Headache is an extremely prevalent problem and can be a severely disabling condition. Like most conditions we have discussed there is a huge spectrum of different types of headache with different causes all requiring different kind of treatment approaches. It is estimated that 30% of people who consult a Neurologist do so because of headaches. The International Association for the study of headache classifies 126 different types of headaches, not all with a known cause although you can see the challenge involved in identifying the cause of headaches.
Very frequently headaches are referred to as migraine, which has become a general phrase to describe headaches but is in fact a specific type of headache with a known cause and definable triggers. Migraine generally needs to be managed with specific types of drugs and very frequently the persistent migraine sufferer ends up developing secondary headaches known as chronic daily headaches.
These are similar in pattern to the so-called tension type headaches, which are very prevalent and most importantly are treatable with specific physiotherapy techniques to address the neck, upper back, joints and muscles.
In other words tension type headache and chronic daily headache often originate from the cervical spine (neck) and are generally known as cervicogenic headaches. Sometimes they exist in isolation and sometimes they are part of a more complex problem. We frequently see them in association with whiplash but also they can be linked with spontaneous onset of no identifiable cause.
Physiotherapy treatments in these kinds of cases involve mobilising the joints in the upper neck, the junction of the neck and the upper back and very frequently the thoracic spine (the area between the shoulder blades). When muscle tension is part of the pattern specific treatments e.g. stretching, trigger point release, heat packs at home are also part of the first aid management strategies.
Retraining muscle strength and coordination, particularly when patients describe that using the arms or having the head in certain positions provoke symptoms or if they feel the weight of the head as being too heavy. These are all important indicators that these types of headaches can be addressed with appropriate specific physiotherapy. In some cases people have a mixed headache pattern, multiple different triggers sometimes stress related, sometimes hormonal imbalances, dehydration or certain triggers e.g. chocolate, red wine and dairy products.
This can also be superimposed upon a postural joint soreness or muscle spasm pattern, which becomes another trigger to the headache. Effective management involves identifying all of the triggers and controlling them as best as possible.