Headaches & Migraines

A headache is a subjective symptom thus it can vary from person to person including the pattern, location and intensity of the headache. In general, headaches can be categorized as primary or secondary with the former occurring in the absence of any other health condition and the latter, a result of another condition such as high blood pressure, allergies, hypothyroidism, infection and trauma, to name a few. The most common primary headaches include migraines with and without aura, tension-type headaches and cluster headaches.

Headaches are one of the most common complaints among patients. Though they may be debilitating, they can, for the most part be managed on a daily basis. However certain symptoms are considered ‘red flags’ and emergent action is required.

“Red Flag” Symptoms that require emergency assessment:

• Intense sudden onset described as the ‘worst headache ever’
• Persistent headache
• Change in regular headache pattern
• Change in mental status

What are the differences between the primary headaches?

Tension-Type Headaches

Tension-type headaches are one of the more common types of headaches in adults. Though the exact mechanism is unknown, they are associated with continued muscular contraction.

Signs/Symptoms

• Bilateral pain in a band-like distribution
• Mild to moderate discomfort, tightness or pressure
• Absence of throbbing

Triggers

• Stress
• Hunger
• Depression
• Poor posture
• Spinal misalignment

Cluster Headaches

The term ‘cluster’ refers to the headaches occurring continuously over a period of days to weeks and then going in to remission for months to years. These types of headaches are due to vascular changes and more common in men than woman.

Signs and Symptoms

• Abrupt onset commonly at night
• Intensity increases steadily
• Unilateral burning or piercing pain that can be localized around the eye
• Associated symptoms: facial sweating, eye infections, one-sided runny nose, swelling of the eyelid

Common triggers

• Alcohol
• Stress
• Dilation of blood vessels due to heat or wind

Treatments

Regardless of the type of headache, goals of treatment are similar and focus on eliminating triggers, decreasing symptoms and intensity and prevention of migraines.

Alternative treatments focus on a whole-body approach and address underlying inflammation, pain, stress management, and implementing sustainable diet & lifestyle changes