The patient is often a middle-aged male complaining of incredibly painful headaches that are located in the eye region. The headaches cluster over days or weeks and then end, to appear again several weeks or months later. The headaches last on average 20 minutes and are the most painful feeling the patient has felt. The frequency of attacks is on average several times per day, often at night, lasting of one to several weeks. Recurrence may not occur for months or even years later.
There is a possible association with smoking as a trigger and alcohol as an exacerbating factor. There is tearing of the eyes and runny nose on the same side of the headaches. The natural history is for headaches to decrease in frequency and intensity as the patient ages.
Avoidance of alcohol and smoking are important in managing cluster headaches.
Migraine patients usually complain of throbbing on one side of the head that may or may not be preceded by an aura. The aura typically consists of progressively increasing blind spots surrounded by flashing lights. This lasts for about 30 minutes and is replaced by a disabling headache that last for several hours to as long as 1 to 3 days, causing the patient to seek a dark, quiet environment. Migraine with an aura accounts for only about 0% of all migraines.
Typically, the initial onset of migraine headaches occurs in adolescence or the early 20s the period when people are most physically active. Migraine can occur in children as young as age 5, with a peak from 10 to 13 years. Seventy percent of total migraine sufferers are women, though in children both genders are affected equally.
Patients who have migraine will describe the pain as throbbing or pulsating, usually severe, and often incapacitating. Migraine is considered a sick headache with associated symptoms such as nausea, vomiting, and photophobia (sensitivity to sound), diarrhea, dizziness, light headedness, chills, and fatigue.
Once believed to be purely vascular (blood vessel related), migraine headaches are now believed to be neruogenic (nerve related). There appears to be a wide variety of triggers for migraines, including variation in sleeping or eating habits, stress, fatigue, environmental pollutants, certain medications, and food. With food, the primary triggers include chocolate, caffeine, foods containing tyramine, cured meats, cheese, nuts and wine. Patients who routinely consume excessive caffeine may also precipitate a migraine attack if they miss the caffeine-containing beverage or medication. There is usually a family history of migraines.
Management of migraines includes maintaining a regular sleep schedule, stress management, and avoidance of over- or under sleeping, skipping meals and other food triggers. Chiropractic, Physiotherapy, and Targeted Soft Tissue Therapy can help to relieve the overall tension in the neck and upper back during or between your migraine episodes.
Muscle tension headaches, or stress headaches make up 90% of all headaches. They occur frequently and are often worse in the afternoon or early evening. The pain is usually on both sides of the head, often at the base of the neck or above the eyes.
The trigger points commonly stem from: the top of the shoulders (upper trapezius), the back of the head (suboccipitals), and the back of the neck and top of the shoulders (levator scapula). The headaches usually last for days or weeks.
- Correcting any postural imbalances with Functional rehabilitation
- Ensuring proper ergonomics at the workstation
- Stress management
- Targeted Soft Tissue Therapy and Chiropractic for trigger points and misalignments in the neck and upper back