This month we focus on what has become a growing problem for our patients – headaches (HA).
90% of all HA are primary HA, usually appearing between the ages of 20 – 40 years old. The most common types of primary HA are migraines and tension-type HA (as printed in the textbook “Evaluation & Management of Headache”). They each have different characteristics.
Migraines typically present with pulsing head pain, nausea, difficulty tolerating bright light and difficulty tolerating noise. The traditional theory of migraines suggested that they were the result of a problem with blood flow through the small blood vessels of the brain. Migraines are now thought to be caused by an irritation of the nerves in the brain (as published in the journal “Brain”).
Tension-type HA usually present with a non-pulsing “band-like” pressure on both sides of the head, not accompanied by other symptoms (as published in the Journal of the American Medical Association).
Another (less common) type of primary HA is a Cluster HA, characterised by short episodes (15 minutes – 3 hours) of severe pain, usually around one eye, which occur at the same time every day (printed in the textbook Harrison’s Principles of Internal Medicine).
The other form of HA would be secondary HA. These can be caused by problems elsewhere in the head or neck. One of the non-threatening secondary HA is cervicogenic (coming from the neck) which are frequently encountered in chiropractic clinics and resolved quite successfully through chiropractic management. Another non-threatening secondary HA is due to medication overuse (according to the UK NHS). One possible indication that your HA is due to medication overuse would be that your headaches are getting worse with the continuation of the medication.
Your chiropractor is trained to recognise the difference between these two benign secondary headaches. You will be referred to your GP if your HA appears to be medication related, and your chiropractor can successfully manage your HA if it is due to a problem in your neck.
However, there are other more serious causes of secondary HA. The university chiropractic programs devote considerable time and resources to the study of differential diagnosis and “red flag” identification. This allows your chiropractor to determine the cause of your HA, whether it poses a potential threat to you or not and make the appropriate medical referral if required.
With the widespread utilisation of computers, tablets and smart phones, patients are spending much more time in front of screens, monitors and electronic devices. This had led to an increase in the reported incidence of neck pain and HA in Australia. Is it any wonder why over 200,000 Australians consult a chiropractor each week (according to the Chiropractors Association of Australia)?