Aurora, IL Chiropractic - Dr. Robert W. Boer, DC - Fox Valley Physician Services

Headache: Migraine vs Tension

Migraine:

See gov/health_and_headaches or headache info or migrainehelp.com for more info.

A migraine is not just a headache. Although moderate to severe head pain is the most common symptom, there are usually other symptoms that help diagnose frequent bad headaches as a migraine. It is important for you to understand and recognize these symptoms in order to help your doctor diagnose your headache and provide you with proper treatment.

Anyone who's ever been diagnosed with migraines knows that they're more than just bad headaches. Migraines can produce any of the following symptoms. Not everyone will experience all of the symptoms, and symptoms may vary from individual to individual and from attack to attack.

Symptoms you may have include: 

                  • Nausea or vomiting
                  • Sensitivity to light and/or sound
                  • Stuffy or runny nose and watery eyes
                  • Dizziness
                  • Mood changes
                  • Tunnel vision or seeing "spots"

 

Types of Pain you may have include: 

                  • Pain on one or both sides of the head
                  • Pain in the back of the neck
                  • Pain or pressure in the face, eye area, or sinuses
                  • Pain that disrupts normal activity
                  • Pain that is aggravated by routine activity

Most experts believe that during a migraine, blood vessels on the surface of the brain expand, causing the area around them to become inflamed and irritate nerve endings. This dilation (expansion) and irritation may account for the pain you experience during a migraine. It may also lead to nausea, sensitivity to light and sound, and other symptoms associated with migraine.

Many people report that their migraines have specific triggers, which can be different for each person. Some patients seem to have no specific triggers. By familiarizing yourself with potential triggers, you can learn about causes that may contribute to your migraine attacks.

                Potential Triggers Include:

                • Food & food additives
                • Alcohol  (especially red wine), caffeinated beverages,

                nuts, nitrite/nitrate-preserved foods (hot dogs, pepperoni),

                smoked or pickeled foods.

                • Light - Strong or glaring light.

                Flickering lights from TV or computer screen,

                strobe or laser lights, or reflections.

                • Smells/Odors - Intense, specific food odors,
                • cigarette or other smoke, perfumes, cleaning products 
                • Stress.  Migraine attacks often occur after stress

                especially on weekends and holidays. 

                Many people mistake these as tension headaches.

                • Weather Changes.  High humidity, atmospheric pressure changes,

                rapid temperature fluctuations,

                and exposure to extreme heat or cold may bring on mgraine attacks. 

                Many people mistake these for "sinus headaches.

 

Here are a few simple ideas that may help you manage your migraines. You should try and work them into your daily routine in order to help control your attacks:

Maintain a regular sleep schedule.
Research has shown that it is especially important to maintain a regular sleep pattern. Go to bed around the same time every night and start each day at approximately the same time, even on weekends. Try to avoid naps or oversleeping.

Reduce stress.
Cutting down on stress doesn't just help reduce the frequency of migraines but can improve your overall sense of well-being. So take breaks. Even better, take vacations. Consider joining a local relaxation or stress-reduction group.

Exercise with care.
Exercise helps some migraine sufferers. You should consult your doctor if you want to begin or alter an exercise regimen.

See Dr. Boer.

Dr. Boer can evaluate you and set you up on a therapy plan that address some of the cause of your migraine headaches.  Manipulation has proven to be quite effective in treating migraines.  Infact, Dr. Boer used to get migraine headaches and has had only one Migraine Headache in the past 18 years.  Hows that for helpful!  See the PainTreatment page for treatment options for headaches.  Click to return to CommonConditions page or to the Home page. 

 

Tension:

See Tension headaches for more info.

A tension headache is a condition involving pain or discomfort in the head, scalp, or neck, usually associated with muscle tightness in these areas.

Causes, incidence, and risk factors:

Tension headaches are one of the most common forms of headache. They can occur at any age, but are most common in adults and adolescents. If a headache occurs two or more times weekly for several months or longer, the condition is considered chronic.

Tension headaches result from the contraction of neck and scalp muscles. One cause of this muscle contraction is a response to stress, depression or aniety. Any activity that causes the head to be held in one position for a long time without moving can cause a headache. Such activities include typing or use of computers, fine work with the hands, and use of a microscope. Sleeping in a cold room or sleeping with the neck in an abnormal position can also trigger this type of headache.

Other causes include eye strain, fatigue, alcohol use, excessive smoking, excessive caffeine use, sinus infection, nasal conjestion, overexertion, colds, and influenza. Tension headaches are not associated with structural lesions in the brain.

Symptoms are:

  •  Headache
    • Dull, pressure-like
    • Generalized, worse in the scalp, temples or back of the neck
    • Not one sided
    • Feels like a tight band or vise on the head
    • Occurs as an isolated incident (or occurs constantly or daily)
    • Worsened or triggered by stress, fatigue, noise, glare, etc.
  • Difficulty sleeping

Signs and tests:

A headache that is mild to moderate, not accompanied by other symptoms, and which responds to home treatment within a few hours may not need further examination or testing. If a neurologic examination is performed, a tension headache causes no abnormal findings but musculoskeletal tenderness is often present.

The health care provider should be consulted (to rule out other disorders that can cause head pain) if a headache is severe, persistent or if other symptoms accompany the headache.

Headaches that disturb sleep, occur whenever the person is active, or that are recurrent or chronic may also require examination and treatment by a health care provider.

Treatment:

The goal is to relieve symptoms and prevent future headaches. Prevention is the best treatment. If possible, remove or control precipitating factors.

Learn and practice stress management strategies. Some people find relaxation exercises or meditation helpful.  Biofeedback (a means of providing information about certain body functions) may enhance relaxation exercises and may be helpful for chronic tension headache.  Spinal manipulation has been found to significantly relieve stress/tension headaches.  Improving the normal function of the cervical spine and improving nerve function and blood flow has been found to be as effective as medications and is reported to have a longer positive benefit.

Other preventive measures may include keeping warm if the headache is associated with cold, using a different pillow, or sleeping position or similar changes. Use good posture when reading, working, or doing other activities that may cause headache. Exercise the neck and shoulders frequently when typing, working on computers, or doing close work.

Adequate sleep and rest or massage of sore muscles can help reduce the chance that a headache will occur. Hot or cold showers or baths may relieve a headache for some people.

Over-the-counter analgesics such as aspirin, ibruprofen, or acetominophen may relieve pain if the above measures are ineffective. An antidepressant or other medication may be advised for chronic headache. A nonsedating muscle relaxant like Skelaxin helps some patients.

A headache diary can help you identify the source of chronic headaches. When a headache occurs, write down the date and time the headache began. Note what you ate for the preceding 24 hours, sleep pattern and amount of sleep, what was being experienced immediately before the headache, unusual stress or other circumstances, how long the headache lasted, and what made it stop.

Lifestyle changes may be required for chronic tension headaches. This may include adequate rest and exercise, change in job or recreational habits, or other changes.

Expectations (prognosis):

Tension headaches usually respond well to treatment without residual effects. They are annoying, but not dangerous.

Complications:

  • The headache may not be a tension headache, but it may be a symptom of another more serious disorder.
  • Rebound headaches may occur from overuse of analgesic medications.

Calling your health care provider:

See Dr. Boer or your health care provider if headaches are severe, persistent, recurrent, or accompanied by other symptoms (such as drowsiness, vision changes, changes in movement or sensation, seizures, changes in alertness, nausea/vomiting or other symptoms).

Also call if headaches disturb sleep, occur whenever your are active, are recurrent or chronic, or if a headache does not respond to treatment.

Prevention:

Avoid situations that may cause a tension headache. This can include keeping warm if the headache is associated with cold, using a different pillow or sleeping position, or similar changes.

Use good posture when reading, working, or involved in activities that may cause a headache. Exercise the neck and shoulders frequently.  See Dr. Boer for your regular treatment.  Once every month to every other month should be a good frequency for most tension headache sufferers.