Cervicogenic Headache is caused by the dysfunction of structures in the upper neck, classing it as a secondary headache. The discs, muscles and joints in the upper three joints of the neck are able to cause head pain via their connection to the brainstem. Sensory information from these structures converges at the brainstem with sensory information from the head and face. The miscommunication of this sensory information, causes pain to be felt in the head as a response to dysfunctional sensory information from the cervical spine.
Pain will generally be one-sided and is associated with stiffness and a loss of range of motion in the neck. Sufferers of cervicogenic headaches can also experience; dizziness, tinnitus, nausea and vomiting.
Modern research suggests that sensitivities in the brainstem are involved with cervicogenic headaches, however this is often overlooked in treatment.
Chronic Daily Headache
Up to 80% of the Gold Coast population are affected by Chronic Daily Headache. Chronic Tension-Type Headache, New Daily Persistent Headache, Chronic Migraine and Hemicrania Continua are the four most common types of Chronic Daily Headache. Headaches are often mild-moderate in severity, and can include the symptoms of migraine headache and tension-type headache. By definition, these headaches are experienced more days than not, over a period of three months or longer.
Dysfunction in the upper cervical spine, and sensitivities in the brainstem, are now known as the underlying causes of these chronic headaches. Despite this knowledge, the true causes are often overlooked in treatment plans.
While they are rare, Cluster headaches still affect people in the Gold Coast region. Affecting just 0.1% of the population, they have been described as the most severe and debilitating headache type. Cluster Headaches are typically experienced at night, or at regular times during the day. Each attack can last up to 3 hours before stopping. Sufferers will experience these attacks for long periods of time before they stop for a period of remission.
Cluster headache sufferers will experience very severe pain in a small area of the head, commonly around the eyes or temple. As well as pain, people can have; droopy eyelids, red or watery eyes, blocked or congested noses and constricted pupils. The severity of pain and debilitating nature of cluster headaches has led to them aptly being labelled as suicide headaches.
Despite the severity, there are treatment options.
Cyclical Vomiting Syndrome
While Cyclical Vomiting Syndrome is most commonly seen in children aged 3-7, it is possible for it to occur in the adult population. It involves bouts of very intense vomiting and abdominal pain, that are followed by remissions without any symptoms at all. These attacks typically involve several vomiting episodes each hour, lasting between hours and days.
The pattern and presentation of Cyclical Vomiting Syndrome means that it is classified as a migraine condition. Studies have also shown that children who suffer from Cyclical Vomiting Syndrome have a higher prevalence of migraines later in life.
While Cyclical Vomiting Syndrome is often mis-diagnosed and mis-treated, there is an effective treatment option!
Hormones are reported to be a common cause of migraines for females on the Gold Coast. 60% of female migraineurs experience migraines with their menstrual cycle, while 14% will only experience their symptoms at this time. Similar to other migraine types, symptoms include; nausea, vomiting, photo-sensitivity, phono-sensitivity and osmo-phobia.
Despite the timing and frequency of Hormonal Migraines, research has shown that there is no difference in hormone levels between sufferers and non-sufferers. As well as this, treatments like Hormone Replacement Therapy have been shown to have little to no effect on Hormonal Migraines. In these cases, sensitivities in the brainstem may be the true underlying cause.
The occipital nerve originates in the upper cervical spine and provides sensory information to large parts of the skull and face. Occipital Neuralgia is caused by compression or irritation of different branches of the occipital nerve, resulting in pain. Aberrant blood vessels, osteophytes at cervical joints and growths like carcinomas are common causes of the nerve irritation that results in Occipital Neuralgia.
Symptoms commonly include; a sharp piercing pain along an occipital nerve branch, skin sensitivity, eye pain and nausea. Many patients report pain with simple activities, like brushing their hair.
A structural cause isn’t found in many of the patients that we see at Gold Coast Headache & Migraine Clinic.
Located behind your eyes, nose and cheeks, your sinuses are a series of cavities designed to promote air-flow and clear out pathogens by draining mucous. When the sinuses become inflamed, there is an over-production of mucous. This often will happen in response to the introduction of a pathogen, like dust or pollen, into the body. The pressure caused by this inflammation can cause pain felt in the head or face, known as a sinus headache.
Symptoms are often felt bilaterally, and will be associated with; a blocked or runny nose, watery eyes and pressure felt in the sinuses.
Many of Sinus Headache Patients that we see at Gold Coast Headache & Migraine Clinic, experience symptoms with very limited pathogen involvement. In these cases, we assess the brainstem to see if it is the true cause.
Tension Type Headache
The most common headache type, world-wide, is Tension-Type Headache. Research has shown a world-wide prevalence of up to 86%, and 7 million Australians suffer from tension-type headaches. Pain is often felt on both sides of the head and is described as a tightening or a squeezing around the head. People who experience tension-type headaches can also experience photo-phobia and phono-phobia.
Tension-Type Headaches can be categorised according the frequency that they are experienced. Episodic Tension-Type Headaches are experienced less than 15 days in a calendar month. While Chronic Tension-Type Headaches are experienced on more than 15 days in a moth, for longer than three consecutive months.
Despite the high prevalence worldwide, most treatments are ineffective in the long run.
Trigeminal Neuralgia is a condition that is brought on by seemingly normal activities, like; chewing, talking and brushing your teeth. Symptoms include a sharp and shooting pain on one side of the face, and sensitivity along branches of the trigeminal nerve. Trigeminal Neuralgia can be experienced extremely frequently due to the low threshold for attacks, some sufferers may even experience 50 attacks per day.
Classic Trigeminal Neuralgia refers to when the nerve roots of the trigeminal nerve are compressed by blood vessels close to the brainstem. While Secondary Trigeminal Neuralgia is when another medical condition is the cause, like multiple sclerosis or tumours. Most of the patients we see at Gold Coast Headache & Migraine Clinic don’t have either of these presentations, and have what is called Idiopathic Trigeminal Neuralgia.
Whiplash is a common injury reported after car accidents, or as a result if sporting or diving incidents. Classically, it will involve a deceleration mechanism, causing strain the muscles, joints and discs in the spine. Whiplash injuries can be complex in nature, due to the wide area that can be affected and the different structures involved. It is common for headaches to be reported in whiplash injuries, due to dysfunction caused in the upper cervical spine.
Many different types of headache are caused by whiplash, including; migraine, tension-type headache and cervicogenic headache. The length of time that someone has been experiencing these headaches can help to classify them. ‘Acute whiplash Headaches’ have been experienced within three months of a whiplash injury. While ‘persistent whiplash headaches’ have lasted for longer than three months.
The appropriate treatment must address the true cause of your headaches or migraines.