As much as half of all adults will experience a headache at least once in any given year. Headaches are the most frequently reported physical discomfort. It is no wonder that there are more than 200 officially classified types of headache ranging from harmless to life-threatening. Broadly speaking, headaches are divided into 2 groups: Primary, accounting for 90% of headaches suffered, where the headache is the condition itself, and; Secondary, where the headache is due to another condition.

Primary headaches typically start between 20 and 40 years of age. They usually produce a stable pattern of headache for over 6 months with predictable triggers with the sufferer feeling well between attacks. The most common primary headache is a tension headache, accounting for 22% of all reported headaches and typically presents as a non-pulsing pain with a band of pressure around the head. Migraine, at 12%, are the next most common, presenting most frequently as a pulsing pain, with nausea and an increased sensitivity to bright light and loud noise. Only 30% of migraine sufferers will present with an “aura” which most commonly can include visual disturbances, unusual smells and reports of hallucinations. Less often, primary headaches are as a result of nerve damage called neuralgia. Trigeminal neuralgia produces a sudden shock like pain, less commonly sufferers will report a persistent burning, on 1 side of the face. The symptoms are often triggered by touching the face. Occipital neuralgia produces a persistent pain at the upper, back of the neck, the back of the head and behind the eyes. Occipital neuralgia usually affects 1 side of the head.

As mentioned, secondary headaches are as a result of another condition. The most common being pain radiating from the muscles of the neck called a cervicogenic headache. Usually the pain starts at the back of the head/base of the skull and spreads towards the forehead. This can be associated with neck pain and stiffness. Taking too many painkillers for a headache can cause a medication overuse headache or rebound headache and typically occurs daily. Hitting your head can produce a concussion headache together with nausea, dizziness, sensitivity to light and sound, fatigue, memory loss and anxiety. Infections causing sinusitis can leave you feeling pain and pressure around your forehead and cheeks often worsening when you lean forward and a blocked, stuffy nose.  More seriously, meningitis produces a headache with fever and neck stiffness. Sufferers can also experience nausea, sensitivity to light and sound, confusion or altered consciousness. Certain causes of meningitis can produce a rash that does not fade under pressure (the rolling glass test). Bleeding in the brain, such as an aneurysm, causes a headache while bleeding around the brain usually causes a headache and stiff neck, both without a fever. A brain tumour often presents with nausea and vomiting for some time before the headache appears. Due to the occasional life-threatening causes of secondary headache it is important to try to recognise when to consult a medical professional. Consider: Is this your first headache ever? Your worst headache ever? Or different to your usual headache. Did the headache come on very suddenly and severely? Are you over 40? Do you have any underlying disease such as cancer? Do you have a fever or have you recently lost weight without good reason? Have you lost feeling or function (weakness) in your limbs?

It is reassuring that the vast majority of headaches and causes thereof are benign. Arming yourself with a little knowledge can prepare you to recognise when this is not the case. If you are in doubt, consult a medical professional. A chiropractor is ideally placed to provide an accurate diagnosis, request additional tests and treatment if indicated.

Headaches and Chiropractic