Education

Common Chronic Headache Types

Migraine Headache:

This is the most common type of chronic headache that people suffer from. Migraine headaches more commonly affect women than men. The pain can range from moderate to severe and can significantly interfere with the completion of necessary daily activities. The pain can last anywhere from 2 hours to a few days in duration (usually limited to 72 hours) and is often experienced as a throbbing or pounding sensation. There are many common triggers for migraine headaches. Unavoidable migraine triggers include change in barometric pressure and onset of a woman’s menstrual cycle. Modifiable migraine triggers include stress, exposure to environmental triggers (such as strong odours, bright lights and loud sounds) and certain dietary triggers. Migraine headaches may be accompanied by nausea and vomiting as well as sensitivity to light, sound and strong odours.

Cervicogenic Headache:

With cervicogenic headaches, headache pain is referred from the neck and may be due to a variety of postural, structural or trauma-related issues (such as whiplash injury from an accident). The pain is usually described as an ache or pressure sensation.

Tension Headache:

Tension headaches are a common type of headache and are largely triggered by stress. The pain is usually experienced as a sensation of ache or pressure over the head.

Cluster Headache:

Although a less common type of chronic headache, cluster headaches are among the most severe headache types that patients experience. The pain appears suddenly and is of relatively short duration, usually lasting no more than 2 hours per episode. However, when these headaches do occur, they occur in groups or “clusters” which recur on a daily basis for a period of weeks to months at a time. The pain is debilitating and is usually centred around one eye. Unlike migraine headaches (which occur more often in female patients), cluster headaches are much more likely to occur in young male patients.

Headache Resulting from Disorders of the Temporomandibular Joints:

Pain from disorders of the temporomandibular joint can easily be mistaken for one of the above-mentioned headache types, as the symptoms occur in similar locations on the head. The temporomandibular joints are located just in front of the ears on either side of the head. The joint is involved in the processes of chewing and talking, and accordingly, when disorders of these joints occur, the result can be quite disruptive to daily function. Symptoms that result from disorders of the temporomandibular joint may include headache, jaw pain, ear pain, jaw clicking, dizziness and tinnitus (ringing in the ear).

Medication-Overuse Headache:

Medication-overuse headaches (commonly referred to as “rebound headaches”) are a perplexing situation. In these cases, the very medication that is used to treat the headache ends up perpetuating the cycle of pain. This can occur with the excessive use of any short-acting medication to treat pain, including over the counter medications such as acetaminophen, aspirin or ibuprofen.

Chronic Facial Pain:

There are many causes of facial pain, some of which are easily diagnosed and treated (including pain from sinus infection). However, many other causes for chronic facial pain are less clear in presentation. This presents a frustrating situation for patients who are informed by numerous specialists that there is no clear identifiable cause for the pain and no available treatment options to help alleviate their discomfort. At the Centre for Chronic Headache and Pain Management, we receive referrals for many such patients (even from other specialty offices such as ENT specialists and Neurologists). These patients require careful and detailed assessment of their pain in order to determine the cause, and eventually develop a treatment plan based on the specific cause. Dr. Sandhu has had a significant amount of success in managing these complex chronic facial pain cases.

Chronic Daily Headache:

While this is often listed by Neurologists as an actual diagnosis, this is in fact more of a classification system of headache pain referring to those patients that suffer with at least 15 days of headache pain per month. There are often many contributing factors to the pain in these patients. This requires careful assessment and management of the various factors, often resulting in some combination of the above-listed headache types. Once identified, these factors can be addressed in the management plan to allow a patient to recover.

New Onset Daily Persistent Headache:

This is a type of headache which does not have a clearly understood origin. In this headache type, a person who was previously well develops sudden onset headache pain. This pain remains persistent following the initial onset and is often disruptive to overall function. As with chronic daily headaches, this type of headache pain must be carefully assessed to determine the cause of the pain in order to develop an effective treatment plan. Despite the poor understanding of the cause of this type of headache pain, there are treatment options available. Dr. Sandhu has had many such patients who have improved significantly once following through with the recommended treatment process.