The brain in itself is not sensitive to pain, because it lacks nociceptors. Several areas of the head and neck however can sense pain and cause headaches. In medicine, a headache is a symptom of a number of different conditions of the head and sometimes neck. Some of the causes are benign while others are medical emergencies. Headaches rank among the most common pain complaints.
There are a number of different classification systems for headaches. The most well recognized is that of the International Headache Society. Under this classification system the primary headaches are migraine, tension-type headaches and cluster headaches.
Migraine
Migraine is a neurological syndrome characterized by altered bodily perceptions, headaches and nausea. Physiologically, the migraine headache is a neurological condition more common to women than to men. Migraines are caused by altered blood flow to the head. Blood flow to the head is controlled by the stellate ganglion, which is an artery that expands and contracts, and is located at the base of the neck. If you have had a previous injury that involved the base of the neck, perhaps a car accident or a sport injury, you may be susceptible to migraines because the stellate ganglion may be affected by the resulting swelling. When you do exercise that aggravates the area around the ganglion, like chopping wood or playing tennis, this might trigger swelling. This causes the nerves to malfunction and stimulate the stellate ganglion to close off the circulation to the brain depriving the brain of oxygen and essential nutrients. However, the brain overrides the nervous system and re-opens the stellate ganglion so that we can keep getting oxygen and nutrients to the brain, to stay alive. Unfortunately, when the brain overrides the nerves it doesn't say how much to open, therefore it dilates far more than needed causing a considerable rise in pressure in the skull. This is what creates a migraine. The typical migraine headache is unilateral and pulsating, lasting from 4 to 72 hours. Symptoms include nausea, vomiting, photophobia (increased sensitivity to bright light), and hyperacusis (increased sensitivity to noise).
The signs and symptoms of migraines vary among patients. Warning signs for a migraine may include, (but are not limited to) altered mood, irritability, depression or euphoria, fatigue, yawning, excessive sleepiness, craving for certain food (e.g. chocolate), stiff muscles (especially in the neck), constipation or diarrhea, increased urination, and other visceral symptoms. These symptoms usually precede the headache phase of the migraine attack by several hours or days, and experience teaches the patient or observant family how to detect that migraine attack is near.
There are prescription drugs that minimize the effect of migraines, however they don't cure the headaches because they don't treat the cause. At 'physiotherapy + pilates evolved' we believe that by treating the underlying problem in the back and neck, rather than the symptoms, it is possible to give permanent relief. If the back and neck can be cured then aggravation which causes swelling will cease and blood flow will remain constant and steady.
Tension Type Headache
Tension type headaches are characterised as dull, aching and non-pulsating pain and affect both sides of the head. They result from muscle tightness in the shoulder, upper back and neck area. A tension headache may feel like a band around the neck or head which is a "vice - like" pressure. Pain primarily occurs in the forehead, temples or the back of the head and/or neck. It is important to seek help for headaches if they are frequent, continuous or extremely severe. Living with discomfort will affect your concentration, mood and on a whole, your ability to lead a healthy life.
Relieving muscle tension is an essential part of treating tension type headaches. We realise everyone is different and treat you individually, adopting appropriate methods to suit your symptoms. Some techniques we may use are:
- Massage therapy
- Trigger Point Dry Needling (TDN)
- Electrical Stimulation
- Home Exercises and Stretches
Your individual symptoms and physical state will affect what treatments your physiotherapist believes is best for you.
Cluster Headache
"Cluster" refers to the tendency of these headaches to occur periodically. Cluster headaches are less common than migraines and men tend to be more affected than women. The pain of a cluster headache commences quickly, without warning, and reaches a peak within 2 to 15 minutes. It is often very intense and is a deep non-fluctuating pain. The pain normally begins in, around or above the eyes or temple. Occasionally the face, neck or ear may be affected. Cluster headaches are always unilateral, and generally affect the same side in subsequent bouts. However, it may shift to corresponding regions of the opposite side.