Headaches: Tension and Clusters and Migraines, Oh My!

Although we’ve all had a headache at one time or another, you may not realize that not all headaches are the same. While they all involve head pain, there are actually a whole host of different types of headaches ranging significantly in location and severity. Often, how the headache presents can tell you what is causing it  – and, more importantly, how to treat it.

One of the most common types of headaches is a tension headache. Typically these start at the base of the skull and can wrap around the head like a headband.  These are often triggered by stress, either physical or emotional.  There are a host of things that can be done to prevent and treat this type of headache, but the most effective greatly depends on the underlying cause.  If it tends to pop-up when you are emotionally stressed it may be a good idea to consider talking to an objective friend or therapist, start meditating regularly, or finding some other way to promote stress reduction and a better stress response. Additionally if your body is physically stressed it may also respond with a tension type headache. This is best treated with appropriate rest, exercise and diet. If there is a mechanical issue that is contributing to it osteopathic manipulation can help reduce this physical stress.  One thing that can play a big role in both emotional and physical stress is a lack of sleep. So make sure you are getting enough sleep every night and that you feel rested in the morning. If you are not feeling rested you may want to talk to your doctor about checking to see if you have an underlying medical issue that could be contributing to this. Of course there is always ibuprofen and acetaminophen, but chronic use of either of these medications has been shown to reduce their efficacy and as always no medication is without its side effects. So it is best to identify the underlying cause and treat appropriately.

Another very common type of headache is the sinus headache.  These are most typically associated with allergies, but can also be associated with sinusitis, upper respiratory infections and the flu. They can range from a mild discomfort to excruciatingly painful.  The reason the sinuses hurt is because they build up pressure and this pressure results in pain. While it can present in several different areas depending on exactly which sinus is causing the pain. Typically it is in the front of the head of face. Occasionally the pain will also feel like it is right behind the eyes. Once the sinus pressure is alleviated the pain should resolved as well. If your sinuses are not draining well this may be your only symptom as it is often the drainage that results in the vast majority of other symptoms associated with allergies. By treating the allergies and encouraging drainage it can help resolve a sinus headache. This includes over the counter antihistamines, prescription medications, osteopathic manipulation and a variety of home remedies that can promote drainage. (See allergy post)

Migraines are another common type of headache. Many people think that they have migraines just because their pain is severe, but this may not be the case. Some people with migraines don’t get a headache at all, but rather just have a form of sensory disturbance like a loss of vision, or smells or tastes that aren’t present.  Typically a migraine presents with a throbbing pain on just one side of the head, and tends to be associated with nausea, vomiting, and severe light avoidance.  A classic migraine will also present with an aura.  This is an abnormality in one or more of the senses (vision, hearing, smell, touch, and taste).  Presently medicine is uncertain as to the underlying cause of migraines. Previously migraines were believed to be vascular in nature, due the mechanism of action of the medications that were used to treat migraines, but recent studies have refuted this theory.  There is a long list of both preventative and abortive prescription medications that can be taken for migraines. However the most important thing to do to treat migraines is to learn how to avoid them. Many people have specific triggers that tend to flare up a migraine. This can be a food, a smell, a flickering or bright light, weather changes, menstruation, or stress.  By paying close attention and identifying the triggers, migraine suffers can reduce the frequency of these headaches.

Another notably less common type of headache is the cluster headache. It is often considered to be the most painful of headaches. It is often described as burning. People suffering from these headaches have trouble holding still (the opposite of those with migraines). The heads tend to flare several times a day for up to a few months. In addition to the standard over the counter medications, there is a long list of prescription medication that can be taken for it as well. But one of the safest treatments is high concentration of oxygen, but it’s hard to carry around an oxygen tank all the time.

While some people do present with a single type of headache, it is important to remember that it is not uncommon for one type of headache to flare up other types of headaches as well. So if your headache doesn’t match any specific presentation precisely, it could be that you have a mixed type of headache.  Each headache may need to be treated individually, or you may just want to treat the main underlying cause to avoid being on a multitude of medications.  As always, if you have any concerns or are uncertain, it would be a good idea to contact your doctor on the matter.