Understanding Headaches: Types, Triggers, and Treatments
On any given day, an estimated 15.8% of the global population will suffer from a headache. This means that roughly one in every six people you interact with today—at the grocery store, at the office, or in line at Starbucks—will be dealing with a headache. That number has been on the rise for several decades.
Headaches can be a source of incredibly debilitating pain, especially when accompanied by other symptoms such as neck pain, nausea, or sensory sensitivity. Unlike a sprained ankle that feels better with ice or a sore muscle that improves with rest, headaches can be mysterious and persistent, often resisting typical pain-relief strategies. To effectively tackle headaches, we must first understand the source of the pain, but this is easier said than done.
Headaches come in several different forms, each with its own triggers, presentation, and treatment approach. Below, we will discuss the causes, symptoms, and treatment for the three major categories: tension-type headaches, migraines, and cervicogenic headaches.
Tension-Type Headaches
Tension-type headaches can stem from various causes but are often the result of excess tension in the muscles of the scalp, face, and neck. This tension is frequently triggered by stress or emotional conflict. Excessive neck and eye strain, jaw dysfunction, sleep disorders, and mood disorders such as anxiety and depression can also contribute to their onset.
Tension-type headaches present as a dull, achy pain that spreads diffusely across both sides of the head, often described as a tight band squeezing the cranium. Though the symptoms are typically milder than those of other headache types, they can still be difficult to manage. Sufferers may experience anywhere from 1 to 30 episodes per month, with pain lasting days or even weeks at a time. Additional symptoms may include sensitivity to light and sound, neck and shoulder tension, and a decreased appetite.
These headaches affect women more than men by a 3:2 ratio, and researchers estimate that over 70% of people have experienced this type of headache at some point.
Managing Tension-Type Headaches
If you suffer from tension headaches, the key to managing your symptoms is managing your stress. Strategies include getting good sleep, exercising regularly, and engaging in mindfulness activities to calm your nervous system and release muscle tension. Addressing neck or jaw tension through massage or physical therapy can also help reduce the frequency of tension headaches. Heat, ice, or over-the-counter pain relievers can provide temporary symptom relief.
Migraines
Migraines are the most mysterious of the three categories, as their exact causes and contributing factors vary greatly from person to person. These moderate to severe headaches are brought on by the stimulation of nerve fibers that run through layers of protective membranes in the brain. Since these nerve fibers interact with many other processing areas, they can become hyperactive due to hormonal changes, stress, lack of sleep, strong odors, diet, or other factors.
Migraines tend to be genetic and frequently occur in individuals with other medical conditions. They present as pain around the eyes and in the front and side of the head, often concentrating on one side with a slight spread across the forehead. Sufferers typically experience 1 to 4 episodes per month, lasting anywhere from 4 to 72 hours. The pain is severe, throbbing, and pulsing, often accompanied by nausea, vomiting, visual changes, vertigo, and sensitivity to light and sound. Migraines affect women more than men by a 3:1 ratio.
Managing Migraines
If you suffer from migraines, it’s important to identify your personal triggers. Since the potential triggers vary widely, keeping a symptom diary can help determine contributing factors. Once identified, lifestyle modifications may be necessary, such as avoiding problematic foods, improving sleep habits, reducing stress, and staying hydrated.
For those experiencing visual or sensory changes like vertigo, blurred vision, or motion sensitivity, physical therapy can help address these issues. Stress management and relaxation training may also be beneficial. Consult your physician to explore drug therapy options that can help manage chronic migraines.
Cervicogenic Headaches
Cervicogenic headaches are considered secondary headaches because they result from problems in the neck rather than the head itself. Dysfunction in the joints, discs, or soft tissues of the cervical spine can refer pain to the head, causing headache symptoms.
Because the source of the problem is in the neck, patients often report that their headaches start in the neck before radiating upward. These headaches are commonly triggered by neck movement, poor posture, or tightness, and limited mobility in the cervical spine. The pain is typically located at the back and top of the head, as well as around the eyes, and it usually remains confined to one side. Sufferers may experience episodes lasting from one hour to several weeks, often on a chronic basis. The pain is steady and non-throbbing, and aside from neck stiffness, there are usually no other significant symptoms. Unlike other headache types, men and women are equally affected.
Managing Cervicogenic Headaches
If you suffer from cervicogenic headaches, physical therapy is the best option. It is essential to address dysfunction in the neck before headaches can be resolved. Improving cervical spine mobility, releasing tight tissues, and strengthening weak neck muscles can help reduce the frequency of referred pain into the head. Additionally, paying attention to head posture and sleeping positions can contribute to a healthy neck and support recovery.
Take Control of Your Headaches
Headaches can be frustrating and difficult to manage, but understanding their causes and treatment options can help you take control of your symptoms. If you struggle with persistent headaches, consult with a physical therapist or physician to determine the best course of action and conquer your headaches for good!
By: Lauren Smith, SPT