Headaches v. Migraines

If a client is experiencing neck & shoulder tension, I usually ask them if they are having headaches and often they tell me they’ve been having migraines. But what you may not realise is that there are a number of different types of headaches, and migraines are not a bad headache, per-say but have a different pathophysiology to headaches altogether.

Often mistaken for a tension or sinus headache, a migraine is a neurological condition caused by an overreactive “switch” in the brain stem.

Symptoms include throbbing pain; sensitivity to light, sounds, and smells; nausea and vomiting; and other symptoms. Twenty percent of sufferers have aura—symptoms such as visual disturbances that precede the onset of pain. The pain is moderate to severe, with triggers such as stress, hormonal changes, weather changes, some foods. Treatments include stress relief, lifestyle changes, OTC and Rx medications

Tension headache
This is by far the most common type of headache, affecting as many 90 percent of people at some point in their life. It’s caused by tightness in the muscles of the scalp and the back of the neck. Symptoms include dull pressure or tightness in a band around the head, especially the forehead. Usually no other symptoms. The pain is usually mild to moderate caused by stress, fatigue or activity. There are specific trigger points in the head, neck and shoulders that cause referral pain into the scalp.


Over the counter pain relievers like ibuprofen and paracetamol can help. Massage, hydrating properly and taking some time to de-stress—deep breathing, gentle yoga, napping, or meditation—might also help.

Sinus headache
It’s fairly uncommon; most people who think they have one actually have a migraine. “Almost half of people with migraines have runny or stuffy nose or teary eyes with their headaches,” Dr. Tepper explains. Symptoms include pain around the nose and eyes; runny nose, often accompanied by fever. The pain can be mild to severe and is triggered by an acute sinus infection. Treatment includes over the counter pain relievers and sinus meds.

Cluster headache
Rare, it affects 0.1 percent of the people, more commonly men. Because it tends to occur at the same time every day, doctors suspect the hypothalamus—the part of the brain that controls the body clock—is involved. Symptoms are intense, penetrating pain behind one eye that usually starts shortly after you fall asleep. They last an hour or two but come in clusters of one or two headaches a day over several weeks. Excruciating pain, that can be triggered by alcohol, diet. Also more common in smokers.
Because not much is known about the cause there is little treatment. Prevention can include prescription drugs, nerve blocks injected into the back of your head, and melatonin. Triptans and other medications are used to treat an attack once it’s started.

Here’s some points to consider telling your doctor for a diagnosis and effective treatment;
Are my headaches are severe and pounding?
Do I often feel nauseous or sensitive to light and noise during a headache attack?
The headaches come before or during my menstrual cycle.
My parent/sibling has the same kind of headaches.
I have missed work or important events because of my headaches.
Moving around too much or bending over can make the pain worse.
The pain is often on one side of my head.
Pain killers don’t help much (or not at all).
My headache can last from about five hours to several days.

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