What is a Headache?


Headaches are more common in adults, although they can develop at any time in life. Approximately 4 out of 5 children have headaches at some point, but most are benign and self-resolving. In fact, many adults who suffer from headaches report having the first headache in childhood.

Headache symptoms usually begin gradually. In fact, the sudden onset of severe headache may signify a serious problem and requires immediate medical attention. Common headache is often described as achy, dull or throbbing pain. It typically begins at the base of the skull/upper part of the neck and may radiate into the eye(s), the temple, or other locations. Headaches may be felt on one or both sides of the head. Often loud noises or bright lights may make them worse. Some patients may become nauseated or experience odd smells, sounds, or sights before and during the headache attack.

How Is a Headache Evaluated?

Early diagnosis and treatment are important in identifying a serious underlying cause for your headache. In most cases, an in-depth history and physical examination can help determine if your symptoms are related to an easily treated problem, or if it is more serious.

Your doctor can use other tests that reproduce the symptoms of your headache to help develop a specific management plan for your condition, or refer you to another health care provider. X-rays, laboratory tests and even advanced imaging studies like magnetic resonance imaging (MRI) may be necessary. Your doctor may ask you to complete a headache diary, recording:
  • day and time of the headache
  • headache location
  • what the headache feels like
  • what you were doing when the headache began
  • how long the headache lasts
  • what makes it feel better or worse
  • anything else you notice before, during, or after the attacks
What Causes Headaches?

Headaches can be primary and secondary. Primary headaches do not result from some other health condition.The most common type of primary headache is caused by problems with the neck muscles. Changes in the blood vessels inside the skull usually cause migraines. Other common types of headache include “cluster” headaches—headaches grouped together over weeks at a time; sinus headaches, associated with allergies and/or sinus infection; and headaches from poor vision.

Secondary headache results from some other cause or condition—head injury, concussion, blood vessel problems, or high blood pressure—or from side effects of some medications, infections in the head or sinuses or elsewhere in the body. Rare headache causes include tumors, aneurysms and other abnormal growths inside the skull, and toxic substances in the blood. Certain foods, such as monosodium glutamate (MSG), a food flavor enhancer, may cause headaches, as well.

Types of Headaches

Tension Headaches
Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers. Most people describe a tension headache as a constant dull, achy feeling either on one side or both sides of the head, often described as a feeling of a tight band or dull ache around the head or behind the eyes. These headaches usually begin slowly and gradually and can last for minutes or days, and tend to begin in the middle or toward the end of the day. Tension headaches are often the result of stress or bad posture, which stresses the spine and muscles in the upper back and neck.

Tension headaches, or stress headaches, can last from 30 minutes to several days. In some cases, chronic tension headaches may persist for many months. Although the pain can at times be severe, tension headaches are usually not associated with other symptoms, such as nausea, throbbing or vomiting.

Migraine Headaches

Each year, about 25 million people in the U.S. experience migraine headaches, about 75% are women. Migraines are intense and throbbing headaches that are often associated with nausea and sensitivity to light or noise. They can last from as little as a few hours to as long as a few days. Many of those who suffer from migraines experience visual symptoms called an “aura” just prior to an attack that is often described as seeing flashing lights or that everything takes on a dream-like appearance.

Migraine headaches are caused by a constriction of the blood vessels in the brain, followed by a dilation of blood vessels. During the constriction of the blood vessels there is a decrease in blood flow, which is what leads to the visual symptoms that many people experience. Even in people who don’t experience the classic migraine aura, most of them can tell that an attack is immanent. Once the blood vessels dilate, there is a rapid increase in blood pressure inside the head. It is this increased pressure that leads to the pounding headache. Each time the heart beats it sends another shock wave through the carotid arteries in the neck up into the brain.

Migraine sufferers usually have their first attack before age 30 and they tend to run in families, supporting the notion that there is a genetic component to them. Some people have attacks several times a month; others have less than one a year. Most people find that migraine attacks occur less frequently and become less severe as they get older.

Cluster Headaches
Cluster headaches are typically very short-duration, excrutiating headaches, usually felt on one side of the head behind the eyes. Cluster headaches affect about 1 million people in the United States and, unlike migraines, are much more common in men. This is the only type of headache that tends to occur at night. The reason that they are called ‘cluster’ headaches is that they tend to occur one to four times per day over a period of several days. Like migraines, cluster headaches are likely to be related to a dilation of the blood vessels in the brain, causing a localized increase in pressure.

What Is the Treatment for Headaches?

Headache treatment is cause-related. Doctors of chiropractic often treat patients with tension-type headaches and headaches caused by problems with the joints and muscles in the neck, as well.

Joint manipulation and mobilization of the neck, along with stretching and strengthening exercises, have been demonstrated to be effective in the treatment of this type of headache.

Massage and other forms of soft-tissue treatment can sometimes be helpful.

Scientists are also investigating other therapies, such as acupuncture, to prevent and treat this disorder. Over-the-counter pain relievers, such as acetaminophen, can be used for an occasional headache, but not for long-term headache management.

More serious causes of headache require aggressive treatment, and your doctor of chiropractic can assist you in finding a medical headache specialist. The majority of patients with headache recover completely after treatment. Unfortunately, the recurrence rate is relatively high, particularly with tension-type headache. If you have any questions or concerns about headache, feel free to discuss them with your doctor or chiropractic.

Trigger Point Therapy for Headaches

Trigger point therapy for headaches tends to involve four muscles: the Splenius muscles, the Suboccipitals, the Sternocleidomastoid (SCM) and the Trapezius.

The Splenius muscles are comprised of two individual muscles – the Splenius Capitis and the Splenius Cervicis. Both of these muscles run from the upper back to either the base of the skull (splenius capitis) or the upper cervical vertebrae (splenius cervicis). Trigger points in the Splenius muscles are an extremely common cause of headache pain that travels through the head to the back of the eye, as well as to the top of the head.

The Suboccipitals are actually a group of four small muscles that are responsible for maintaining the proper movement and positioning between the first cervical vertebra and the base of the skull. Trigger points in these muscles will cause pain that feels like it’s inside the head, extending from the back of the head to the eye and forehead. Often times it will feel like the whole side of the head hurts, a pain pattern similar to that experienced with a migraine.

The Sternocleidomastoid (SCM) muscle runs from the base of the skull, just behind the ear, down the side of the neck to attach to the top of the sternum (breastbone). Although most people are not aware of the SCM trigger points, their effects can be very widespread, including referred pain, balance problems and visual disturbances. Referred pain patterns tend to be deep eye pain, headaches over the eye and can even cause earaches. Another unusual characteristic of SCM trigger points is that they can cause dizziness, nausea and unbalance.

The trapezius muscle is the very large, flat muscle in the upper and mid back. A common trigger point located in the very top of the Trapezius muscle refers pain to the temple and back of the head and is sometimes responsible for headache pain. This trigger point is capable of producing satellite trigger points in the muscles in the temple or jaw, which can lead to jaw or tooth pain.

How Can Headaches Be Prevented?

Muscle-tension headaches can often be avoided by maintaining proper posture and neck movements while performing your normal activities. You should:
  • Avoid slouching
  • Avoid reading with your neck bent forward
  • Keep your computer monitor at eye level
  • Take frequent breaks from reading and working on the computer.
  • Try a low-fat, high-complex carbohydrate diet. A recent study demonstrated that such a diet can dramatically lower the frequency, intensity, and\duration of migraine headaches.
Avoid Headache Triggers
  • Stress may be a trigger, but certain foods, odors, menstrual periods, and changes in weather are among many factors that may also trigger headache.
  • Emotional factors such as depression, anxiety, frustration, letdown, and even pleasant excitement may be associated with developing a headache.
  • Keeping a headache diary will help you determine whether factors such as food, change in weather, and/or mood have any relationship to your headache pattern.
  • Repeated exposure to nitrite compounds can result in a dull, pounding headache that may be accompanied by a flushed face. Nitrite, which dilates blood vessels, is found in such products as heart medicine and dynamite, but is also used as a chemical to preserve meat. Hot dogs and other processed meats containing sodium nitrite can cause headaches.
  • Eating foods prepared with monosodium glutamate (MSG) can result in headache. Soy sauce, meat tenderizer, and a variety of packaged foods contain this chemical which is touted as a flavor enhancer.
  • Headache can also result from exposure to poisons, even common household varieties like insecticides, carbon tetrachloride, and lead. Children who ingest flakes of lead paint may develop headaches. So may anyone who has contact with lead batteries or lead-glazed pottery.
  • Foods that are high in the amino acid tyramine should also be avoided, such as ripened cheeses (cheddar, brie), chocolate, as well as any food pickled or fermented foods.Contact us today!



Comprehensive Health and Chiropractic Center (CHCC)
555 S. Rancho Santa Fe Rd., Suite 200
San Marcos, CA 92078
(760) 736-0286