Homemade treatment and massage for headache and categorization of neurological and tension headaches
Headache is defined as a pain arising from the head or upper neck of the body. The pain originates from the tissues and structures that surround the skull or the brain because the brain itself has no nerves that give rise to the sensation of pain (pain fibers). The thin layer of tissue (periosteum) that surrounds bones, muscles that encase the skull, sinuses, eyes, and ears, as well as thin tissues that cover the surface of the brain and spinal cord (meninges), arteries , veins, and nerves, all can become inflamed or irritated and cause headache. The pain may be a dull ache, sharp, throbbing, constant, intermittent, mild, or intense.
How are headaches classified?
There are three major categories of headache based upon the source of the pain.
- Primary headaches
- Secondary headaches
- Cranial neuralgias, facial pain, and other headaches
The guidelines also note that a patient may have symptoms that are consistent with more than one type of headache, and that more than one type of headache may be present at the same time.
What are primary headaches?
Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache.
- Tension headaches are the most common type of primary headache. Tension headaches occur more commonly among women than men.
- Migraine headaches are the second most common type of primary headache. Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected.
- Cluster headaches are a rare type of primary headache. It more commonly affects men in their late 20s though women and children can also suffer from this type of headache.
Primary headaches can affect the quality of life. Some people have occasional headaches that resolve quickly while others are debilitating. While these headaches are not life threatening, they may be associated with symptoms that can mimic strokes.
Many patients equate severe headache with migraine, but the amount of pain does not determine the diagnosis of migraine.
What are secondary headaches?
Secondary headaches are those that are due to an underlying structural or infectious problem in the head or neck. This is a very broad group of medical conditions ranging from dental pain from infected teeth or pain from an infected sinus, to life-threatening conditions like bleeding in the brain or infections like encephalitis or meningitis.
Traumatic headaches fall into this category including post-concussion headaches.
This group of headaches also includes those headaches associated with substance abuse and excess use of medications used to treat headaches (medication overuse headaches). "Hangover" headaches fall into this category as well. People who drink alcohol may waken with a well-established headache due to the effects of alcohol and dehydration.
What are cranial neuralgias, facial pain, and other headaches?
Neuralgia means nerve pain (neur=nerve + algia=pain). Cranial neuralgia describes inflammation of one of the 12 cranial nerves coming from the brain that control the muscles and carry sensory signals (such as pain) to and from the head and neck. Perhaps the most commonly recognized example is trigeminal neuralgia, which affects cranial nerve V (the trigeminal nerve), the sensory nerve that supplies the face and can cause intense facial pain when irritated or inflamed.
17 types of headaches
The different types of headaches depend upon the class to which they belong. Some common types include:
- Primary tension headaches that are episodic
- Primary tension headaches that are chromic
- Primary muscle contraction headaches
- Primary migraine headaches with aura
- Primary migraine headaches without aura
- Primary cluster headache
- Primary paroxysmal hemicrania (a type of cluster headache)
- Primary coughheadache
- Primary stabbing headache
- Primary headache associated with sexual intercourse
- Primary thunderclap headache
- Hypnic headache (headaches that awaken a person from sleep)
- Hemicrania continua (headaches that are persistently on one side only. right or left [unilateral])
- New daily-persistent headache (NDPH) (a type of chronic headache)
- Headache from exertion
- Trigeminal neuralgia and other cranial nerve inflammation
- Secondary headaches due to:
- Structural problems with the bones of the face, teeth, eyes, ears, nose, sinuses or other structures
- Substance abuse or withdrawal
What causes headaches?
Migraine headache is caused by inflammation or irritation of structures that surround the brain or affect its function. While the brain itself has no pain nerve fibers, everything else above the shoulders, from the neck, skull, and face, can cause a person to have of head pain. Systemic illnesses, including infection or dehydration, can have associated headache. These are known as toxic headache. Changes in circulation and blood flow or trauma can also cause headache.
Changes in brain chemistry may also be associated with headache: medication reactions, drug abuseand drug withdrawal can all cause pain.
Every person is different so the history of the headache is important. Recognizing patterns or precipitating (foods eaten, stress, etc.) factors, in combination with the physical examination and associated symptoms, can help identify the cause for each individual's specific headache.
What causes tension headaches?
While tension headaches are the most frequently occurring type of headache, their cause is not known. The most likely cause is contraction of the muscles that cover the skull. When the muscles covering the skull are stressed, they may become inflamed, go into spasm, and cause pain. Common sites include the base of the skull where the trapezius muscles of the neck insert, the temples where muscles that move the jaw are located, and the forehead.
There is little research to confirm the exact cause of tension headaches. It is believed that tension headaches occur because of physical stress on the muscles of the head. For example, these stressors can cause the muscles surrounding the skull to clench the teeth and go into spasm. Physical stressors include difficult and prolonged manual labor, or sitting at a desk or computer concentrating for long periods. Emotional stress also might cause tension headaches by causing the muscles surrounding the skull to contract.
What causes cluster headaches?
Cluster headaches are so named because they tend to occur daily for periods of a week or more followed by long periods of time -- months to years -- with no headaches. They occur at the same time of day, often waking the patient in the middle of the night.
The cause of cluster headaches is uncertain but may be due to a sudden release of the chemicals histamine and serotonin in the brain. The hypothalamus, an area located at the base of the brain, is responsible for the body's biologic clock and may be the source for this type of headache. When brain scans are performed on patients who are in the midst of a cluster headache, abnormal activity has been found in the hypothalamus.
Cluster headaches also:
- tend to run in families and this suggests that there may be a role for genetics;
- may be triggered by changes in sleep patterns; and
- may be triggered by medications (for example, nitroglycerin, used for heart disease)
If an individual is in a susceptible period for cluster headache, cigarette smoking, alcohol, and some foods (for example, chocolate, and foods high in nitrites like smoked meats) also are potential causes for headache.
What diseases cause secondary headaches?
Headache is a symptom associated with many illnesses. While head pain itself is the issue with primary headaches, secondary headaches are due to an underlying disease or injury that needs to be diagnosed and treated. Controlling the headache symptom will need to occur at the same time that diagnostic testing is performed to identify the underlying disease. Some of the causes of secondary headache may be potentially life threatening and deadly. Early diagnosis and treatment is essential if damage is to be limited.
Head and neck trauma
- Injuries to the head may cause bleeding in the spaces between the meninges, the layers of tissue that surround the brain (subdural, epidural, and subarachnoid spaces) or within the brain tissue itself (intracerebral hemorrhage: intra=within + cerebral=brain, hemorrhage=bleeding).
- Edema or swelling within the brain, not associated with bleeding, may cause pain and a change in mental function.
- Concussions, where head injury occurs without bleeding. Headache is one of the hallmarks of post-concussion syndrome.
- Whiplash and neck injury also cause head pain.
Blood vessel problems in the head and neck
- Stroke or transient ischemic attack (TIA).
- Arteriovenous malformations (AVM) when they leak.
- Cerebral aneurysm and subarachnoid hemorrhage. An aneurysm, or a weakened area in a blood vessel wall, can expand and leak a small amount of blood causing what is called a sentinel headache. This may be a warning sign of a future catastrophic bleed into the brain.
- Carotid artery inflammation
- Temporal arteritis (inflammation of the temporal artery)
Non-blood vessel problems of the brain
- Brain tumors, either primary, originating in the brain, or metastatic from a cancer that began in another organ
- Idiopathic intracranial hypertension, historically called pseudotumor cerebri, where pressure within the spinal canal increases. The cause is unknown and while it can occur in all ages, it often affects young, obese females. Idiopathic intracranial hypertension can cause significant headache and if left untreated may, on occasion, lead to blindness.
Medications and drugs (including withdrawal from those drugs)
Oral contraceptives, medications used to treat erectile dysfunction, blood pressure or other cardiac medications can all lead to or cause headaches. Medication overuse headache, occurring when pain medications are taken too frequently, can be caused by acetaminophen (Tylenol and others), aspirin, ibuprofen (Advil and others), OTC analgesics with caffeine, as well as narcotic analgesics and other prescription pain medications.
- Systemic infections (for example, pneumonia or influenza)
Changes in the body's environment
- High blood pressure (hypertension)
- Kidney dialysis
Problems with the eyes, ears, nose throat, teeth, sinuses, and neck
- Sinus infection
- Dental pain
How to treat the headache with medication?
The most common ways of treating headaches are rest and pain relief medication.
Generic pain relief medication is available over the counter (OTC), or doctors can prescribe preventative medication, such as tricyclic antidepressants, serotonin receptor agonists, anti-epileptic drugs, and beta-blockers.
It is important to follow the doctor's advice because overusing pain relief medication can lead to rebound headaches. The treatment of rebound headaches involves the reducing or stopping pain relief medication. In extreme cases, a short hospital stay may be needed to manage withdrawal safely and effectively.
Home remedies for headaches
A number of steps can be taken to reduce the risk of headaches and to ease the pain if they do occur:
- Apply a heat pack or ice pack to your head or neck, but avoid extreme temperatures.
- Avoid stressors, where possible, and develop healthy coping strategies for unavoidable stress.
- Eat regular meals, taking care to maintain stable blood sugar.
A hot shower can help, although in one rare condition hot water exposure can trigger headaches. Exercising regularly and getting enough rest and regular sleep contributes to overall health and stress reduction.