What are Cluster Headaches?
Cluster Headache sufferers tend to report their pain as the worst imaginable, and these are often considered the worst of the primary headache disorders. Such is the pain that Cluster headache sufferers can be suicidal.
Cluster headaches tend to start in people in their late twenties and are the only headache more common in men than women.
What are the Symptoms of Cluster Headaches?
Sufferers will also experience swelling of the eye and congestion of the nasal passage on the affected side. Some people also experience facial sweating and agitation. Cluster headaches have a distinct pattern of occurrence.
Sufferers will tend to have daily headaches from between 3 to 6 weeks. Cluster headaches are side-locked, meaning they always present on the same side, even after a long remission. The headaches will last between 15 minutes and 3 hours. The headaches will then go into remission for up to a year before another ‘cluster’ occurs.
How are Cluster Headaches Diagnosed?
There is no one specific test that identifies cluster headaches. Your diagnosis will be made based on your health professional’s interpretation of your symptoms and how you respond to different treatments. Your GP may refer you to a Neurologist who will clarify your diagnosis.
What about X-rays, CT scans and MRI?
Unfortunately, X-rays, CT scans and MRI’s are not diagnostic of a cluster headache.
However, X-rays and scans may identify structures that could potentially be causing your headache. We recommend that you have at least cervical spine X-rays if you have been suffering headaches or head pain for any extended period.
Mixed Headache-Migraine Types
There are over 300 sources of headache, and cluster headaches are reasonably uncommon. Unless your symptoms identify you as a likely cluster headache sufferer, you are more likely to suffer from another problem or migraine source.
You may also be suffering from a mixed or multi-source headache.
Your physiotherapist will advise you if you have symptoms that could indicate a different cause for your headache. These instances will also direct you towards further investigations or tests that may assist your diagnosis and subsequent treatment.
You can simultaneously suffer one, two or more types of headache or migraine.
One type may cause another or overlap with another. For example, a painful neck can cause an increase in muscular tension, which will increase your blood pressure. In this scenario, you would be suffering a neck headache + tension headache, + migraine!
In our experience, finding the primary source of your headache or migraine is the key to successful management.
What Else Could Be Causing Your Headaches or Migraine?
Your physiotherapist and doctor will be able to assist with your diagnosis and headache source. Sometimes specific tests can confirm your diagnosis. On other occasions, it can be by process of elimination.
In a small percentage of patients, unfortunately, a sinister cause of your head pain requires investigation. These can include brain tumours, aneurysms, meningitis and other systemic illnesses.
Your physiotherapist or doctor may recommend that you complete a headache or migraine questionnaire that will assist in your headache classification, diagnosis and treatment. Once you complete these questionnaires, please present your physiotherapist or doctor’s results to help with your diagnosis and treatment.
Common Causes of Headache & Migraine
Specific Migraine - Headache Types
- Neck Pain
- Bulging Disc
- Wry Neck
- Text Neck
- Pinched Nerve
- Cervical Radiculopathy
- Facet Joint Syndrome
- Neck Sprain
- What Causes Cervicogenic Headache?
- How Do You Get Rid Of A Neck Headache?
- When Should You Be Concerned About A Headache?
What's Causes Cervicogenic Headache?
Your neck headache originates from a variety of musculoskeletal and neurovascular structures. These structures include the upper three neck joints, C2/3 disc, spinal cord coverings, and neck muscles. Dysfunction in these areas can trigger pain signals that travel to your trigeminocervical nucleus (TCN) in your brainstem. This information is then transmitted into your brain and interpreted as a headache (Bogduk 2003).
Upper Neck Joints
The most likely source of your neck headache is a dysfunction of your upper neck joints. Your neck muscles or nerves become involved from pain signals that travel to your trigeminal nucleus in your brainstem, where you interpret the pain signals as a neck headache.
The most common cause of a neck headache is the dysfunction of your upper three neck joints. The most common neck joints involved are your:
- atlantooccipital joint (O-C1),
- Atlanto-axial joint (C1/2), and
- C2/3 cervical spine joints.
In simple terms, your neck joints can cause a neck headache or pain if they are either too stiff or move too much (e.g. wobbly and unsupported by weak muscles) or locked in an abnormal joint position, e.g. a locked facet joint or poor neck posture. Once your neck joint becomes stressed and painful, the pain signals refer to the trigeminocervical nucleus in your brainstem. You start to feel a neck headache or, in some cases, face pain!
Your neck and headache physiotherapist can assess and correct neck joint dysfunctions that result in a neck headache. Their professional diagnosis and treatment are essential for neck headache sufferers.
Your neck and shoulder blade muscles that originate from your neck will cause pain if they are overworking, knotted or in spasm. Some of your neck muscles overwork when protecting injured neck joints. Other neck muscles become weak with disuse—this further demands your overworking muscles resulting in muscle fatigue-related symptoms. Your deep neck flexors are frequently weak or lack endurance. Your neck muscles work best when they have healthy resting tension, length, strength, power and endurance.
Your skilled physiotherapist assesses and helps you correct any muscle imbalances that result in a neck headache.
Cervical and Occipital Nerves
Nerves in your upper neck may become pinched by extra bony growths, e.g. arthritis, disc bulges or swelling. The results can result in nerve irritation or a reduction in the neural motion known as neuromechanosensitivity or abnormal neurodynamics. Irritation of your upper neck structures refer to pain messages along the nerves and cause your headache. In simple terms, your neck is the "switch", nerves are the "power cords", and your headache is where the "light" comes on.
Your headache physiotherapist can assess your neuromechanosensitivity.
How Do You Get Rid Of A Neck Headache?
Quality neck physiotherapy can have a speedy and effective result for relieving your neck headache—the key to better treatment response in confirming your diagnosis. After your assessment, your physiotherapist will start you with treatment techniques that address your problems.
Your neck headache treatment may include all or some of the following techniques:
- Stiff neck joints may need to be loosened or unlocked via joint mobilisation (gentle gliding techniques), joint traction or, in specific cases, a gentle and localised joint manipulation technique.
- Hypermobile (or dynamically unstable) joints may require specific deep neck muscle strengthening exercises to stabilise, control and limit the joint movement available.
- Tight or overactive muscles may require muscle stretching, neck massage, acupuncture, dry needling, trigger point release or other relaxation techniques.
- Weak muscles may require specific strengthening exercises. This weakness may include your postural shoulder blade and neck muscles.
- Nerve dysfunction identified by your physiotherapist will depend upon your specific examination findings. Neurosensitivity is a common finding that needs addressing with attentive, professional care.
- Posture correction via specific posture exercises, posture awareness techniques, posture taping, or a brace.
- Provide helpful advice on preventing neck dysfunction in the future, e.g. workstation setup, ergonomics, awkward neck positions and postures to avoid.
Who Treats Cervicogenic Headaches?
In addition to relieving your neck headaches, your physiotherapist aims to address why you are experiencing neck headaches. After all, helping you to avoid future neck headaches is a crucial component of your rehabilitation. Chronic headache sufferers typically resolve their neck headaches within days or weeks.
Relief of your neck headache is quite often immediate! If a neck headache solely causes your trouble, it is common to experience instant relief as you walk out of the clinic.
Depending on the severity and the specific underlying causes of your neck headaches, most sufferers will experience a reduced headache after your initial consultation.
For more information, please consult your neck headache physiotherapist.