Basic information on headache disorders for patients in our osteopathic practice
Cluster headache
Cluster headaches are among the most painful types of headache and have a frequency of 0.1-0.4%. They mainly affect men (9:1 ratio) (1). They occur periodically or in so-called clusters. The pain usually starts at night and affects one eye or one side of the skull. Cluster headaches can last for several weeks or months and then disappear for extended periods. Sometimes there are several years between cluster attacks.
The exact cause of cluster headaches is unclear, although it is suspected that cluster headaches may be related to our biological clock, the hypothalamus (2). Unlike migraine or tension headache, the pain is not triggered by a specific trigger. Sometimes the cluster headache is related to taking certain medications. It is also possible that there is a hereditary predisposition. Smokers are affected more often.
Cluster headache is an extremely severe pain, usually behind or around one eye. Sometimes it radiates to other parts of the face or neck. It is usually one-sided. The affected eye is red and the nose is blocked.
During a cluster period, the pain usually occurs daily at a specific time and lasts between 15 minutes and 3 hours. Often the pain attacks occur at night.
This information has been provided to you as a general source of background information only, as in accordance with german law as Heilpraktikers, we are forbidden to list conditions or diseases we potentially treat, as this is considered a promise of cure. If you would like to know whether osteopathy is an option for your cluster headaches, please feel free to call us.
(1) Farooq K, Williams P (2008) Headache and chronic facial pain. Contin Educ Anaesth Crit Care Pain 8: 138-142.
(2) Enchao Qui, Yan Wang, Lin Ma, Lixia Tian, Rouzhuo Liu, Zhao Dong, Xian Xu, Zhitong Zou and Shengyuan Yu (2013). Abnormal Brain Functional Connectivity of the Hypothalamus in Cluster Headaches. PLoS One 2013; 8(2)
Migraine
In the western world, migraine has a prevalence of 4-9% in men and 11-25% in women (1) and is characterised by a severe, throbbing headache, usually on one side. It is often accompanied by nausea and sensitivity to light. Migraine attacks can last from a few hours to several days.
Some patients experience a so-called aura prior to the attack, during which vision changes or speaking difficulties may develop. For many patients, migraines progress in four stages, although not all stages are always experienced:
Prodrome – one to two days prior to the migraine attack, physical changes occur, such as digestive problems, neck stiffness, increased thirst, mood swings, frequent yawning or a strong need for certain foods.
Aura – This occurs in some patients just prior to or during the migraine attack. The symptoms build up slowly and last between 20 to 60 minutes. They include, for example, visual difficulties or phenomena such as flashes or bright spots, the feeling that the arms or legs are falling asleep, numbness in the face, perception of non-existent sounds and twitching movements.
Attack- The duration of migraine attacks varies greatly for each suffererer, although if untreated, symptoms remain between 4 and 72 hours if untreated. The severe headache is usually located on one side of the skull, accompanied by nausea and extreme light sensitivity.
Postdrome – After a migraine attack, many patients feel exhausted and drained. Sudden head movements can cause the pain to flare up again briefly.
The causes of migraine are partly unclear, although current opinions suggests migraine to be a complex neurological phenomenon involving several areas of the brain and brainstem. Migraine attacks can be triggered by hormonal changes, alcohol, stress, caffeine, changes in weather, changes in sleep habits, strong sensory input, food and medication.
This information has been provided to you as a general source of background information only, as in accordance with german law as Heilpraktikers, we are forbidden to list conditions or diseases we potentially treat, as this is considered a promise of cure. If you would like to know whether osteopathy is an option for your migraine, please feel free to call us.
(1) Manzoni GC and Torelli P (2003). Epidemiology of migraine. The Journal of Headache and Pain 2003 Mar; 4(Suppl 1): s18-s22.
(2) Burstein R, Noseda R, Borsook D (2015) Migraine: Multiple Processes, Complex Pathophysiology. Journal of Neuroscience 2015 Apr 29; 35(17): 6619-6629.
Tension headache
Tension headache is usually perceived as a mild to moderate headache, often described as a pressing band around the head. Tension headache is the most common type of headache, with a lifetime incidence (at least once in a lifetime) of 78% (1). The pain is usually felt as dull and pressing, both on the forehead and on the sides and back of the head. Sometimes there is also scalp, neck and shoulder tenderness.
The cause of tension headache is not fully understood, although studies suggest that pericranial myofascial structures are the most likely cause (2).
This information has been provided to you as a general source of background information only, as in accordance with german law as Heilpraktikers, we are forbidden to list conditions or diseases we potentially treat, as this is considered a promise of cure. If you would like to know whether osteopathy is an option for your tension headaches, please feel free to call us.
(1) Ann Indian Acad, Debashish Chowdhury. Tension type headache. Neurology. 2012 Aug; 15 (Suppl 1): S83-S88.
2) Bendtsen L. Central sensitization in tension-type headache-possible pathophysiological mechanisms. Cephalalgia. 2000;20:486–508
Cervicogenic headache
Cervicogenic headache is generally located on one side of the head stemming from the upper neck region. It is often provoked from certain neck movements leading to pain and restriction. It may be triggered by unilateral strain, tension or a previous injury to the neck. Cervicogenic headache is caused by dysfunction in the upper neck joints which leads to headache as a result of a complex neurological interplay between the spinal cord and the brain. The pain may last for several hours, but may also be continuous with variable intensity. Cervicogenic headache often occurs between the ages of 30 and 45 and has an estimated incidence of 0.4-2.5%. It is four times more common in women. (1)
This information has been provided to you as a general source of background information only, as in accordance with german law as Heilpraktikers, we are forbidden to list conditions or diseases we potentially treat, as this is considered a promise of cure. If you would like to know whether osteopathy is an option for your cervicogenic headaches, please feel free to call us.
(1)Haldeman S, Dagenais S. Cervicogenic headaches: a critical review. Spine J. 2001;1(1):31-46.
Benign paroxysmal positional vertigo (BPPV)
BPPV can occur in varying degrees of intensity. It is caused by the migration of tiny crystals in the inner ear from the utriculus through to the semicircular canals of the inner ear during rotational movements. When the head is moved, most commonly rotated, the crystals attempt and fail to move out of the semicirular canals back to the utricus thereby leading to continued crystal movement some time after head movement has stopped. This subsequently causes the brain to receive conflicting information, leading to dizziness, loss of balance, nausea and/or vomiting.
Affected people come in all ages, with the incidence of positional vertigo increasing after 50 due to the degeneration of the utriculus of the inner ear.
This information has been provided to you as a general source of background information only, as in accordance with german law as Heilpraktikers, we are forbidden to list conditions or diseases we potentially treat, as this is considered a promise of cure. If you would like to know whether osteopathy is an option for your BPPV, please feel free to call us.
Tinnitus
Tinnitus describes continuous noises such as ringing, whistling, beeping, hissing or buzzing in the ear, of which, are not audible to anybody else. These noises can occur in one or both ears and can vary in volume and intensity. Tinnitus is the result of another condition, such as age-related hearing loss, ear injuries or circulatory diseases. A distinction is usually made between two types of tinnitus:
– Subjective tinnitus
This is the most common form of tinnitus with sounds only hearable to the patient. The cause can be a disease of the ear or the auditory nerve, or
– Objective tinnitus
Objective tinnitus can be heard by the therapist during examination. This form of tinnitus is rare and may be due to a blood vessel problems, middle ear problems, muscle contractions or temporomandibular joint (TMJ) dysfunction.
There are some possible causes of tinnitus, such as constant trauma to the inner ear from loud noise, metabolic diseases such as diabetes and hypertension, certain medications (e.g. high-dose aspirin use), diseases of the auditory nerve (e.g. Meniere’s disease) and mechanical causes such as TMJ dysfunction and whiplash due to activation of the cochlear nuclei in the brainstem and subsequent electrode bombardment of the auditory centre in the brain.
This information has been provided to you as a general source of background information only, as in accordance with german law as Heilpraktikers, we are forbidden to list conditions or diseases we potentially treat, as this is considered a promise of cure. If you would like to know whether osteopathy is an option for your tinnitus, please feel free to call us.