By Keltie Cheney, Physiotherapist
Every visit I have with a client I ask how they are doing. I often hear, “Oh, pretty good, but I have a headache. I get them all the time but I can’t do anything about it”. Are headaches supposed to be just a normal part of life, like tired muscles from a tougher-than-usual work-out or sore feet from standing all day? Well, no actually. Headaches should not be taken so lightly. There are many kinds of headaches which mostly classify into three main types: 1) Migraine 2)Tension 3) Cervicogenic. Let’s discuss a bit what each of these classifications mean:
1) Migraine: Symptoms are usually unilateral (one side of the head), pounding, usually quite intense, photophobia (sensitive to light), phonophobia (sensitive to sound), can have nausea, is helped by resting/sleeping, and lasting usually between 4-72 hours. Treatment is often pharmacological agents like prescription medicines or simple analgesics as well as antiemetic medications (for nausea/vomiting).
The cause of a migraine is still unknown but it is generally thought to have a lot to do with spasms of the arteries that go to the brain and supply it with blood. Triggers to this spasm can include food substances e.g. chocolate, red wine, dairy products, as well as dehydration, fatigue, and stress. But also importantly, improper or not enough exercise, physical loading, improper ergonomics and musculoskeletal factors (such as stiff neck, tight jaw) can also be major triggers. Talk to your physiotherapist if you experience migraines because there may be treatment that does not have to be just reactive (medication) but proactive (e.g an active, healthy lifestyle and proper positioning at your work desk) that will help prevent your migraines from occurring as often.
2) Tension: Symptoms include dull pressure with a band of pain from forehead to the back of the head. It often involves neck muscles becoming very tight and stiff as well. Most often the cause is not known but improving muscular function around the neck and shoulder blades are often effective in preventing reoccurrence while relaxing the over-active muscles of the neck and head give good relief. Your physiotherapist understands the biomechanics and anatomy of the neck, head, and shoulder blades very well and can be very useful in relieving your tension headache and hopefully enable you to have them less frequently.
3) Cervicogenic: Symptoms often last longer than a migraine, two days and up to a week, but are less acutely painful. Sleep does not change the pain which is usually localized to one side of the head, around the eye, cheek, and jaw (therefore co-existing temperomandibular joint (TMJ) pathology may compound the diagnosis). Pain is likely referred from one or more muscular, neurogenic (nerves), osseous (bones), articular (joints), or vascular (veins and arteries) structures in the neck. Ask your physiotherapist to do specific exam of your neck to see if there may be something they can do to help your neck function better and therefore relieve your headache pain.
Some things to always be aware of if you have a headache: is it instantaneous, coming out of nowhere? Are you having any difficulty talking, swallowing? Do you have a fever, any weakness, or unexplained neck stiffness? Is your headache worse after wakening? Have you had any head trauma? If you have said yes to any of these then you should contact your doctor as soon as possible as they are “red flags” that need to be checked in case of a more serious problem.
Headaches do not need to be passed off as something that is unpreventable and uncontrollably debilitating. Consider the above information and if you think you fit into one of these categories talk to a physiotherapist at One to One Wellness who may be able to help you get back to “normal” life again.
