by Dr. Jim Hendricks, Freeport Integrated Health Center, Freeport, Maine

Dr. Jim HendricksA headache is pain or discomfort in the head, neck or face area that can be single or recurrent in nature and localized to more than one area at a time. Headache pain may have many different qualities and can be constant or intermittent in frequency. Some headaches may last only seconds or minutes, whereas others last hours or even days. They may occur on a regular basis or less frequently as well. However, not all headaches are same and the cause is some times not completely understood. According to the National Institute of Neurological Disorders and Stroke (NINDS), as many as 45 million Americans suffer from severe headaches and result in more than 8 million doctor visits per year. The American Council for Headache Education (ACHE) reports that nearly 90 percent of men and 95 percent of women have had at least one headache in the past year.

Tension Headaches
Tension type headaches are the most common and often are the result of temporary stress, anxiety, fatigue or anger. Symptoms include soreness in your temples, a tightening band-like feeling around your head, pressure sensations, and contracted head and neck muscles. The pain is usually a continuous dull steady pain and surfaces in your forehead, temples or the back of your head or neck and may also include tightness in your neck as well. The headache has a slow onset and usually hurts on both sides of the head. Tension headaches can be either episodic or chronic in nature depending on the underlying precipitating factors and its duration. Precipitating Factors may include: poor posture, arthritis (particularly cervical arthritis), disorders in the neck muscles, bones or discs, eye strain, misalignment of teeth or jaw, depression or other emotional factors.

Cervicogenic Headaches
Cervicogenic headaches are caused from an underlying dysfunction of neck or cervical spine. The pain can be caused from trauma to the cervical spine, cervical misalignment, fatigue, muscular sprain/strains or tension, prior surgery, cervical arthritis or disorders of the intervertebral discs and vertebral joints themselves. The headache can also be a referral of pain from muscular trigger points in the neck and shoulder blade area, causing pain in the forehead, around the eyes are or at the back of head. The first 2-3 vertebral joints of the cervical spine are responsible for nearly half the motion of the entire neck and head. This results in a continuous amount of repetitive stress and strain and may contribute to cervical pain and headache.

Migraine headaches are form of vascular headaches because they are associated with vasodilatation (enlargement) of the temporal artery. When a migraine starts, the temporal artery enlarges stretching the nerves that surround it, causing the release chemicals that lead to inflammation and pain. The headache may occur on one or both sides of the head, is generally throbbing or pounding in quality and may last a few hours or possibly a few days. It may also cause the following symptoms: sensitivity to light or sound, nausea and/or vomiting, abdominal discomfort or sweating. Some migraines may occur with what is called an aura. The aura begins before the actual onset of the headache and can result in visual disturbances (see dots or flashing lights, tunnel vision or blind spots) and can also included disturbs in hearing, smell and taste. Migraines can be precipitated by the following: stress, sleep disturbances, fatigue, certain foods (i.e. chocolate, peanuts, red wine), caffeine, alcohol or the menstrual cycle.

Here are some other headache "red flag" signs that should alert you to get medical attention immediately:

The above are the three most common types of headaches that I see in practice. However, there are three others that I would like to mention although I did not cover them today: cluster, hormonal and sinus headaches. I have obtained very favorable results using spinal manipulation, therapy modalities, postural and ergonomic recommendations and therapeutic exercise with patients who suffer from the three headaches I have covered here. While results do vary, the majority of patients demonstrate a substantial amount of improvement with care. If you or some one you know suffers from recurring headaches, urge them to seek care, because they are not something "you have to live with."

Dr. Jim Hendricks is a doctor of chiropractic at Freeport Integrated Health Center in Freeport. His undergraduate education is in Sports Medicine and he is Certified Strength and Conditioning Coach. For more information go to https://www.freeport-chiro.com/


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