Headaches & Migraines
What type of Headaches & Migraines do I have?
Headache is a broad term that describes pain felt anywhere in the head region. They are a very common condition thought to be experienced at least once, in everyone's lifetime. However, the location, symptoms, aggravating factors and how long they last, can tell us what type of headache you have and what treatments can help.
What are the most common headaches?
Cervicogenic Headaches
The most common headaches we see are known as ‘Cervicogenic headaches’. They are caused by tight muscles in the neck which then refer pain into the head. The headache can be provoked when pressure is applied to the tight neck muscles. It usually occurs only on one side of the head, is aggravated by neck movements and feels like an ache, rather than a throbbing sensation. These headaches are usually accompanied by reduced neck motions. Cervicogenic headaches respond well to massage and osteopathy treatment, but do not respond well to medication.
Migraines without Aura
Migraines without aura are the most common form of migraine which usually lasts 4-72 hours. They have at least two of the following symptoms:
Throbbing/ Pounding sensation
Only on one side of the head
Moderate to severe in pain intensity
Aggravated by physical activity
As well as, at least one of:
Nausea/ Vomiting
Light sensitivity (Photophobia)
Sound sensitivity (Phonophobia)
Migraines with Aura
Migraines with aura usually last less than 60min and involve visual, sensory or other central nervous system symptoms that develop gradually. These symptoms are commonly followed by a headache and associated migraine symptoms. The central nervous system symptoms felt prior to the headache can involve:
Visual disturbances such as spots, flickering, loss of visual field
Sensory disturbances such as pins and needles, numbness
Speech disturbances (Dysphasia)
There are not any specific factors associated with an increase in migraines. However, females seem to contract them more than men. Having a family history of migraines is also a common risk factor for migraines.
Tension Type Headaches
Tension type headaches are described as a band-like tightness felt across the front of the head. They are usually mild to moderate in pain intensity and can last from 30 minutes to 7 days. These headaches do not cause a ‘throbbing’ sensation but rather a ‘tight’ or ‘pressing quality’. They do not get worse with physical activity, are not related to nausea/vomiting and do not usually have light or sound sensitivity together (however one may be present).
Menstrual Related Migraine (MRM)
Approximately 50% of female migraine sufferers experience menstrual-related migraines. MRM commonly occurs two days prior to menstruation as well as mid-cycle. This has been attributed to a drop in oestrogen which reacts with serotonin.
Cluster Headaches
Cluster headaches are rare and commonly affect men more than women. They are characterised as severe, one-sided pain located around or behind the eyeball, as well as the temporal region. They are usually accompanied with other head symptoms such as irritated or watery eyes, sweating, eye drooping, eyelid swelling and runny nose located on the same side of the headache. Cluster headaches usually last 15-180 minutes and can range in frequency (once a week, to eight episodes a day).
What can I do at home to help with my headaches & migraines?
Rest: A lot of headaches, especially ones that come with light and noise sensitivity, require rest and/or sleep in order to decrease pain levels.
Avoid painful activities: Your practitioner will help you identify the movements to avoid (if any) along with any activities that may contribute to the condition.
Medication: Different medications can help with different types of headaches. It is important to consult your general practitioner, as a lot of these medications are by prescription only.
Exercises and stretching: Your osteopath will be able to identify the muscles that may be weak or too tight which may contribute to the headache. They will then prescribe a specific exercise regime to tackle these imbalances.
Supplements: Studies have found that migraines, in particular, have been found to decrease in intensity and frequency with a daily intake of these 3 supplements → Folic acid (2mg), Vitamin B6 (25 mg) and Vitamin B12 (400mcg)
What foods or supplements can I take for headaches or migraines?
Common supplements that show to help with migraines:
Magnesium Powder (600mg+ daily)*
- Decreases brain cortex hyperexcitability
- Normalises energy production within the cells
- Reduces vasoconstriction in blood vessels
- Decrease muscle tension that is good for sleep and mental healthVitamin D (1000 - 4000mg daily) - For increase magnesium absorption
VITAMIN B Supplements + Folic Acid - helps with seratonin synthesis
Vitamin B1 (300mg daily)**
Vitamin B2 (400mg daily)**
Vitamin B6 (80mg daily)**
Vitamin B12 (500mcg daily) **Folic Acid (2mg daily) **
Vitamin E (400 IU daily) - Good for menstrual migraines
Electrolytes - Sodium and Potassium
Melatonin (only as prescribed by GP - requires more research)
SOURCE:
*Domitrz, I. and Cegielska, J. (2022) ‘Magnesium as an important factor in the pathogenesis and treatment of migraine - from theory to practice’, Nutrients, 14(5), p. 1089. doi: 10.3390/nu14051089
**Nematgorgani, S. et al. (2022) ‘B vitamins and their combination could reduce migraine headaches: a randomized double-blind
Foods found to help soothe a headache or migraine:
Water – The most common cause of headache is dehydration!
Almonds – High in tryptophan [releases serotonin (the feel-good brain chemical)]
high in magnesium [relaxes your muscles and blood vessels]
Walnuts - Increase potassium
Whole Grain Toast – Too little carbohydrates may trigger headache
Watermelon/Cucumber - High water content
Yogurt - High in calcium [body may be deficient in calcium]
Sesame Seeds
Vitamin E [stabilises oestrogen level, improves circulation]
High in magnesium [relaxes your muscles and blood vessels]
Spinach Salad/Broccoli/Mushrooms – High in Vitamin B2 [riboflavin]
Potato/Banana – High in potassium [replenishes electrolytes]
Salmon – High in omega-3 fatty acids [reduces inflammation]
Foods to avoid when experiencing a headache or migraine:
Containing tyramine - red wine, cheese, smoked fish, chicken livers
Containing nitrates - bacon, hot dogs, salami
Containing food additives - monosodium glutamate (MSG), artificial sweeteners (Aspartame)
Other foods to avoid - chocolate, nuts, peanuts, onions, avocado, banana, citrus, dairy products, fermented pickled foods, alcohol, caffeine
Can osteopaths help with headaches & migraines?
In your 45min consultation, your osteopath will assess how your headache came about and classify your headache.
They may also order radiographic imaging or blood tests to assist with the correct diagnosis and prognosis (tissue healing time).
They will help you identify the actions in your day-to-day life, which may be contributing to your headache.
Individualised soft tissue, joint manipulation and adjunct treatment techniques will be implemented during your 45min appointment to promote tissue healing, pain reduction and fluid movement.
A comprehensive exercise rehabilitation program will be implemented as part of the ongoing treatment plan, to help with stability and strengthening of the neck.
Below we have listed which different types of treatment therapies help with different types of headaches.
Doctor of Osteo’s team of osteopaths are available to help you with your headaches and migraines. Click the button below to make an appointment.
Providing healthcare with our osteopaths near me in Hawthorn, Hawthorn East, Kew, Balwyn, Canterbury, Camberwell, Camberwell East, Richmond, Malvern and Glen Iris.
Here are the other types of headaches and migraines (Listed in Alphabetic Order)
Allergy Headache
Symptoms: Generalised headache, nasal congestion and watery eyes.
Risk Factors: Seasonal allergens (pollen, moulds). Food allergies are not usually a factor.
Treatment: Antihistamines; topical, nasal cortisone sprays etc.
Prevention: Avoid the cause of allergy.
Aneurysm / Subarachnoid Haemorrhage
Symptoms: Sudden Onset headache starts in the suboccipital region (localised) - then after a few hours you may experience meningitis symptoms such as pain and stiffness, vomiting with no nausea, visual changes, mental confusion and loss of consciousness (due to increasing meningeal irritation due to intracranial pressure). On examination: papilledema, visual changes.
Risk Factors: Congenital tendency & hypertension.
Treatment: Surgery, if discovered early. Lumbar puncture.
Prevention: Controlled blood pressure.
Arthritis Headache
Symptoms: Pain at back of head or neck which is worse on movement.
Risk Factors: Family history of arthritis.
Treatment: Anti-inflammatory drugs, muscle relaxants.
Prevention: Only some evidence suggest having a healthy diet and exercise may reduce symptoms, but not prevent it.
Cervicogenic Headache
Symptoms: Unilateral pain, caused by muscular strains or cervical facet or disc inflammation. Worse in in the morning. Starts at suboccipitals over top of head to frontalis (no throbbing)
Risk Factors: Neck movements and Kemp’s
Treatment & Prevention: Treating the cause of the headache.
Chronic Daily Headache (CDH)
Symptoms: A broad term for headaches that occur 15+ days per month. Two types based on headache duration: <4hrs and >4rhs.
Risk Factors: Evolve from migraines or episodic tension-type headaches. Medication overuse.
Treatment: Limit analgesic use. Different treatments based on type of CDH.
Prevention: Different based on type of CDH, duration and the number experienced per month.
Cluster Headache
Symptoms: Excruciating pain in the eyes, watering of the eyes, nose congestion and flushing of the face. Pain develops during sleep and lasts for several hours. Attacks occur every day for weeks/months, and then disappear for up to a year. More common in males than females in their 20s to 50s.
Risk Factors: Excessive alcohol or smoking.
Treatment: Oxygen, ergotamine, sumatriptan or intranasal local anaesthetic.
Prevention: Use of steroids, ergotamine, calcium channel blockers and lithium.
Eyestrain Headache
Symptoms: Frontal, bilateral pain directly related to strain of the eyes. Rare.
Risk Factors: Muscle imbalance, uncorrected vision, astigmatism.
Treatment & Prevention: Correction of vision.
Exertional Headache
Symptoms: Generalised head pain (minutes to hours) during or following physical exertion (running, jumping or sexual intercourse) or passive exertion (sneezing or coughing).
Risk Factors: 90% related to migraine or cluster headache.
10% related to organic diseases such as aneurysms, tumours or blood vessel malformation.
Treatment: Aspirin, indomethacin or propranolol.
Prevention: Choosing exercise that can be tolerated.
Giant Cell Arteritis
Symptoms: Burning/jabbing pain caused by inflammation of temporal arteries. Pain around ear when chewing, weight loss, eyesight problems. Age >50.
Risk Factors: Unknown.
Treatment: Steroids.
Prevention: None.
Tic Duolourex Headache
Symptoms: Short, jabbing pain in trigger areas in the face (around mouth/jaw). Pain from chewing, cold air or touching face. Frequency and duration varies. More common in women 55 years and older
Risk Factors: Unknown. Is under 55y/o may result from neurological disease, such as MS.
Treatment: Anticonvulsants and muscle relaxants.
Prevention: None.
Hangover Headache
Symptoms: Throbbing pain and nausea that is not localised to one side.
Risk Factors: Excessive alcohol consumption.
Treatment: Liquids (including broth), fructose (honey, tomato juice, etc.)
Prevention: Decreasing alcohol consumption.
Hypertension Headache
Symptoms: Generalised or “headband” type of pain. Most severe in the morning. It diminishes throughout the day.
Risk Factors: Severe hypertension (over 200 systolic & 110 diastolic)
Treatment: Blood pressure medications.
Prevention: Control blood pressure.
Menstrual Headache
Symptoms: Migraine-like pain occurring before, during or immediately mensuration or at mid-cycle (ovulation).
Risk Factors: Variances in oestrogen levels.
Treatment: Early stages: biofeedback, ergotamine, dihydroergotamine or 5-HT agonist.
Prevention: Biofeedback; betablockers (propranolol, timolol); anti-convulsant (divalproex sodium); calcium blockers; and NSAIDs.
Migraine with Aura
Symptoms: “Warning signs” = Visual disturbances or numbness in arm or leg. Warning signs subside within 30 minutes, followed by severe head pain.
Risk Factors: Hereditary, certain foods, OCP, menopausal hormones, excessive hunger, changes in altitude, weather, lights, excessive smoking and/or emotional stress.
Treatment: Biofeedback, ergotamine, dihydroergotamine, or a 5-HT agonist. During headache pain, treat with: ice packs; isometheptene; mucate; combination products containing caffeine; ergotamine; DHE injectable and nasal spray; 5-HT agonists; analgesics or medications, which constrict the blood vessels. Steroids may be helpful for prolonged attacks.
Prevention: Biofeedback; betablockers (propranolol, timolol); anti-convulsant (divalproex sodium); calcium blockers; and NSAIDs.
Migraine without Aura (common)
Symptoms: Severe, unilateral, throbbing pain often accompanied by nausea, vomiting, cold hands, sensitivity to sound and light. Lasts for a few hours to days.
Risk Factors: Hereditary or factors including certain foods; red wine, strong odours, the Pill or menopausal hormones; excessive hunger; changes in altitude; weather; lights; excessive smoking; and emotional stress.
Treatment: Usually resolves with sleep. Ice packs; isometheptene; mucate; combination products containing caffeine; ergotamine; DHE injectable and nasal spray; 5-HT agonists; analgesics or medications, which constrict the blood vessels. Steroids may be helpful for prolonged attacks.
Prevention: Biofeedback; betablockers (propranolol, timolol); anti-convulsant (divalproex sodium); calcium blockers; and NSAIDs.
New Daily Persistent Headache
Symptoms: Rapid development (<3 days) of unrelenting headache. Typically presents in people with no history of headache.
Risk Factors: Possibly a viral infection.
Treatment: Resolves on its own within several months.
Prevention: Anti-seizure medications, Topamax or Neurotine.
Post-traumatic Headache
Symptoms: Localised of generalised pain occurring on a daily basis and are resistant to normal headache treatment.
Risk Factors: After minor traumas, however, the cause of pain is difficult to pinpoint.
Treatment: Anti-inflammatory drugs, propranolol or biofeedback.
Prevention: Standard precautions against trauma.
Sinus Headache
Symptoms: Gnawing pain over nasal area, increasing in severity throughout the day.
Risk Factors: Infection, nasal polyps, anatomical deformities (such as deviated septum that blocks sinus ducts).
Treatment: Antibiotics, decongestants, surgical drainage.
Prevention: None.
Temporomandibular Joint (TMJ) Headache
Symptoms: A muscle-contraction type of pain, sometimes accompanies by a painful “clicking” sound on opening the jaw.
Risk Factors: Poor bite, stress
Treatment & Prevention: Relaxation, biofeedback and bite plate. In extreme cases the correction of malocclusion may be necessary.
Tension-type Headache
Symptoms: Dull, non-throbbing pain, bilateral and associated with tightness of scalp or neck.
Risk Factors: Emotional stress, hidden depression.
Treatment: Rest; aspirin; acetaminophen; ibuprofen; naproxen sodium; combinations of analgesics with caffeine; ice packs; muscle relaxants; antidepressants, if appropriate; biofeedback; psychotherapy; temporary use of stronger prescription analgesics, if necessary.
Prevention: Avoidance of stress; use of biofeedback; relaxation techniques; or antidepressant medication.
Tumour Headache
Symptoms: Pain progressively worsens; projectile vomiting; possible visual disturbances speech or personality changes; problems with equilibrium; gait, or coordination; seizures. It is an extremely rare condition.
Risk Factors: Unknown.
Treatment: Surgery if discovered early.
Prevention: None.