Headaches can manifest on their own but are also very common symptoms in neck pain patients as more than 60% of patients with a primary neck pain complaint report having concordant episodes of headache. Therefore, it’s essential to find out what kind of headache the patient is suffering from.
To start off let’s differentiate between primary and secondary types of headaches – but what does that mean? Simply put, primary headaches are a disease themselves whereas in secondary headaches the headache is a symptom of another condition. So, primary headaches would be migraines, tension-type headaches, and cluster headaches. secondary type headaches are headaches caused by tumors, hemorrhage, other trauma, TMJ dysfunction, substance overdose, or neck pain aka the cervicogenicheadache.
Now let’s take a closer look at migraines, which are a primary type of headache. Migraines have a mean 1-year prevalence of 11.2% around the world with women being more often affected than men in an age range between 20 to50 years Migraines exist in two distinct forms that are either with or without the presence of a phenomenon called an aura, but we will get to that later. In order for a headache to qualify as migraines it has to fulfill certain criteria: A) there have to have been a minimum of 5 attacks fulfilling the following criteria.
B)the headache lasts from 4-72 hours. The duration is an essential characteristic because if an untreated episode lasts less than 4 or more than 72 hours migraines are excluded. C) the headaches at least 2 of the 4 following characteristics which are: 1)it’s a unilateral headache 2) the headache has a pulsating quality 3) it has a moderate to severe pain intensity Or 4) the headache is aggravated by routine physical activity such as climbing stairs and D) Next to the headache patients have at least 1 of the following additional symptoms.
These are 1) nausea or vomiting and 2) being sensitive to bright lights and sounds called photo- and phonophobia respectively. In order for a headache to be classified as migraine with aura, the patient has to present with the previously mentioned criteria and one or more reversible aura symptoms. These are disturbances in the following subsystems: visual, sensory, speech motor, brainstem, or retina. Imagine vision changes, numbness, dizziness, confusion, etc. Furthermore, at least 2 of the 4 characteristics have to apply.
1)at least one aura symptom spreads gradually over more than five minutes and/or two or more symptoms occur in succession. 2) Each individual aura symptom lasts 5 – 60 minutes. 3) At least aura symptom is unilateral and 4)The aura is accompanied or followed within 60 minutes by headache. While aura symptoms resemble those of a CVA they build up much slower over 5 minutes compared to within seconds in a CVA. Tools you can use to assess the impact of a headache on your patient are the HIT.
Also note that it can be difficult for a patient to answer all the questions on duration, intensity, and characteristics of their headache during your assessment. Therefore asking them to complete something like a headache diary can help in the assessment and management of the headache and you should be aware that there can be an overlap between multiple headache disorders. Okay in the intro I mentioned that headaches are quite often associated with neck pain, so be sure to click on our neck pain guideline playlist on the left.
I’ve personally evaluated approximately 5,200 headaches and migraine patients over the past 17 years. With the continual refinement of this evaluation and treatment system, it’s like an algorithm, we’ve been able to achieve true healing and lasting relief for the overwhelming majority of our patients. That means that in an average of, say, six sessions give or take a couple of sessions, its routine for patients to no longer need medications, injections, ongoing therapies, that includes our own.
And I’m happy you’re here on this page because this information could open your mind to new ways of thinking about your pain. Maybe you think you have just impossible pain and symptom problems, but I’m referring to actual symptom reversal and lasting healing, like lasting outcomes, of what others consider a “disease process.” And our evaluation algorithms routinely identified the exact source of where your symptoms pain and symptoms are coming from, and you’ll find there’s nothing comparable out there if you suffer from Menstrual Migraines.
Your head pain likely spikes a day or two before your cycle and lasts up to two to three days after. I mean that’s typical and you’re likely not thrilled about continuing to use migraine medications because of only partial relief or no relief, plus you potentially have side effects from that. So if you’re ready for something other than just temporary relief of your symptoms and you want more in-depth deeper knowledge of what’s going on with your pain and symptom problems.
Because ultimately I think you’re seeking reversal, like lasting relief, not just a temporary band-aid because chances are that you’ve investigated that or experienced it yourself and realize that there’s really nothing out there that going to offer a lasting solution for your problems. common of all the primary headaches types.
Migraines go through these 4 phases. Phase 1: Prodromal. This phase can occur several hours before the upset of pain, symptoms include mood swings unusual food cravings, and compulsive yawning. Phase 2: Aura. This next phase may involve neurological events known as auras. Auras can begin 20 – 60 minutes prior to an actual migraine. Patients see metallic lines, changes in sensation, motor deficits, and speech abnormalities. However, auras don’t occur for every migraine sufferer. Phase 3: Attack. This phase involves pain and other symptoms like light sensitivity.