Headaches 101

Let’s face it – medical terminology can be incredibly confusing. We healthcare providers toss around all sorts of “fancy” words that sound like they’re straight out of a Harry Potter movie. As a patient, this can leave you frustrated and maybe even a little scared. Dr. Rachel and I will always try to explain muscles, diagnoses, and treatments in patient-friendly language, but there is one area that needs nuanced terminology—headaches. 

Headaches are extremely common, with 66% of the population affected and an estimated lifetime prevalence of 96%. If this wasn’t enough of a problem, there are 14 categories of headaches, ranging from sinus headaches and caffeine headaches to full-blown migraine headaches. As clinicians, we care about the type of headache because it directly impacts the treatment that we provide. Unfortunately, many headaches are misdiagnosed, either by the patient or their provider. This can lead to unnecessary tests, procedures, and medications… along with continued headache suffering. 

Here are some of the most common headache types and their classic presentations: 

1. Migraine. While a lot of people assume their headache is a “migraine,” true migraines have specific symptoms. 

Some Key Characteristics:

  • Come with or without an “aura” (sensory changes, such as seeing visual “floaters”)
  • Unilateral Symptoms
  • Last 4-72 hours
  • Moderate-severe pain; often throbbing
  • Aggravated by physical activity 
  • Treatment: medication, avoiding triggers 

2. Tension-Type. This headache is also confusing because it’s named for the tense “vice grip” sensation that it’s associated with, NOT because it’s caused by muscle tension. 

Some Key Characteristics:

  • Bilateral Symptoms 
  • Pressing/tingling sensation
  • Mild-moderate symptoms 
  • NOT aggravated by activity; often triggered by stress
  • No nausea/vomiting
  • Treatment: managing stress, relaxation to head and neck muscles

3. Cervicogenic. Cervical = neck; genic = starting…. So this literally translates to “originating from the neck.” These headaches are incredibly common, with some data suggesting nearly 80% of headaches have cervical spine involvement

Some Key Characteristics:

  • Neck pain and tenderness; history of neck trauma
  • Direct relationship to sustained neck postures.
  • Unilateral symptoms: head, neck, shoulder, or jaw
  • Decreased neck range of motion
  • Can have dizziness, nausea, light sensitivity, tinnitus, earache, changes in taste/smell
  • Responds to treatment to the cervical spine
  • Treatment: manual therapy, joint manipulation, dry needling, and specific exercise

Next time you have a headache, don’t jump to the conclusion that it’s a “migraine.” Rather, consider the symptoms you’re feeling and potential triggers, whether that be stress, too much computer work, or an awkward sleeping position. The good news is, tension headaches and cervicogenic headaches (remember, over 80% of all headaches!) respond great to interventions like dry needling, spinal manipulation, and manual therapies—all things that we take great pride in providing here at The Body Lab. If you’re suffering from headaches, or even if you’re not sure what type of headache you have, I encourage you to reach out to us rather than trying to diagnose and treat it yourself. With a good treatment plan, a strong majority of headaches can be knocked down and managed.

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