In today's society, headaches are one of the most common medical complaints. Headache pain may be extremely intense, but most headaches are unrelated to structural neurologic disease. While some are related to life-threatening disorders, the vast majority of headache pains are chronic and not related to neurologic dysfunction. More than 300 different conditions can produce headache pains, and for that reason precisely, determining the cause of this pain can be a difficult process.
The most common types of headaches seen by healthcare providers include migraine headaches (with or without aura), tension headaches and those originating in the neck area (cervical muscular headaches).
Migraine headaches affect 20 percent of the population. If the migraine headache is infrequent, treating single episodes with medication and non-medication therapies is preferable. If the migraine headaches occur on a frequent or regular basis, preventive (prophylactic) migraine pain management is needed. Headache pain management treatment may include lifestyle changes, daily medications and/or physical therapy. Daily tension headaches are often treated effectively with stress reduction therapies and anti-depressant medication.
Cervical muscular headaches usually occur after a neck injury. The origin may be any of the pain-generating structures in the neck — torn muscles or ligaments, damage to joints or damage to the discs in the neck. These are often the components of pain that are referred to as "whiplash” injury. If cervical headaches don’t resolve within several weeks of the original trauma, aggressive intervention may be needed. MAPS offers a comprehensive headache pain management team, including expert diagnosticians and physical therapists, to help define and resolve these complex headache pains.
The key to making any diagnosis about the cause of headache pain is first to obtain a thorough history from the patient. Details about the headache pain — such as when it started, where it is located, the quality of the symptoms, what makes it better or worse — are all pertinent. Other health conditions and lifestyle choices may also be contributing factors to headache pain.
The next step is to carefully examine the patient. Depending on the source of the headache pain, it may be able to be replicated during the exam, leading to the discovery of its cause. Diagnostic tests or trials of therapeutic treatments often help identify the source of headache pain. For example, facet joint injections in the cervical spine can help to diagnose the root cause of headache pain, as well as be a therapeutic intervention.
The type of headache and its associated symptoms determine the choice of headache / migraine pain management and treatment. Ideally, the goal of headache pain treatment is to become headache-free. However, when that is unlikely, the goal is to decrease the pain intensity, as well as the frequency of the headaches. There are a number of headache and migraine pain management and treatment options that help reduce headaches and migraines, which include: