Headaches
Headaches
The most common is the tension headache – felt commonly in the back of the head and can also come round the sides and or the temple and behind the eyes. Caused by trigger points in the neck muscles. We treat these with soft tissue and manipulative therapy such active release technique and either cervical manipulation or muscle enrgy techniques. FSM Microcurrent is very good at softening tension and fibrosis in these tissues.
What is it?
A headache is an extremely common complaint, in which both athletes and non-athletes
complain of a generalized or specific discomfort in their heads.
A headache is not always a migraine—this is only one specific form of headache.
What causes it?
Headaches may result from a number of causes, including:
1. Viral illnesses, e.g. sinusitis
2. Cervical headache—referred from the neck
3. Abnormalities within the brain, e.g. tumor or bleed
4. Exercise-related headache, e.g. ‘footballers’ migraine’
5. Vascular headache, e.g. migraines
6. Other—trauma, drugs, stress
Cervical Tension headache
What is it?
A cervical headache is a headache occurring secondary to abnormalities of the joints,
muscles or soft tissues of the neck.
What causes it?
The exact mechanism of production of the headache from the neck region is unknown, but is
thought to be referred from to the head from focal abnormalities or by irritation of nerve and
related structures in the neck region.
Who is at risk?
Any athlete or non-athlete may experience cervical headaches. Particular risk factors
include:
1. Previous trauma—‘whiplash’
2. Poor posture
3. Stress
What are the symptoms?
A cervical headache is typically described as a constant, steady, dull ache, usually occurring
on one side, but occasionally on both sides of the head. It is often referred from the base of
the head to the forehead.
The onset of the headache is usually gradual, often present early in the morning, improving
during the day. They are often present for days, weeks or even months.
How is it diagnosed?
Consultation with a sports physician is required. A full history and examination is required for
the diagnosis. Investigations are necessary only if the headaches fail to settle with treatment,
or if the presentation is atypical.
How is it treated?
Treatment of the patient with a cervical headache requires correction of the abnormalities in
the neck with a combination of physiotherapy, massage and stretching (including nerve
stretches). Anti-inflammatory medication may be required in the early stages. Acupuncture
may be helpful to relieve muscle tightness. Correction of posture and stress reduction may
also be required.
Exercise related headache
What is it?
This is a specific type of headache that occurs only with exercise.
What causes it?
The exact cause is unknown, but may be related to a minor disturbance in the functioning of
the brain with exertion.
Who is at risk?
Although more common in runners and weightlifters, it may occur in any other sporting
activities.
What are the symptoms?
The headache is usually of sudden onset, lasts only seconds or minutes and is associated
exclusively with exertion. Following the initial severe headache, dull pain persists for a
number of hours.
How is it diagnosed?
Consultation with a sports physician is mandatory. A full history and examination should be
performed. Investigations are required to exclude abnormalities of the skull or brain. These
include:
1. Skull X-ray
2. CT scan or MRI of the brain
How is it treated?
Treatment involves either avoidance of the activity, or medications to help prevent the
headache. If neck stiffness is contributing to the headache, physiotherapy and exercises
involving the neck muscles may assist in the treatment.
Vascular headache
What is it?
Vascular headaches refer to the throbbing headaches that occur due to dilation of the blood
vessels are the outside surface of the brain. Common types of vascular headaches include:
migraine, cluster headache, exertional headache and some types of post-traumatic
headache.
a) Migraines:
Vascular headaches that are may be associated with:
(i)
(ii)
neurological (nervous system) symptoms—visual disturbance, slurred
speech, drowsiness, pins and needles, limb weakness, dizziness.
Nausea, vomiting, diarrhea.
b) Cluster headaches:
Vascular headaches that occur in ‘clusters’ or attacks. The headaches are described
as an intense burning. They may be associated with:
(i)
(ii)
(iii)
(iv)
a runny nose
a blocked nose
sweating
red, painful eyes
Who is at risk?
Vascular headaches usually begin around the time of puberty and adolescence. There is
often a family history of such headaches. Medications such as the oral contraceptive pill and
some blood pressure tablets may exacerbate the tendency towards developing such
headaches.
What are the symptoms?
The main symptom of a vascular headache is that of a throbbing headache, often beginning
in the early morning and reaching high intensity within 2 hours. There are often associated
symptoms (see above). The headache may last for a number of hours, but usually resolves
within a day; however, they may re-occur daily or several times a week. They are often more
frequent in certain seasons.
How are they diagnosed?
Consultation with a physician is required. A full history and examination suggest the
diagnosis. Initially, investigations may be required to exclude other causes of the headaches.
How are they treated?
a) Migraines:
(i)
(ii)
(iii)
Rest—sleep often ends the attack.
Medications—pain-killers, as advised by your physician.
Prevention—if attacks are frequent, a preventive medication may be
required. Avoidance of trigger factors is important.
b) Cluster headaches:
Treatment depends on the age and health of the patient, and the timing of the attack.
(i)
(ii)
(iii)
Inhalation of 100% oxygen, administered by medical staff, often relieves
the headache.
Medications—pain-killers as recommended by the physician.
Prevention—if headaches are frequent, preventive medication may be required