Have you experienced a throbbing or pounding pain in your head? Maybe you’ve also felt nauseous and needed to lay in a dark room? Or have you ever felt like someone has wrapped a tight band around your head when you’re at the computer for too long? These are common stories we hear at DMC health when people report headaches.
Headaches can vary in their intensity and duration, as well as persist with several ancillary symptoms, like dizziness, vision disruption and nausea. It’s important to understand what type of headache you are experiencing so the most effective treatment may be provided. Before you reach for the Panadol, let’s understand the most common types of headaches we see in clinic, the role of chiropractic care in managing them, and what you can do to help yourself!
Not all headaches are the same
There are so many different types of headaches, but for this insight, we will cover the 3 most common – tension-type, cervicogenic, and migraine. We can classify these based on the symptom characteristics.
Tension-type
Tension-type headaches, also referred to as stress headaches, are the most common. The exact cause of tension-type headaches is still unclear, but it is most likely due to muscle tension and stress (1). Clinically, we see these headaches often occurring in office workers who sit at a desk for long periods.
What do tension headaches feel like?
People describe the feeling of a “tight band” wrapping around their head. This usually occurs on both sides, and lasts anywhere from 30 minutes to 7 days. These headaches are usually less intense compared to other kinds.
Cervicogenic headache
Cervicogenic headaches are caused by irritation to the joints, nerves, or muscles in the upper neck. These usually occur after an injury to this area, creating inflammation and tension.
What do cervicogenic headaches feel like?
People describe a dull ache that radiates from the neck to around the head, usually on one side. The pain is worse when moving in a specific direction, generally side-to-side or looking up. Because of the stiffness and tension, people notice they can’t move their neck as far in those directions.
Migraine
Migraines can be very debilitating for patients and have several underlying causes. They are more common in women, often start earlier in life, and can be linked to menstrual cycles. Different environmental factors can trigger migraines, such as alcohol, strong smells/lights, medications, or even certain foods. Some people experience an ‘aura’ before a migraine, this is basically a warning sign that a migraine is about to start. Common auras include flashing lights or a kaleidoscope of colours in their vision.
What do migraines feel like?
People describe a “pounding” or “throbbing” pain, usually on one side of the head. Other symptoms such as nausea or vomiting, as well as sensitivity to light and/or sound are commonly reported. When experiencing a migraine, people will often have to go lay down in a dark room to relieve the pain.
How can a chiropractor help headaches?
Firstly, at DMC Health we take a detailed history to accurately diagnoses the specific type of headache you have. This is also to rule out other potential causes of headaches that may require referral to the GP.
Chiropractic care is effective for treating these types of headaches. Gentle adjustments to the back and neck (2,3), dry needling (4), massage and neck strengthening exercises (3) are all recommended to reduce pain and improve function for tension-type, cervicogenic and migraine headaches.
What can I do to help myself?
Because these headaches can happen periodically over time (episodic) or increase in frequency to the point they’re happening most days (chronic), having self-management strategies to relieve symptoms are very important. Here’s a few we find most effective:
Keep a headache diary
Keeping track of your headaches, including the duration, frequency, severity as well as aggravating and relieving factors can be important to better understand your headaches. This will help you identify specific triggers that bring on headaches or make them worse, so that you can avoid them in the future.
Neck stretches and exercises
Gentle stretches and exercises for the neck, upper back and shoulders can help to reduce pain and tension during a headache as well as prevent future episodes. Start by sitting up tall, take one hand hold onto the opposite side of your head. Gently pull your ear to your shoulder, and look towards your armpit on the same side. You should feel stretch in the opposite shoulder and neck.
Acute symptom relief
For immediate relief, over the counter pain medication (Panadol or Nurofen), heat or cold packs, or massage balls are useful options to reduce symptoms yourself, especially when you can’t seek treatment.
Optimise work environment
If your headache is brought on after spending long periods at a desk or while working, you may need to consider your set up. Headaches may be aggravated when your neck is in a sustained position for too long, such as looking at a monitor that is too high. So, adjusting your chair, desk or monitor height to relieve neck strain can be useful.
About the authors
David McNaughton is a clinician, researcher and lecturer. He is the director and principal chiropractor at DMC Health & Wellness. He has an extensive background in the diagnosis and management of chronic pain. In addition to his clinical studies, David holds a Master’s of Research and PhD in Psychology. He regularly publishes his research in peer reviewed medical and psychology journals. David has taught both undergraduate and postgraduate studies in Chiropractic and Psychology.
Isaac Searant completed a Bachelor of Chiropractic Science, Master of Chiropractic and Master of Research at Macquarie University. His research aims to understand the clinical decisions health practitioners make about diagnostic imaging. His clinical interests include spinal pain (neck and back) and sporting injuries. Regardless of the condition, his goal as a chiropractor is to work collaboratively with patients.
References
- Ashina S, Mitsikostas DD, Lee MJ, Yamani N, Wang SJ, Messina R, Ashina H, Buse DC, Pozo-Rosich P, Jensen RH, Diener HC. Tension-type headache. Nature Reviews Disease Primers. 2021 Mar 25;7(1):24.
- Fernandez M, Moore C, Tan J, Lian D, Nguyen J, Bacon A, Christie B, Shen I, Waldie T, Simonet D, Bussières A. Spinal manipulation for the management of cervicogenic headache: A systematic review and meta‐analysis. European Journal of Pain. 2020 Oct;24(9):1687-702.
- Bryans R, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg R, Shaw L, Watkin R, White E. Evidence-based guidelines for the chiropractic treatment of adults with headache. Journal of manipulative and physiological therapeutics. 2011 Jun 1;34(5):274-89.
- Pourahmadi M, Dommerholt J, Fernández-de-Las-Peñas C, Koes BW, Mohseni-Bandpei MA, Mansournia MA, Delavari S, Keshtkar A, Bahramian M. Dry needling for the treatment of tension-type, cervicogenic, or migraine headaches: A systematic review and meta-analysis. Physical therapy. 2021 May 1;101(5):pzab068.
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