What are the types of headaches?

A comprehensive headache classification guide was established by the International Headache Society and includes more than 150 headache categories.

Based on research, a practical headache classification divides headaches into two main categories primary and secondary headaches.

Primary headaches

Primary headaches are those that are not the result of another medical condition. The category includes tension-type, migraine, and cluster headaches.

• Tension-type headaches are the most common type of headache. Tension-type headaches tend to be mild to moderate, non-throbbing, and occur on both sides of the head (bilateral). They usually do not get worse during routine activities (bending over, walking stairs, etc.) Because tension-type headaches tend to be mild, patients usually treat them successfully with over-the-counter medications. Patients should be aware that using over-the-counter medications too often can lead to long term (chronic) daily headache.
• Migraines are the second most common type of primary headaches. The exact cause of migraines is unknown, although they are caused by changes in the nerves and blood vessels. Migraines are also related to changes in the brain and inherited abnormalities in certain areas of the brain. Migraine pain is moderate to severe, often described as pounding or throbbing. Migraines can last from 4 hours to 3 days and usually occur less than 15 times per month. Migraine symptoms include sensitivity to light, noise or odors; nausea or vomiting; loss of appetite; and stomach upset or abdominal pain.
• Cluster headaches are themost severe, type of primary headache. The pain of a cluster headache is intense and has a burning or stabbing quality that is throbbing or constant. The pain is so severe that most patients with cluster headache cannot sit still and will often pace during an attack. The pain is located behind one eye or in the eye region, without changing sides. The term “cluster headache” refers to headaches that come in a group, or cluster. Cluster headaches occur one to eight times per day during a cluster period, which may last 2 weeks to 3 months. The headaches may disappear completely (go into “remission”) for months or years, only to recur.
• New daily persistent headaches (NDPH) start abruptly as a headache that is new to the patient. The patient is able to pinpoint the brief period of time (within 72 hour) when the headache appeared. While these headaches may not be related to other diseases, they tend to be constant or persistent without any remission, located on both sides of the head (bilateral), and don’t respond to many medications.

Secondary headaches

Secondary headaches, or those that result from another medical or neurological condition, include sinus headaches, medication overuse headaches, or headaches that occur because of an infection, disease of the blood vessels in the brain, head injury, trauma, or more serious condition such as a tumor.

• Sinus headaches are associated with a deep and constant pain in the cheekbones, forehead, or bridge of the nose. The pain usually gets worse with sudden head movement or straining and occurs with other acute sinus symptoms, such as nasal discharge, foul taste in the mouth, a feeling of fullness in the ears, fever, facial swelling, and pain over the involved sinus.
• Medication overuse headaches occur as a result of the overuse of either readily available over-the-counter analgesics or prescribed painkillers such as opiates and sedative hypnotic tablets designed for headache management (butalbital-containing headache remedies). This is among the most common type of chronic headache seen in specialty headache centers and is referred to as a “transformed” headache. Tension-type or migraine headaches that recur can transform into a chronic headache from the inappropriate “overuse” of medications. These headaches can also happen without the overuse of analgesics. It is believed that 4 percent of the population worldwide has chronic daily headaches of some type, and a good percentage of this population includes headaches caused from medication overuse.

How are headaches treated?

Your family physician may recommend different types of treatment, or may recommend further testing or refer you to a headache specialist.

The proper treatment will depend on several factors, including the type and frequency of the headache and its cause. Not all headaches require medication management. Treatment may include education, counseling, stress management, biofeedback, as well as medications. The treatment prescribed for you will be tailored to meet your specific needs.

• Headache education includes identifying and recording what triggers your headache, such as lack of sleep, not eating at regular times, eating certain foods or additives, caffeine, environment, or stress. Avoiding headache triggers is an important step in successfully treating the headaches.
• Counseling in the form of one-on-one sessions, group therapy, or support groups can help you identify your headache triggers and teach you useful coping techniques.
• Stress management. To successfully treat headaches, it is important for you to identify what causes or triggers the headaches. Then you can learn ways to cope or remove the stressful activities or events. Relaxation techniques are helpful in managing stress and include deep breathing exercises, progressive muscle relaxation, mental imagery relaxation, or relaxation to music. Ask your healthcare provider for more information about these techniques.
• Biofeedback. Biofeedback equipment includes sensors connected to your body to examine your involuntary physical responses to headaches, such as breathing, pulse, heart rate, temperature, muscle tension, and brain activity. By learning to recognize these physical reactions and how the body responds in stressful situations, biofeedback can help you learn how to release and control tension that causes headaches.
• Medications. There are three types of headache medications, including symptomatic relief, abortive (treats an individual attack), and preventive medications (reduce the frequency and severity of individual attacks).
• Injections can help some types of headaches.

Botox Injections

Occipital Nerve Blocks

Third Occipital Nerve

This is an ablation at the C2 C3 cervical space in the neck, this is where the third occipital nerve exits the spine and we can apply the energy to the nerve to stop it from sending the pain signals. Before we would do this we would complete two tests in which we just put numbing medicine on the nerves, if they are the nerves that are causing the pain the numbing medicine will stop the headache for a short time.