Headaches can be vascular, tension (caused by muscle contractions), traction, or inflammatory. Vascular headaches occur when blood vessels inside the head expand or contract; migraines are a classic example. Tension headaches result from excessively tight muscles in the neck and scalp. Traction headaches occur when structures in the head are affected, such as when a brain tumor grows. Inflammatory headaches include problems like sinus headaches and infections.
Migraines are a true neurological disorder that includes a number of symptoms in addition to the headache. Migraine pain is usually severe and tends to occur on one side of the head. Other symptoms include an “aura” that precedes a migraine, and may include visual disturbances like flashing lights. Other migraine symptoms can mimic a stroke: coordination and balance problems, mental confusion, or slurred speech. Some patients who have severe migraines may develop numbness and tingling in the face or extremities, muscle weakness, or even temporary paralysis.
Chronic migraines are often associated with neck pain, which is usually more on one side than the other. They can also be associated with lower thoracic muscle spasm and paraspinal pain on the same side as the neck pain, associated with scoliosis.
Dr. Hutchinson is a leading proponent of the use of botulinum for headaches as well as scoliosis.
Headaches tend to run in families, which indicates a genetic component. Being female increases the risk of developing any kind of a chronic headache. Lifestyle factors can affect headache patterns, making the headaches more severe or frequent. For example, sleep deprivation can be an issue in chronic headaches, and migraines often have food triggers. Daily or frequent headaches can coexist with depression, bipolar disorders, and anxiety.
Treatment is always dependent on the cause of the headache. For migraines, medications may be used to help prevent, as well as relieve the headache. Lifestyle management such as good sleep hygiene, dietary changes, and stress management are typically recommended. Tension headaches may respond to stress management and/or therapeutic massage. Inflammatory and traction headaches usually have a serious underlying cause like infection or brain tumor, which must be treated to relieve the headache.
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