The dreaded headache. Migraine, sinus, cluster, stress, ocular, tension, etc… They are all terrible. Some are worse than others, but again, they are all terrible. I’ve had more than a couple myself. I’ve done everything from ice, heat, cold shower, hot shower, sticking my head in a freezer, chiropractic adjustments, medication (even chiropractors will succumb to pills in the worst of pains), acupressure, massage, ointments, you name it. The crazy thing? I don’t have NEARLY as many as most people. My goal in writing this is to give you a little background of the different types of headaches, insight as to WHY people get headaches, and of course, a few tips on how to either get rid of them or at least manage them effectively.
Different Types of Headaches, Their Triggers, and Treatments!
Headaches come in many different forms. Most have different types of “triggers,” or things that bring on the headache. Here’s a quick review.
This is probably the most common type of headache we see. At my chiropractic office, we treat this routinely, as the typical trigger is some sort of cervical (neck) trauma. It doesn’t have to necessarily be a severe injury. The cause could easily be a “sleeping wrong” situation or just your everyday effects of bad posture. The bones in the neck become misaligned or dysfunctional, and the nerves that give feedback to the brain send signals of pain. Frequently, the upper neck is the culprit, and the nerves that are innervated by C1, C2 or C3 spinal nerves affect the trigeminal nerve, a nerve that runs directly off the brain that gives sensation to the face. This is why it sometimes gets tricky. Several of the pains can be very significant in the area of the sinuses and these are VERY often confused with sinus headaches. Roughly 15% or possibly more of people who suffer from frequent (>5 days per month) headache suffer from cervicogenic headache. Fortunately, in studies and clinical trials, spinal manipulative therapy (chiropractic adjustments) has shown the best outcomes in treatment of neck related headaches. (As if 18 years of doing this stuff didn’t provide me with the evidence I needed.) It ranked higher than acupuncture, massage, physical therapy, and electric stimulation. Amitriptyline was more effective at controlling headache severity, but there was no change in frequency. How about side effects, though? Four (4) percent of adjustment patients compared with eighty-two (82) percent of amitriptyline patients had negative side effects. Hmmm…which should we pick?? Other worthwhile options are massage, topical analgesic (I’m biased to KinetiCream), heat or ice, all focused on the neck.
I live in the Midwest United States. Sinus problems aren’t the exception; they’re more the norm. Pretty much every season, with our intense humidity, high pollen count, and temperature that changes in the blink of an eye, comes with a burden to our immune systems. Our body temperature and pressure is in part regulated by our hypothalamus, a part of the brain. When we can’t quite keep up, there is a higher chance for immune system compromise, opening the opportunity for infection. Sinusitis (inflammation of the linings of the sinus cavities in your skull) is frequently caused by infection, whether bacterial, fungal or viral. This changes the pressure inside of those cavities, causing sinus headaches. While infection is frequently the trigger, others are cigarette smoke, pollution, allergen exposure (dust, mold, etc..) or structural problems in the nasal cavity like polyps or deviation of the septum. One of the less common thought of triggers is actually exposure to dairy products. This is a frequent allergen to those who do not tolerate lactose well, and it will create increased mucus production and can cause a mild to moderate sinusitis. Sinus headaches do not typically cause nausea and are not usually accompanied by neck pain. Effective natural treatments such as acupressure, steam baths, facial saunas are around as well as the traditional medicinal route. Any anti-inflammatory herbals seem to be effective as well. In my office, I use an Activator, which is a spring-loaded mechanical tool that sends a mild physical impulse when squeezed. I use it over the frontal and maxillary sinuses on its lowest setting to create a brief increase followed by an extended decrease in the internal sinus pressure. I then use a very small amount of KinetiCream, which contains natural ingredients known to have anti-inflammatory properties, over the sinus areas. This creates both an anti-inflammatory and a vapor inhalant effect similar to the Vick’s your mom used to use, but far better smelling and minus the harmful chemicals. Plus, it isn’t greasy.
This is the doozy of headaches. They are horrible. Migraines are typically accompanied by light sensitivity, dizziness, visual disturbance, nausea, neck pain, and your head usually feels like it’s in a vice. They can last for hours or even days at a time. The longest in my practice that I have seen was 13 days straight. Common triggers for migraines include smoking (if you still smoke knowing everything that is bad about it, I would like to smack you through the computer), alcohol (especially red wine), bright lights, hormonal fluctuation, crying, caffeine, certain medications, odors, loud noises or even a smaller sinus or cervicogenic headache can morph into a migraine if left untreated. In the nutrition world, chocolate, dairy, cheese, MSG, artificial sweeteners, bacon (The beloved bacon? Yeppers.), hot dogs, fermented or pickled food can all be triggers as well. Gender is a risk factor. Sorry girls, you are three times more likely than men to get migraines. Often, medication just doesn’t touch these debilitating headaches, and what I have found in my practice is that whereas a chiropractic adjustment will help almost instantly with a cervicogenic headache, an adjustment does not help a shorter duration migraine immediately. Usually, the adjustment will allow the person just barely enough relief to sleep, which then takes care of the migraine. The exception to this seems to be the multi-day migraines. A chiropractic adjustment does usually break this cycle, and I have had people walk out of the office after a four or five day migraine with literally zero pain. Chiropractic, however, has been clinically shown to help PREVENT migraines very successfully. One study showed chiropractic care to be as effective as Elavil (a migraine medication) in preventing migraine, with obviously fewer side effects. There was also no benefit by combining the chiropractic and medical therapies. Acupuncture, lifestyle changes, herbal and homeopathic therapies, reflexology and massage have shown promise. In the herbal world, Feverfew and Butterbur seem to be the best for treating migraine. I am in no way an expert in the homeopathic medicine world, so rather than comment, I will say that there is research to support homeopathic treatment, and you could find a practitioner to work with that could help.
There are a few more types of headaches, but 95% will fall into the three categories above. If you suffer from any headaches, I will offer the following advice to prevent them. I find that prevention is always better than treatment and if we focused a bit more on these steps, it wouldn’t just be headaches being affected. Here you go:
- Don’t smoke. Don’t be around smoke. Encourage others to stop smoking. (Did I beat this dead horse enough?)
- Exercise regularly. This improves circulation and a general sense of well-being. It also improves immune function, reducing potential for sinus issues. There is typically a positive effect on range of motion in your neck, which minimizes the chance for cervicogenic headaches
- Get enough rest. While we don’t all need eight hours, adequate sleep is not only a key to preventing headaches, but it gives your brain the rest it needs and allows your body to recover from the day.
- Eat regularly spaced and similar sized meals throughout the day. This prevents hormonal fluctuation that can trigger headaches.
- Watch the diet content as well!!! So many foods are inflammatory to the digestive system and even entire body, so they should be minimized in general. Be especially cautious with dairy, gluten and wheat products.
- Take a whole-food multivitamin like Catalyn from Standard Process. I also recommend their Magnesium Lactate and Trace Minerals B-12 to minimize headaches.
- Drink a sufficient amount of water. Dehydration symptoms are often disguised as musculoskeletal pain and neurological irritation. Shoot for about 1/2 to 3/4 gallon per day, depending on activity level and weather.
- Try and reduce stress. (Yeah, right.) At least manage it as best as possible. Try meditation, yoga, relaxation techniques, get regular massage, etc.
- Get adjusted at a chiropractic office regularly. Take care of your spine. Funny how we are so concerned with our hair and teeth that we take care of them on a regular basis, but since the spine is under the layer of skin and muscle, it seems as if it’s an out of sight-out of mind situation. Wigs and dentures have come a long way. There is no artificial spine (artificial discs are out there, but they are still mostly ineffective.)
- Use cryotherapy. Vasoconstriction of the blood vessels going to the head really helps. Heat may feel good at the time, but usually makes it worse in the end.
- Try dry needling. Dry needling is extremely effective when it comes to headaches. Whether targeting the muscles of the jaw, face, neck or head, this technique can be a lifesaver.
There are many more tips, and tricks of course. This is not an exhaustive list of headache types, triggers or treatments. It’s just the most common stuff I’ve seen firsthand and a touch on what the research supports. If you want references, e-mail me. I have them here, but I’m going to ruin my own sleep patterns if I list them all, and I don’t have time for a headache tomorrow! Stay healthy!
– Dr. Craig