nasal congestion and eye tearing are on the same side as the headache.
  • Some patients have one of these symptoms; some have all of them.

Causes

  • The exact cause of cluster headaches is unknown; they can happen to anyone.
  • Certain lifestyle factors like smoking, drinking heavily, and consuming caffeine can trigger them.
  • Men are three times more likely than women to experience cluster headaches.
  • Cluster headaches may run in families.

Treatment

  • Medication prescribed by your doctor is the primary treatment for cluster headaches.
  • Inhalation of oxygen through a mask can provide relief during an episode.
  • Nasal sprays with local anaesthetics may also be helpful.

5. Sinus or Allergy Headaches

Allergic reactions can sometimes trigger headaches, and the pain is often centred around the sinus area and the front of the head.

However, true sinus headaches are relatively rare. If there are no nasal symptoms, the headache is more likely to be a migraine attack.

What They Feel Like

  • Pain and pressure behind the eyes, cheeks, and forehead, with aching in the teeth. The pain is similar to a migraine and may worsen when bending over or lying down.

Causes

  • Inflammation of the sinuses due to allergies or infection.

Treatment

  • Sinus drainage massage (adjustments to the skull performed by a chiropractor).
  • Resting and drinking plenty of fluids can help relieve symptoms.
  • Over-the-counter pain relief can be effective.
  • Nasal decongestants and saltwater nasal sprays from the pharmacy may provide relief.
  • Antihistamines and steroid nasal sprays, available on prescription, can also help.
  • Antibiotics may be prescribed by your GP if there is a bacterial infection.

6. Post-Traumatic Headaches

If you experience a head injury due to an accident, you may get a post-traumatic headache, typically two or three days after the trauma. These headaches can last for several months and may become chronic.

It’s important to consult a doctor immediately after an accident, as other complications can arise, such as concussion.

What They Feel Like

  • Post-traumatic headaches can feel similar to tension headaches or migraine episodes.
  • Additional symptoms may include memory problems, fatigue, irritability, vertigo, and light-headedness.

Causes

  • Head injuries

Treatment

  • Mobilisations and stretches are provided by your chiropractor.
  • Over-the-counter pain relief can help manage post-traumatic headaches (consult your GP).
  • If symptoms are severe or worsen over time, seek immediate medical attention.

7. Hormonal Headaches (Menstrual Migraines)

People who menstruate may experience headaches linked to hormonal fluctuations. These headaches often occur two days before or during the first three days of the menstrual period or during ovulation.

What They Feel Like

  • Throbbing pain on one side of the head, sometimes accompanied by nausea, vomiting, sensitivity to light and sound, and aura (audio-visual disturbances preceding other symptoms).

Causes

  • Hormonal changes during menstruation
  • Use of oral contraceptives
  • Pregnancy
  • Menopause

Treatment

  • Resting or sleeping in a dark, quiet room can provide relief (sleep can shorten or stop migraine episodes in some individuals).
  • Staying hydrated and having a light meal can help if hunger or dehydration is a trigger.
  • Keeping a symptom diary can help identify connections between migraine symptoms and hormonal fluctuations.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and medications can help alleviate your symptoms (consult your doctor).

8. Hypertension Headaches

Hypertension headaches occur in a small percentage of people when their blood pressure becomes dangerously high (greater than 180/120 mmHg). The pain from these headaches is often experienced all over the head and may be described as a “hair band” type pain.

What They Feel Like

  • All-over pressure, most severe in the morning, improving throughout the day. Pain may be described as throbbing or pulsating.
  • Feelings of depression and general ill-being may accompany symptoms.
  • Other symptoms can include nausea, vomiting, visual disturbances, and dizziness.

Causes

  • High blood pressure
  • Pre-eclampsia and eclampsia (in third-trimester pregnant mothers and post-delivery mothers)

Treatment

  • Your GP or obstetrician may prescribe medication to lower your blood pressure, or use intravenous medication during emergencies.
  • Lifestyle changes are essential to manage hypertension headaches effectively:
    • Avoid smoking and excessive alcohol consumption.
    • Engage in regular physical activity.
    • Manage stress levels.
    • Reduce salt and fat intake while increasing fruit and vegetable consumption.

Primary vs Secondary Headaches

Headaches are classified as either primary or secondary.

Primary headaches account for about 95% of headaches4. They occur independently, whereas secondary headaches occur as a result of other health problems.

Today, the majority of primary headaches are associated with muscle tension in the neck. Modern lifestyles with increased sedentary activities and prolonged fixed postures (such as working at a computer) can contribute to joint irritation and muscle tension in the neck, upper back, and scalp, leading to debilitating headaches.

Chiropractors can help release these headaches through mobilisation techniques, soft tissue therapies such as massage and manual adjustments.

The Do’s and Don’ts of Headaches

👍 Do

  • Take time to rest or sleep in a dark, quiet room to allow your body to recover (especially for migraine).
  • Regularly stretch and practice low-impact exercises, such as walking, gentle swimming, or yoga, especially if you suffer from primary headaches.
  • Stay well-hydrated by drinking 8 glasses (approximately 2 litres) of water daily, as dehydration can trigger headaches.
  • Maintain a headache diary to identify patterns and triggers. This will help you and your doctor manage your headaches more effectively.
  • Consult your chiropractor to diagnose the specific type of headache you’re experiencing and receive appropriate treatment.
  • Consider seeking chiropractic care early on to help diagnose which type of headache you have and organise a treatment plan. Chiropractic can be an effective treatment option especially for cervicogenic headaches, tension headaches and migraines.

👎 Don’t

  • Avoid jaw/teeth clenching, as it can lead to tension headaches. Be conscious of this habit throughout the day and during your sleep.
  • Avoid using over-the-counter pain medications more than 3 times a week, as this can lead to ‘medication overuse headaches’, not to mention constipation.

When Should I Seek Help?

While headaches are common and often mild, you should consult your doctor if they occur frequently and hinder your daily activities, if you find yourself regularly taking pain medicine for headaches, or if you experience any of the following symptoms alongside your headache:

  • The worst headache you’ve ever had (10 out of 10 pain, usually at the base of your skull)
  • Paralysis in any part of your body
  • Fever of 38°C or higher
  • Slurring of words
  • Stiff neck
  • Rash
  • Vomiting
  • Confusion
  • Visual loss
  • Loss of balance
  • Loss of sensation
  • Ringing in the ears
  • Change in personality
  • Aura (vision) symptoms lasting longer than an hour
  • Morning headaches accompanied by nausea that persist

Proper diagnosis and treatment are crucial in managing headaches effectively, so don’t hesitate to reach out to healthcare professionals.

That’s a Wrap

Headaches are a common problem that most people experience at some point in their lives. In this guide, we discussed the eight main types of headaches and how to manage them. The most common types of headaches are cervicogenic headaches, tension headaches, and migraines.

Sometimes, headaches can be managed by making simple lifestyle changes, such as getting enough sleep, staying hydrated, and reducing stress.

However, if you experience severe or frequent headaches, you should consult your GP for further investigation. It’s also a good idea to keep a headache diary to help identify patterns and triggers.

Chiropractors can help relieve your pain with specific adjustments and personalised advice on lifestyle, exercise, diet and food supplements. At Rasura Chiropractic Centres, we help our patients free themselves from headaches every day.

Frequently Asked Questions

Headaches can be caused by various factors, including stress, muscle tension, dehydration, lack of sleep, eyestrain, sinus congestion, hormonal changes, medication side effects, or underlying health conditions such as migraines, tension-type headaches, or cluster headaches.

Seek medical attention if you experience severe or sudden headaches, headaches accompanied by neurological symptoms (such as numbness, weakness, difficulty speaking, or vision changes), headaches after a head injury, persistent headaches that worsen over time, or headaches associated with fever, vomiting, or confusion.

For mild to moderate headaches, try resting in a quiet, dark room, applying a cold or warm compress to the forehead or neck, practicing relaxation techniques (such as deep breathing or meditation), staying hydrated, and taking over-the-counter pain relievers like acetaminophen or ibuprofen. Avoid triggers such as certain foods, stress, or lack of sleep.

Schedule an appointment with your healthcare provider if you experience frequent or severe headaches that impact your daily activities, headaches that do not respond to over-the-counter medications, or if you have a history of headaches with specific triggers or associated symptoms.

Common headache triggers include stress, fatigue, dehydration, skipped meals, certain foods (such as processed meats, caffeine, alcohol, and artificial sweeteners), bright lights or glare, loud noises, strong odors, hormonal changes (such as menstrual periods or menopause), and excessive screen time.

While some headaches cannot be entirely prevented, you can reduce the frequency and severity by identifying and avoiding triggers, maintaining a regular sleep schedule, staying hydrated, practicing relaxation techniques, managing stress through regular exercise or mindfulness activities, and ensuring proper posture and ergonomics during work or activities. If you suffer from frequent headaches, your healthcare provider can help develop a personalized prevention plan based on your specific triggers and needs.