Headache

There are many types of headache. Migraines and tension headaches are so common that almost everyone has had them before. Other types of headache include cluster headache, headache due to neck joint issues, sinus headache, occipital neuralgia, post-trauma headache, and medication overuse headache.

What is a migraine headache?

It is one sided in most people, both sided in 30%
It builds up slowly, is throbbing, and is worse when there is exertion and activity
Patients find relief by lying down in a dark room
Lasts anything from 3 hours to 3 days
There is sensitivity to light and sound, and there be an aura which refers to changes to your vision or hearing right before the attack happens
It can be treated with medications or pain procedures like a sphenopalatine injection or occipital nerve block

What is a tension headache?

It is always on both sides of the head. If it is not symmetrical, it is unlikely to be tension headache
There is a pressure sort of sensation along with tightness
Comes on slowly
Can last for many days
Usually manageable with simple pain killers

What is a cluster headache?

It is a headache that is felt behind the eye or around one temple
Always on one side
Severe in intensity, coming on quickly within minutes
Continuous and excruciating
Lasts 30 mins to 3 hours
There may be a red-eye, a blocked nose, and droopy eyelids
Strong opioids may be required
Can try sphenopalatine blocks or stellate ganglion blocks

What is a cervicogenic headache?

This is a headache due to wear and tear or injury of the small joints of the neck
Problem lies in the neck but is felt in the back of the head, neck as well as the trapezius
It can be treated with physiotherapy, medications and pain procedures that target the small nerves that cause the pain sensation i.e. radiofrequency ablation

What is occipital neuralgia?

Pain at the back of the head near the bony prominences
May have an electric sensation or a dull ache
It can spread upwards over the scalp
There may be nausea vomiting, difficulty balancing, and slurred speech
Treatment includes medications, injections, pulse radiofrequency to the nerve
Occasionally surgery may be required to free up the nerve that is caught in between the muscles

What is sinus headache?

This occurs as a result of sinusitis, an infection of the sinuses
It mimics migraines and tension headaches
There may be fever and tenderness over the sinuses
Treatment will require antibiotics and surgery to open up the sinuses for drainage

What is post-trauma headache?

Can be due to injury, trauma, or surgery to the skull
There is headache, giddiness, and changes to mood, as well as personality changes
It may be difficult to concentrate, and oversensitivity to light or sound
Medications may be tried first
Occipital or sphenopalatine blocks may be tried to hasten recovery

What is medication over-use headache?

Medications like opioids and paracetamol that are used to treat headache can become the source of headache if taken over a long time
Treatment is to stop the medications
A preventer like amitriptyline may be used for long term control
It can be difficult to ascertain which medicine is causing the headache

Pain Conditions