Non-Migraine Headaches

One of the most common types of pain is a headache. Many people resort to over-the counter medications to relieve their headache, instead of trying to eliminate the cause of it. Twenty-seven percent of patients with headaches seek alternative forms of therapy, with the most common being chiropractic care. Below is an overview of the most common forms of non-migraine headaches. (For information on migraine headaches, please see the article “What is a Migraine Headache?”)

Tension Headache
These headaches are often worse in the afternoon or early evening. The pain is usually on both sides of the head and/or around the eyes. Tension headaches can last for days or weeks, and come and go over a long period of time. They are occasionally relieved with over-the-counter analgesics. Tender points and tight muscles are usually found in the neck. Deep massage to the muscles at the back of the head and neck helps, as does ultrasound and moist heat to the same area. Supplement options include valerian root and passionflower for stress reduction, and magnesium and calcium for muscle tension.

Cervicogenic Headache
Cervicogenic headaches often present with a reduction in neck motion and associated neck pain. They are due to referral from the soft tissues and joints in the neck. The headache is usually worse with head movement. The primary recommended form of treatment is chiropractic manipulation of the neck.

Cluster Headache
These headaches, which are felt around the eyes, are more common in middle-aged males. They “cluster” over days or weeks and then end, and appear again several weeks or months later. Cluster headaches typically begin at the same time each day or night. They are short-lived, lasting an average of 30 minutes, but they are extremely intense. During an attack, there is often tearing and a runny nose on the same side as the headache. There is usually a history of smoking and possible alcohol abuse. The cause of cluster headaches is unknown. Cluster headaches generally decrease in frequency and intensity as the individual ages. Conservative management includes moist heat, trigger point therapy, ultrasound, and spray-and-stretch to reduce muscle tension; cervical and upper thoracic chiropractic adjustments to decrease contributing joint dysfunction; avoidance of screen glare from computers and televisions; and stress reduction.

Hypertensive Headache
These headaches are pulsing and occur early in the morning. They are associated with high blood pressure, obesity, stress, lack of exercise, high sodium diets, drug sensitivity, kidney disease, and heart disease. Hypertensive headaches come on when blood pressure is 200/120 mm Hg or higher. The headaches can be at the top of the head, the front of the head, or the back of the head, and can be generalized or one-sided. The headache may become worse when reclining and is less severe when seated. Management includes dietary modifications (high fiber, low salt); avoidance of caffeine, high fat, sugar, and alcohol; and moderate exercise.

Sinus Headaches
These headaches are attributable to inflammation of the mucosa of the sinuses from allergies or bacterial or viral infections. The headache is generally felt over the forehead and cheeks, and occasionally around the teeth and behind the ears. Sinus headaches are worse in the morning and are aggravated or relieved by head position, which may help or hinder nasal drainage. Conservative treatment options include avoiding known allergens, correcting areas of cervical dysfunction that may hinder sinus drainage, and using a vaporizer or hot compresses on the face to clear sinus congestion. Anti-inflammatory herbs such as turmeric, ginger, and feverfew are of some benefit.

References:
Souza, Thomas A. Differential Diagnosis and Management for the Chiropractor: 415-433. Gaithersburg, Maryland: Aspen Publishers, 2001.

Huff, Lew, and David M. Brady. Instant Access to Chiropractic Guideline and Protocols: 12-15. Saint Louis, Missouri: Mosby, Inc., 1999.