Treating Headaches and Migraines
Headaches are the most common disorder of the nervous system and it is estimated around 50% of people will have headaches at some point during any given year and that 90% of people will be affected at some point in their lives. They range in severity from severe and disabling to mild and more annoying than painful.
Despite having the potential to have a serious cause, the vast majority of headaches are not serious in nature and come under the category of ‘Primary headaches’ – meaning they are their own diagnosis, rather than being a symptom of an underlying problem.
The three main types of primary headache are Migraines, Tension-type headache and Cervicogenic headache (headache caused by the muscles and joints in the neck). All three of these types of headaches can respond well to manual therapy such as Chiropractic treatment.
What is causing my headache?
There are many possible causes for primary headaches, and these vary slightly dependent on the type of headache.
The exact cause of migraines is unknown, but it is thought to be related to temporary changes to the nerves, chemicals and blood vessels in the brain. Sometimes migraines are associated with certain triggers such as hormones (many women will find they get migraines at the beginning of their menstrual cycle), stress, tiredness or certain foods.
The exact cause of tension-headaches is unknown, but, like migraines, there are some common triggers. These can include things such as stress and anxiety, poor posture, tension in the muscles around the neck, shoulder and jaw, tiredness and certain smells such as strong perfumes.
These are caused by tension in the joints and muscles of the neck. This can be related to an injury (recent or previous such as whiplash) or can build up slowly due to normal day-to-day stresses on the neck.
What could indicate my headache is serious?
The majority of headaches are not serious in nature, however there are a few indications that you should seek a medical opinion including:
- Sudden onset of a very severe headache
- New onset of headaches (when you have never suffered with headaches before) especially if you are over 50, pregnant or have an underlying health condition
- A new headache that wakes you up from sleep
- If your headache is associated with any other symptoms of feeling unwell such as a fever, neck stiffness, vomiting or a rash
- Headache that is bought on by physical exertion, coughing, laughing or sneezing
If you have any of the above, please consult your GP urgently, or if it is out of hours, use the 111 service.
Self-help for Headaches
Many headache’s can be self-managed through a variety of methods. Stress is one of the most common headache triggers, so although avoiding stress altogether is almost impossible, taking active steps to manage your stress levels can be extremely effective. Mindfulness, guided meditation, exercise or even just making time to do an activity you enjoy such as reading, sewing or gardening can be excellent ways to help manage the body’s response to stress.
Migraines in particular are commonly triggered by specific foods. These vary between individuals, but common triggers include alcohol (especially red wine), coffee, chocolate and citrus fruits. This situation is where something like a headache diary can become useful in picking up any potential patterns in your headache and identifying triggers.
A lot of headaches will respond well to simple over the counter painkillers such as Paracetamol and Ibuprofen, particularly if they are taken fairly soon after the headache starts. If you are taking any other prescribed medications or have any pre-existing medical conditions, please check with your GP or pharmacist before taking these medications.
What you can expect when you see a Chiropractor about headaches
Correct diagnosis of the type of headache you are experiencing is essential for effective management. Chiropractors who are registered with the General Chiropractic Council undertake a 5-year full-time degree including a year of supervised practice in order to ensure that they can do this effectively.
Your Chiropractor will take a full, detailed history of both your headache and your medical history, including some family medical history. They will then perform a thorough physical examination including taking your blood pressure, doing a neurological examination and orthopaedic examination of your head and neck including your jaw. After this, they will explain the type of headache that you have and give you advice on the best way to manage it and the types of treatment available. You can then work together to formulate a plan of treatment that is best suited to both the type of headache that you have, as well as your personal preferences regarding treatment.
Treatment options for headaches
Once your Chiropractor has established which type of headache you have, they may offer you treatment or it may be appropriate to refer you back to your GP or to a specialist.
If Chiropractic treatment is appropriate there are many options available. These may include spinal manipulation or mobilisation, soft tissue techniques such as massage and trigger point release (releasing the knots in specific muscles), treatment of the jaw, dry needling (a western medical form of acupuncture) and exercises to strengthen the deep stabilising muscles in your neck as well as helping you to identify any headache triggers and come up with self-management strategies to deal with those.