The types of headaches

Headaches, commonly referred to as head pain, are divided into three main categories: primary headaches, secondary headaches, and neuropathic headaches. Primary headaches include migraines and tension-type headaches, while secondary headaches include cervicogenic headaches. These three types of headaches will be discussed in greater detail in this article, as they are among the most commonly encountered. Neuropathic headaches, on the other hand, include neuralgias.

Primary Headaches

Primary headaches do not have a specific underlying cause. They are divided into three categories: migraines, tension-type headaches, and trigeminal autonomic cephalalgias.

Migraine is the most disabling type of primary headache. It is characterized by unilateral, throbbing pain lasting from 4 to 72 hours. It may be accompanied by photophobia and/or phonophobia, meaning sensitivity to light and/or sound, as well as possible nausea and vomiting depending on the severity of the episode. Migraine is sometimes accompanied by an aura, a period lasting approximately 30 to 60 minutes during which warning symptoms may occur. This is a period during which the onset of the migraine may potentially be reversed when detected early.

Tension-type headache is the most common type of headache. It is estimated that nearly 40% of the general population experiences it. It is characterized by bilateral, non-throbbing pain lasting from 30 minutes to 7 days. It may be accompanied by pain radiating toward the neck, sensations of tightness and pressure, as well as diffuse muscle tension.

Secondary Headaches

Secondary headaches have a specific underlying cause, meaning they may result from a musculoskeletal, circulatory, visual, or other condition. They can therefore be divided into several categories depending on their specific cause.

A cervicogenic headache is characterized by referred pain in the orbital, supraorbital, temporal, or occipital regions originating from a cervical structure. The pain is unilateral, non-alternating, non-throbbing, and may vary in duration.

Other secondary headaches may result from trauma to the head or neck, including a traumatic brain injury or a disorder associated with a cervical sprain. They may also result from circulatory conditions, including cervical arterial dysfunction or stroke. Visual problems or jaw conditions, such as temporomandibular joint dysfunction, may also be a source of headaches.

Neuropathic Headaches

Neuropathic headaches are characterized by pain referred to the head due to involvement of a nerve root or a cranial or cervical nerve branch. Neuralgia is a type of neuropathic headache characterized by unilateral, non-throbbing pain in the temporal or occipital region. It may present as a burning sensation and can be accompanied by sensory changes.

The Role of Physiotherapy

Pharmacological approaches to headache relief have been shown to provide limited results, which is why guidelines recommend a multimodal approach.

A physiotherapist can assess, treat, guide, and provide you with the tools you need throughout your physiotherapy care. Physiotherapists have the skills required to assess and treat impairments and limitations related to posture, cranial and cervical biomechanics, muscle tension, and other contributing factors. They also have the knowledge required to help you better understand your condition and support you in managing your symptoms.

Do not hesitate to consult a physiotherapist if you experience signs or symptoms of headaches, as physiotherapists are well equipped to assess and treat these conditions, which can have a significant impact on your daily life.

Reference

Chapter 6: Headaches. PHT-2312: Musculoskeletal Physiotherapy 3: Upper Quadrant. [Online]. Université de Montréal: Faculty of Medicine, Department of Physiotherapy, Winter 2020. Available at: https://studium.umontreal.ca/