There are many different forms of headaches (around 150 types!) within this blog we will discuss tension type headaches, dehydration headaches and migraines. Firstly the most common headaches experienced (tension type headaches), secondly dehydration headaches and thirdly migraines.
Tension Type Headaches
Tension type headaches are described as a mild to moderate and felt on both sides of your head. The headache is usually dull or squeezing in nature and can last anywhere from 30 minutes to several days. There are two categories: Episodic headaches which occur less than 15 times per month. Also chronic which occur more than 15 times a month for more than 3 months in a row.
Typically you will experience pains on both sides of the head which feels like a pressure behind the eyes and tension into the neck and shoulders. Moreover, you will not experience nausea, vomiting or visual changes and your headache is not usually affected by normal daily routines.
How is a Tension Type Headache diagnosed?
Tension type headaches are diagnosed through the patient’s symptoms. Physical examination of the neck there may be tenderness and scalp muscles which may increase headache symptoms.
Causes of Tension Type Headaches
There are many different causes of tension type headaches which cause additional strain onto the muscles of the head and neck. Stress and anxiety can contribute by elevating your shoulders over long periods of time which affects your upper back and neck posture. In addition, teeth and jaw clenching will contribute towards tension type headaches.
An Osteopath will take a case history and explain to you what is happening. After that they will provide hands on treatment aimed to reduce tensions into your head and neck. The osteopath will address the whole posture to get other areas moving more freely (typically upper back) to reduce pressure onto your head and neck. Osteopaths use a combination of muscular stretching, joint articulations and joint manipulations (only when appropriate) techniques to increase the functionality of movement and reduce your pains. Relaxation techniques and heat therapy will be explained and encouraged for you to try at home. In addition, prescription of muscular stretching and strengthening exercises. Furthermore lifestyle and basic nutrition and hydration advice to reduce the frequency and severity of your tensions type headaches.
GP Medication and Acupuncture referral
GPs will prescribe aspirin, paracetamol or NSAIDs for the acute treatment of tension type headaches. Your GP will take into account the person’s preference, comorbidities and risk of adverse events (NICE 2012). In addition they may refer to an acupuncturist for a course of up to 10 sessions over 5–8 weeks (NICE 2012 & Cochrane 2016). Acupuncture is a therapy in which thin needles are inserted into the skin at particular points which is used with tension type headaches.
Pilates mainly consists of stretching and muscular strengthening exercises. For clients with headaches there will be a physical focus to encourage upper back mobility and strengthening to reduce tensions into the head and neck regions. Furthermore a mental focus to reduce stress through mindful movement and breath work practised in sessions. In Pilates you will focus your attention on flowing movements and your breath for a hour which is calming and therapeutic. Moreover you will leave sessions feeling less stressed and energised. Pilates improves your mood as physical activity causes endorphins to be released and causes a positive feeling in the body. At Wellthy clinic we run studio and matwork Pilates to provide meaningful movement to keep on top of everyday tensions and proactively support your health.
Stress and anxiety can contribute towards tension type headaches. Taking time out of your busy day to concentrate on deep breathing or meditation are effective ways to reduce tensions.
A dehydration headache is caused by not having enough fluid in your body. You require a balance of fluid and electrolytes to function properly. Your body loses water everyday through daily activities, exercise through sweat and urinating. Therefore balancing your fluid intake through drinking or eating fluid rich foods to maintain the right hydration is vital. If your body becomes dehydrated this can lead to complications and dehydration headaches. You are more likely to become dehydrated if you have exercised to the point of extreme sweating, experienced diarrhoea, fever or vomiting and urinated excessively. Dehydration headaches will cause the brain to temporarily contract and pull away from the skull which causes pain.
What does a dehydration headache feel like?
Dehydration headaches can feel dull in nature and mild or intense and severe. The headache can occur at the front, back, sides or all over the head. Unlike a tension type headache you are unlikely to feel the tension at the back of the neck. You may also feel thirsty, have a dry mouth and urinate less often. Moreover have a dark coloured urine, feel confused, dizzy and fatigued. In addition you may have dry skin, a low blood pressure and increased heart rate. If the dehydration headche is severe you may also experience a lack of sweating, fever or even become unconsciousness.
Increase water or a rehydration mix intake, reduce activity and rest. For more severe dehydration headaches after diarrhoea and vomiting this may not be enough. In which case, seek medical care to avoid kidney damage, seizures or shock. Emergency medical professionals can manage severe dehydration with intravenous fluid and salt replacement.
A migraine is described as severe, recurring, one-sided painful headache. It is normally pulsating in nature and can last anywhere from 4-72 hours. There are several different types of migraine with or without aura, menstrual, chronic, hemiplegic, abdominal, vestibular and visual.
In addition to a headache you may also experience nausea, vomiting and sensitivity to light or sound. Your symptoms may worsen with daily tasks such as walking.
Migraine causes still remain to be unknown and it is suggested that migraines occur as a result of abnormal brain activity. This affects the brain’s chemicals, blood vessels and communication between the nerves. There are triggers associated with the start of migraines. These are hormonal, stress and negative mental state, postural tensions, tiredness, food, alcohol and dehydration.
How are migraines diagnosed?
If you are suffering from migraines it is suggested to seek advice from your GP. They will perform a range of tests to exclude any other cause of headaches and may include blood tests, blood pressure, eye exam and scans.
Currently, there is not one single cure for migraines. Therefore, the main aim of treatment is to reduce the frequency of migraines and to control the symptoms of the migraine. There are many different types of treatment for migraine, these include:
Reduce stress, reduce food triggers and avoid certain foods. Keep hydrated, improve your sleep hygiene and increase hours of sleep, participate in regular physical activity and reduce screen time.
Seek advice from your GP and if you choose to take medication there are a number of different options ranging from parcetamol, triptans and anti nausea medications.
If you choose to see an osteopath they will take a case history and explain to you what is happening. After this they will provide hands on treatment aimed to reduce tensions into your head and neck. The osteopath will address the whole posture to get other areas moving more freely (typically upper back) to reduce pressure onto your head and neck. Osteopaths use a combination of muscular stretching, joint articulations and joint manipulations (only when appropriate) techniques to increase the functionality of movement and reduce your pains. You will be advised on how best to self manage your tensions through self relaxation techniques and using heat packs onto your upper back. Muscular stretching and strengthening exercises will also be given for you to perform at home. Furthermore lifestyle and basic nutrition and hydration advice to reduce the frequency and severity of your migraines.
What if a headache lasts for 3 days?
If your headache lasts for more than 3 days or keeps on coming back and painkillers do not help and it feels like your headache gets worse. Moreover if you have a bad throbbing pain at the front or side of your head this could be a migraine or a cluster headache. If you feel sick, vomit and find light or noise painful then phone 111 or contact your GP.
Likewise if your arms or legs feel numb or weak or your jaw hurts when eating, you have blurred or double vision and you are experiencing a sore scalp. These could be signs that the arteries in your head and neck are inflamed. So contact 111 to describe your symptoms and they will tell you what to do.
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Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin BC, Vickers A, White AR. Acupuncture for the prevention of tension-type headache. Cochrane Database of Systematic Reviews 2016, Issue 4. Available at: https://papas.cochrane.org/our-reviews/reviews-topic/headache-and-migraine
NICE National Institute of Health and Care Excellance Headaches in over 12s: diagnosis and management Clinical guideline [CG150] Available at: https://www.nice.org.uk/guidance/cg150/chapter/Recommendations#diagnosis
NHS Headaches (2020) available at https://www.nhs.uk/conditions/headaches/