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What are the three major groupings of headaches?
Tension headaches.- Vasculogenic headaches
- Other causes.
What are tension headaches?
Tension headaches are caused by the tightening
of the muscles which lie in the back of the neck and surround
the face and scalp. These headaches affect both sides of the
head and are often described as tight band or vise-like ache.
Myofascial pain syndrome and cervical facet syndrome can cause
or contribute to tension headaches. These diagnoses are discussed
later.
What are vasculogenic headaches?
Vasculogenic headaches are either a.) migraine
headaches or b.) cluster headaches
Migraine headaches usually occur on one
side of the head. The pain produced by a migraine is described
as a pounding or throbbing. The pain level ranges from moderate
to severe. Nausea and sensitivity to light are two symptoms
associated with a migraine. Fifty percent of people who have
migraine headaches experience an “aura”, or physical
symptom as a “warning signal”, which precedes
the migraine.
Cluster headaches are characterized by their
one-sided location, brief duration, and their occurrence in
“clusters” (numerous attacks within several days).
The common location for a cluster headache is around one eye.
The duration of a cluster headache ranges from a few minutes
to two hours. The pain is excruciating.
Both of these headache types can lead to
myofascial pain which in and of itself causes headaches.
What are other organic causes of headaches?
Headaches radiating from the jaw or caused
by temporomandibular joint dysfunction (TMJ) usually present
as a dull ache beginning around the ear and radiating to the
head at a later date. Symptoms generally increase with jaw
activity such as chewing, talking, and yawning.
A sinus headache will present with facial
pain, possibly congestion and a fever. These headaches often
intensify as the day progresses. Often, tension or migraine
headaches are mistaken for sinus headaches.
Other organic causes of headaches consist
of various diagnoses such as tumor, infection, or other diseases.
These are relatively rare and account for less than two percent
of all headaches.
What conditions cause tension headaches?
Myofascial pain syndrome (MPS) can be a
major contributor to tension headaches. MPS is a benign condition
that can affect people of all ages. The condition is diagnosed
by finding “trigger points” (tender nodules or
taut bands of muscle) on examination. These result from injury
or prolonged physical stress. Once present, excessive contraction
or stretch of a muscle containing trigger points will trigger
pain. Trigger points within certain neck muscles can cause
headaches. Different trigger points characteristically “refer”
pain to different predictable locations in the head and face.
Cervical facet syndrome often feels like
a “catching sensation” in the neck when turning
the head. Spinal facet joints lie between vertebrae and guide
motion of one vertebrae on another, resulting in motion of
the neck. If inflamed, facets will have restricted motion
and cause pain through muscle spasm and irritation of nearby
nerves. This often happens in the upper cervical (neck) vertebrae,
causing a headache which runs up the back of the head. Poor
posture is a significant contributor to cervical facet syndrome,
especially in those who perform a lot of desk work.
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