September 2020
Author: Emily Clout
Headache is one of the most prevalent pain conditions experienced by people of all ages. Despite this, the burden of headache is largely underestimated as headache disorders are often considered minor and unworthy of appropriate medical care. Headaches can have significant impacts on everyday life, and mental and physical wellbeing, so it is vital that collectively we change this message, and advise people who continue to suffer from headaches to seek appropriate medical advice to help alleviate their symptoms.
The International Headache Society classifies headaches into three main categories as seen in Figure 1, however, there are more than 300 types of headaches. Headaches are often misdiagnosed meaning that people might receive inadequate treatment. This is why it is recommended that you see a health professional who is specialised or has a lot of experience working with headaches.
Common headaches are migraines and cervicogenic headaches. Migraines usually have a gradual onset, and often spread from one side of the head to the other. They can last between 24-48 hours and can be very severe with people often experiencing visual and sensory changes, nausea and vomiting. Emerging evidence suggests that migraines are caused by an altered perception of nerve impulses from the trigeminal nerve. The acute care for migraine is to rest in a dark room and in some cases pharmacological management (best done by a specialised medical practitioner), with long term treatment being multifactorial, focusing on diet, hydration, exercise, sleep, reducing stress, and neuroscience education.
Cervicogenic headaches are often less severe than migraines and are often experienced only on one side of the head. The cervical nerve which sends information to the brain about the neck merges with the trigeminal nerve, which is the nerve that provides information to the brain about areas of the head. The nerve fibres overlap which is why people who have neck pain often also have a headache. There is a lot of evidence that physiotherapy with a focus on treatment of the cervical spine is very effective for long term management of cervicogenic neck pain.
The most important reason to seek medical advice is to ensure that the headache is not a symptom of a more serious pathology such as a tumour, aneurysm, meningitis, subdural haemorrhage or a space occupying lesion. Whilst in the majority of cases headaches are not sinister, most types of headache will likely benefit from some form of medical treatment or physiotherapy. Which is why we recommend that if your headache symptoms are impacting your daily life, mental or physical wellbeing that you seek advice from an appropriate health professional such as your GP or physiotherapist.
References:
Brukner, P., & Khan, K. (2016). Brukner & Khan’s Clinical Sports Medicine: Injuries (Vol. 1). McGraw-Hill Education Australia.
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