19/09/2013 Gavin

Headaches – a pain in the neck?

Headaches affect around 60% of the adult population every year.  And at any given time in the UK, more than 1.5 million people are suffering a headache (more on January 1st, but this article isn’t concerned with those).  Despite this, undergraduate medical students (and osteopaths) receive on average 4 hours of training in the study of headache.

What causes headaches?  What can you do about it?  Read on…

The International Headache Society classifies over 140 different types  of headache!  That makes “headache” very difficult to diagnose at times.  However the chances are extremely high that your headache falls into one (or more) of the below categories.

Tension Type Headache (TTH)

As you’d guess from the name, stress seems to be one of the strongest predictors of TTH, as well as generalised anxiety, depression and other mood disorders.  The headache is often described as “pressure” or “a tight band”; it’s generally over both sides of the head, and often front and back.  The mechanism is poorly understood, but believed in many cases to be due to tension in the neck muscles, which is why so many people benefit from physical therapy.

Migraine with Aura

An aura is a spontaneous disturbance of sensation or control; most typically sufferers experience visual difficulties (wavy or zaggy lines for example), but in some cases sufferers experience weakness of a limb, or other “odd feelings”.  Aura can last from a few minutes to an hour, and is then followed by a one-sided severe pulsating headache, lasting from an hour to a couple of days.  Many people have to lie in a dark room with no noise to wait for it to pass.  Migraine can be familial and can be associated with ….     It used to be believed that Migraine was caused solely by changes in blood flow to the brain; however, now we know that there is an unusal slowly spreading activation of nerve cells (causing the aura) and an inflammatory process triggered in the brain.  There are frequent triggers for migraine e.g. tiredness/stress, chocolate, cheese, red wine.

Migraine without Aura

Associated factors are very similar to Migraine with Aura, and the underlying processes are similar too; they just don’t involve the spreading activation of nerve cells (which is the cause of the aura).

Medication Overuse Headache

Ironically, the use of medication to treat headaches (and other pains) can lead to headaches.  These headaches occur on at least 15 days out of the month, are often at their worst on waking in the morning, and tend to steadily increase in frequency over time.  Unfortunately the first treatment is to stop taking the medication – do this in consultation with you doctor though.

What can you do about Headaches?

Make sure you get an accurate diagnosis.  Getting the right help for headaches is totally dependent on getting the right diagnosis; wrong diagnosis=wrong treatment=little (if any) help.  In fact, having the wrong treatment can actually make matters worse in the long run, especially if you run the risk of medication overuse headache.  If your headache isn’t responding to your own treatment (e.g. over the counter medication) or is happening more frequently over time, or worsening in severity, then please contact us for an accurate diagnosis and management plan; we will often involve your GP in this process.