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What kind of Headache are you having?

Did you know that not all headaches are migraines? There are actually several different types of headaches depending on the cause, location, and symptoms. Let’s look at 3 common types of headaches and find out what type of headache you might be suffering from and how to help!


woman having headache on couch

 

First up, you have your migraine. Migraines affect more than 1 billion people each year worldwide. Migraines can be classified with auras and without auras. To be classified as a migraine without an aura, you have to have these 4 symptoms:

1.  An untreated headache lasting 4-72 hours

2.  Headache with at least 2 of the following:

a.  Unilateral (one side of your head)

b.  Pulsating

c.  Moderate or severe pain

d.  Aggravated by physical activity or avoiding physical activity due to pain

3.  During the headache you experience at least 1 of the following:

a.  Nausea and or vomiting

b.  Photophobia (light sensitivity) or phonophobia (sound sensitivity)

4.  Headache not due to another disorder

To be classified as a migraine with an aura you have to have at least 2 attacks with the symptoms below:

1.  One or more of the following aura symptoms:

a.  Visual: blindspots, lines, shimmering spots, flashes of light, vision changes

b.  Sensory: tingling in the arms or face

c.  Speech/language: can’t think of the right words or the words come out wrong

d.  Motor: weakness on one side of the body, dizziness, lack of coordination

e.  Brainstem: vertigo, dysarthria, diplopia, ringing in the ears, impaired hearing, lack of coordination, confusion

f.  Retinal: flashes or sparkling lights, blindspots

2.  At least 2 of the 4 below:

a.  At least 1 aura symptom that spreads over 5 minutes or 2 in a row

b.  Each symptom lasts 5-60 minutes

c.  At least 1 symptom is unilateral

d.  Aura accompanied or followed by a headache within 60 minutes

 

Second, you could be suffering from a tension headache. The cause is unknown but it usually occurs with other types of headaches. Here are 3 things to look for when trying to decide if it is a tension headache:

1.  Last 30 minutes to 7 days and has at least 2 of the following:

a.  Bilateral (both sides of your head)

b.  Pressing/tightening feeling (Not pulsating)

c.  Mild to moderate intensity

d.  Not aggravated by physical activity

2.  No nausea/vomiting

3.  Only Photophobia OR phonophobia, not both

Finally, you have your cervicogenic headache. Here’s what to look for in cervicogenic headaches:

1.  Usually unilateral and localized in the upper neck but can spread to the head in a ram’s horn pattern

2.  Caused my neck movements or sustained postures

3.  It has at least 1 of the following:

a.  Limited neck motion

b.  Change in muscle tone (increased tightness, knots, etc)

c.  Increased tenderness of neck muscles

 

There are of course many other types of headaches such as sinus headaches, cluster headaches, and vestibular migraines. If you are suffering from what you think might be a vestibular migraine, I highly recommend you reach out to Paige Day with the Dizzy Dr. for treatment, she is an expert in this field. (IG tag)

 

When is a headache not JUST a headache and you should seek further care?

1.  If it your first headache or worst headache ever

2.  You are experiencing a new onset of headaches over the age of 50

3.  You have a new onset of headaches and have an immunodeficiency disorder or history of cancer

4.  You have a change in mental status with your headache (confusion, memory loss, etc)

5.  You headache is accompanied by a fever or meningeal signs (neck stiffness, photophobia, seizures)

6.  Headache with neurological symptoms

7.  Increased frequency or severity of headaches

 

Physical therapy can be very successful in the treatment and management of headaches, especially cervicogenic headaches. Treatment can include manual therapy like massage, mobilizations and manipulations, dry needling, and stretching. Specific, guided exercise is also beneficial for headache management.

 

Here are a few other things to help manage your headaches on your own:

1.  Exercise regularly: 30 minutes of moderate intensity, 5 days a week

2.  Limit caffeine to under 400 mg a day

3.  Eat a healthy diet, certain foods may trigger headaches

4.  Limit or eliminate alcohol, smoking, and drugs

5.  Get 7-8 hours of sleep each night

6.  Manage stress: exercise, meditate, journal, etc


 

Amiri P, Kazeminasab S, Nejadghaderi SA, Mohammadinasab R, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Migraine: A Review on Its History, Global Epidemiology, Risk Factors, and Comorbidities. Front Neurol. 2022 Feb 23;12:800605. doi: 10.3389/fneur.2021.800605. PMID: 35281991; PMCID: PMC8904749.

 

Kadian R, Shankar Kikkeri N, Kumar A. Basilar Migraine. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507878/

 

 

 


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