Medical Model of Headaches

The medical model of headaches has two classification of headaches which include primary and secondary headaches.

Primary headaches are of an unknown cause and some of these types include:

• Tension -type Headaches (TTH)

• Migraines

• Trigeminal Autonomic Cephalagies (TACs)

• Cluster Headaches

• Chronic paroxysmal hemicrania

• SUNCT

Secondary headaches are of a known cause and some of these types include:

• Cervicogenic Headaches

• Temporomandibular Dysfunction

• Medical conditions, disease such as tumours, cranial vasculitis, subarachnoid hemorrhages

Migraines

Migraines can present themselves into 3 categories:

• Migraine without an aura

• Migraines with an aura

• Migraine variants (that can be triggered from the stomach, menstrual cycle etc)

Migraines without an aura

• Usually present itself as pain on one side of the head and/or alternates to the other side of the within or between episodes.

• Can feel like a pulsating sensation

• Episode can range from moderate to severe amount of head pain

• Can be aggravated by triggers such as routine physical activity

• Can have associated features like nausea, vomiting, sensitivity to sound, light and smell, increase or decrease activity, food cravings and excessive yawning.

Migraines with an aura

An aura can be described as a gradual development of reversible neurological symptoms that is associated with the migraines such as:

• Visual symptoms: for example, light flickering, spot, waves, lines or in some cases loss of vision

• Sensory symptoms: paraesthesia and/or anaesthesia

• Speech disturbances

Tension Type Headache

• Can be episodic that can be frequent or infrequent

• Chronic tension headache can occur with or without pericranial tenderness

Tension Type Headaches symptoms

• Usually bilateral (symptoms on both sides of the head)

• Can feel achy, tight, squeezy sensation and not pulsating

• Symptoms can vary from mild to moderate in nature

• It is not triggered by physical activity

• Can have associated symptom such as sensitivity to sound and/or light

Cluster Headaches

• Usually present as short burst of unilateral (one side) of severe temporal pain

• This attacks usually present in clusters

• Each cluster can last up to 3 minutes that occur up to 8 times a day

• These clusters can last for week or month or years with remission

• Usually occurs more in males

Cervicogenic headaches

Cervicogenic headache is a secondary headache and the pathophysiology (the cause) is known. This is one headache that may be coming from your neck and is a condition that a physiotherapist may be able to help with.

Some signs of this type headache can include:

• Head pain with neck movement

• Head pain with sustained or awkward head positioning

• Limited movement of the neck

• Shoulder or arm pain on the side of the head pain

How is Cervicogenic headaches diagnosed?

• Referred pain that is felt in the head or face, but it is coming from the neck

• Imaging that shows a disorder in the neck

• Headache that is resolved with an aesthetic block

• Headache that is resolved with treatment of the neck

Cervicogenic headaches is a disorder of a structure supplied by one or more segment in the neck usually associated with C1-C3 nerves. These nerves misinterpret information as residing in the trigeminal field and pain is referred to the head. Therefore, treatment to the neck particular to those segments can help relieve or subside symptoms of your head pain.

If you're experiencing any symptoms or headaches listed above come in for some treatment to see if our specific headache treatment can alleviate your symptoms.