A migraine usually is a throbbing headache that occurs on one or both sides of the head. The headache typically is accompanied by nausea, vomiting or loss of appetite. Activity, bright light or loud noises can make the headache worse, so someone having a migraine often seeks out a cool, dark, quiet place. Migraines can be triggered by certain activities, foods, smells or emotions. Some people are more likely to experience migraines when they are under stress, while others develop migraines when stress is relieved (for example, the day after exams or an important meeting). Conservative management may be effective for controlling symptoms of migraines and reducing their frequency. Further, a study was performed in Australia at the Chiropractic Research Center of Macquarie University that proved that spinal manipulation helps migraines. One hundred seventy-seven volunteers who had migraines for more than 18 years on average were used. The volunteers who received spinal manipulation showed a statistically significant improvement in migraine frequency, duration, and disability.
"Classic" Migraine Headache
Similar to common migraine. Many authorities like to classify this headache into three phases. Phase 1 or prodromal which involves mood behavior changes, wakefulness, appetite and bowel activity changes as well in fluid balance several hours to days earlier. Phase 2 or warning symptoms (pre-headache phenomena or "aura") visual disturbance. The most common focal neurological disturbances in migraine involve the visual system, poorly formed scintillating phenomena, visual hallucinations, and other objects. Fortification spectra represent glittering zigzag patterns. This has even been noted in people with no eyes. Unilateral vision impairment may have an "Alice in Wonderland" phenomena of bizarre alterations of shape, color, size, and body images. One fourth of the patients report flashes of color or non-color images. The third phase or headache phase is approximately 30 minutes later. At this point usually it must run its course as nothing will change it.
"Common" Migraine Headache
Virtually no part of the brain is sparred involvement. Severe one sided throbbing pain, often accompanied by nausea, vomiting, tremor, dizziness, cold hands, or sensitivity to light or sound. Triggered by certain foods, the use of the "pill", menopausal hormones, excessive hunger, drastic changes of altitude or weather, bright or flashing lights, excessive smoking, emotional stress. Mostly females biological predisposition, probably hereditary. Emotional factors are most important precipitating factor, i.e., prolonged stress, skipping meals, strenuous exercise, too much or too little sleep, intermobilized anger and repressed hostilities, depression and a wide variety of other emotional and personality issues.
Those who received spinal manipulation were also able to considerably reduce the amount of medication they were taking, some eliminating the use of medication altogether.
Temporo-Mandibular Joint Dysfunction
Temporal Mandibular Joint (TMJ) is the joint between the jaw or mandible and the skull. It is used every time we chew, talk, or even swallow. Its anatomy, as well as its movement, is very complex. There are significant functional relationships between the TMJ and cranio-cervical (head and neck) neuromuscular systems and these can often become dysfunctional (TMD). This dysfunction can cause pain in the jaw or face, popping or clicking during chewing, limitation of jaw movement or headaches. The muscles involved in TMD are frequently an untreated factor in patients with headaches that may have failed other forms of treatment. The doctors at Sport and Spine Rehab are highly trained in the evaluation and treatment of this orofacial condition. Our conservative approach to temporomandibular dysfunction consists of a detailed examination of the TMJ and its function, as well as the function of the cervical spine (neck). Treatment focuses on releasing the tension with the proper soft tissue treatments, in some cases mobilizing the jaw or manipulating the neck. Patients are engaged in an active care model that works on how to retrain proper jaw motion with rehabilitation exercises. The goal of this treatment is to restore proper function of the joint and stabilize its motion.
Infrequent cause of a headache, it is a muscle contraction type of pain, sometimes accompanied by clicking, popping or snapping sound on opening the jaw. Iatrogenic in nature (generally) malocclusion (poor bite) following dental work. High filling, uneven bridge, false teeth changes, or early use, or tooth extraction, biting down too hard on one side, or biting on something to hard on one side. Bruxism, chronic anger and severe tension, however this usually affects the buccinator more. This headache can also occur due to the mechanism of trauma in Hyperextension injuries.
Cervicogenic headaches occur when joints and/or muscles are dysfunctional in the neck. This can cause pain in the head from a variety of sources: Compression of nerves that innervate the head, Referred pain into the head from the neck from tight muscles, Referred pain into the head from joints in the neck that are not moving properly. Upon physical examination, it can be easily determined if this is the cause of your head pain. Once diagnosed, comprehensive treatment to eliminate the cause of the pain can yield highly successful outcomes.
This comes under the group psychalgia and muscle contraction headache. Tension or irritating non-controllable situations can bring it on or aggravate it. Hatband effect, i.e., tightness band like restrictions about the head and neck and unassociated with gastrointestinal or visual distress but often accompanied by adverse psychological states such as depression, anger and anxiety. Secondary muscle contraction headache can be acute or chronic, the consequence of structural pathology about the head and neck, i.e., cervical spine arthritis, myositis, TMJ syndromes, ocular disease, and abnormalities of posture.
This is a paroxysmal, painful disorder involving the greater occipital. (The lesser occipital nerve commonly varies in size reciprocally with the greater occipital nerve.) Occipital neuralgia frequently results from inflammation and or compression, often from previous trauma, chronic muscle contraction and neuroma formation. Herpes Zoster may also be causative. The pain and "trigger zones" are along the course of the occipital nerve, usually as it emerges from between the trapezius and sternocleidomastoid musculature. Radiation of the pain or numbness to the vertex up to the anterior aspect of the ear. Stimulating will incite and reproduce the symptom to areas innervated by the lesser and greater occipital nerve. The can radiate to the frontal and ocular regions. All of this is generally unilateral.
Post Traumatic Headache
This headache is difficult to be clinically distinguished from muscle contraction headache unassociated with trauma. Pain can be localized or general in nature. It can mimic migraine with some slight differences such as seen in phase 3 of the migraine. Light pressure such as a pillow or hat can precipitate a paroxysm of pain. May be related to vascular and or nerve injury indistinguishable at times from occipital neuralgia. The headache pattern is mixed. The symptoms include unilateral vascular pain localized to frontal temporal region, blurred vision and transient ipsilateral pupillary dysfunction and excessive facial swearing. Decreased libido and alcohol intolerance is common. Tenderness around the ligamentous nucha and muscle attachment with myositis. Myofascitis and suboccipital neuralgia may be present. Most important clues are light headedness, true vertigo, impaired memory, reduced attention span, insomnia, irritability, anger outbursts, mood swings, anxiety, depression, frustration and occasional syncope.
Rather severe excruciating pain around one's eye. Tearing of one or both eyes. Congestion of one nostril or both. May have flushing of the face. Generally occurs during sleep and becomes better after 1 to 2 hours on arising. However, it can occur for hours and can occur every day for weeks or months. The attacks can disappear for up to a year. Occurs mostly in males ages 20 to 30, in excessive smokers and consumption of alcoholic beverages. Many times it is characterized by assertiveness and is controlled by a spouse. Hypochrondial and hysterical features may be present. The pain can be one of the most severe known to mankind as reported by Dr. Karl Ekbom of the Karolinski Institute of Stockholm, Sweden.
A gnawing pain, pressure-like over the nasal frontal or maxillary area. It often increases in severity as the day goes on or may become relieved after heavy drainage. Causative factors are infection usually, may be allergy. Blocked nasal passages by results of fever, swelling, congestion, lack of or decreased drainage. Secondary factors are nasal polyps or deformation such as a deviated nasal system that block the sinus ducts. The headache is often misdiagnosed as a migraine or cluster headache.
Typical is migraine like symptoms of throbbing pain and nausea. Reaction to alcohol induced dilation and irritation of the blood vessels of the brain and surrounding tissue.
Migraine type headache that usually occurs shortly before, during or after menstruation. Can occur at mid cycle due to changes in levels of estrogen due to ovulation.
Pain at the back of the head or neck, has gravely feeling on movement as well as intensification. Causes: inflammation of joints as well as muscles.
Nasal congestion and watery eyes are symptoms of this headache. This headache is differentiated from cluster headaches in that its symptoms are related to seasonal allergies, i.e., pollens, molds. Relief by taking antihistamines and injections. Careful history is a must to eliminate the offending cause. Allergies to foods are usually not a factor.
Food and Vitamin Induced Headache
Headaches due to consumption of the following foods: chocolate, aged cheese, vinegars, relishes, dressings, sauces, alcohol products, sour cream, yogurt, liver, yeast, fatty foods, hot dogs, sandwich meats, MSG, caffeine, sea food, and or vitamins B6, A, Niacin, minerals selenium and iodine.
Pain that strikes just before meal times, caused by muscle tension, low blood sugar and reactive dilation of blood vessels. Relieved by regular nourishing meals containing protein and complex carbohydrates.
Caffeine Withdrawal Headache
Throbbing headache, may have translucent waving pattern in front of the eyes caused by dilation of the blood vessels several hours after consumption of large quantities of caffeine. Changes in pattern of consumption of caffeine containing substances.
Generalized head pain following or during physical activities. Involvement may be due to tumors, aneurysms, blood vessel malformation, but is usually related to migraine or cluster headaches in progress.
Eye Strain Headache
Generally pain on both sides of the front of the head directly related to using the eyes. General consensus is that it is a rare cause of headache. May be eye muscle unbalance, uncorrected vision, and astigmatism.
General head pain that develops with fever, caused by inflammation of blood vessels of the head. In children it is usually due to childhood diseases. Ocular abnormalities, sinusitis, dental disorders, systemic infection, trauma, brain tumors and abscesses, pseudotumor cerebra, subdural hematomas, acute/chronic ear infections and hydrocephalic syndromes.
Drug Induced Headache
A headache brought on by consumption of any of the following: oral contraceptives, propanolol, caffeine, thiazide derivatives, vasodilators, vasoconstrictors, non-steroidal anti-inflammatory agents, antihistamine agents, dextro-amphetimines, nitroglycerine, reserpine, hydrazine, MAO, ephedrine, or from drug withdrawal.
Headache is generalized or "hat band" type pain. The headaches is most severe in the morning and diminishes as the day goes on. Blood pressure is usually over 200 systolic and 110 diastolic.
Aneurysm Associated Headache
Early on may mimic frequent migraine, cluster headaches and made worse on tension or exertion during increased physical activities. Blood vessels may be leaking slowly. Ruptured aneurysm results in unbearable headache, double vision.
Temporal Arteritis Headache
The patient experiences a boring, burning or jabbing pain in the temple area caused by inflammation in the temporal arteries. The pain is often around the ear on chewing. Weight loss problem as well as eye sight problem. Usually affects people after fifty years of age. It is often associated with polymyalgia rheumatica. Initial presentation may include non-specific like symptoms. Severe headaches develop later. Laboratory findings often confirm the diagnosis. Mean age is seventy years.
Tic Douloureux Headache
Short, jab like pain in the facial area, often around the mouth and jaw. This can occur many times and any time during the day. Pain last several seconds to several minutes at a time. It is a rare disease of neural impulses. Chewing, cold air or even toughing the face can bring it on. Usually occurs in women after age 55.
Tumor Associated Headache
Frontal pain 60% of the time. Location of pain does not change. General pain that becomes progressively worse, vomiting, visual disturbances, speech or personality changes, as well as seizures. Usual remedies that give relief have little to no effect on relieving the headache. Pain may wake the patient up at night, associated with changing positions.