Headaches are incredibly common - nearly 50% of the population struggles with headaches on a consistent basis, and 94% will have to deal with headaches at some point in their life. They can be debilitating, and annoying, and can make it a real challenge to enjoy your life the way you want to. Understanding what your headache is and why it’s happening is the first step to appropriately addressing it and managing your symptoms.

Types of Headaches: They’re Not All The Same

1) Tension-Type Headaches

Tension-type headaches (also just called tension headaches) are the most common type of headache. They’re related to a combination of muscular and neurological dysfunction, which basically means that tight muscles and extra sensitive pain receptors both contribute to these headaches.

Trigger points or “knots” in the neck and shoulder muscles are often related to tension-type headaches. These trigger points reduce the mobility of the muscles, while also reducing blood flow and increasing the release of substances that increase pain sensations. Additionally, some of the small muscles in the top of the neck connect directly to the dura, a protective sleeve that covers the brain and spinal cord; if a trigger point forms in these muscles, it can create tension on the dura and the rest of the nervous system, making it more sensitive to incoming pain signals.

A number of other factors can contribute to tension-type headaches. Looking down at your phone, tablet, or book for an extended period of time puts a lot of stress on the joints and muscles in your neck and shoulders, which can cause them to tighten up. Mental and emotional stress decrease our sensitivity to pain and can cause tension-type headaches. Several nutritional factors, including low vitamin B12 and low magnesium, can also cause muscles to be tighter while also changing how our muscles and brains produce energy. (Dysfunctional energy production in the brain appears to be a common factor among many types of headaches, as it makes it harder for the brain to manage and respond to incoming pain signals.)

Symptoms of a tension-type headache include:

• Steady, dull, aching pain with tightening or pressure-like sensation, like your head is getting squeezed

• Pain located in your forehead, the sides of your head, and/or the back of your head

• Tender scalp, shoulder, and neck muscles

• Pain doesn't get worse with physical activity

2) Migraine Headaches

Migraine headaches are a neurovascular problem, meaning that both your brain and your blood vessels create the symptoms you experience when you’re having a migraine. The current theory is that when a migraine begins, you get a wave of neurological activity that spreads across your brain. This creates some of the prodrome and aura symptoms (the warning signs) of an impending migraine, like fatigue, flashing lights, ringing in the ears, and tingling on one side of the face or body. As this wave of activity spreads across your brain, it causes certain pain-sensing areas to become more active and sensitive to pain. This wave of activity also tells the blood vessels in your brain to dilate or swell, which may be related to the pulsating or throbbing aspect of migraine headaches.

Migraines are often associated with triggers, including:

• Excess stress

• Sleep problems

• Hormonal changes associated with the menstrual cycle or menopause

• Excess caffeine or alcohol consumption

• Certain foods including chocolate, MSG, and aged cheeses

• Dehydration

• Strong smells like perfumes or gasoline

Symptoms of a migraine headache include:

• Pulsating or throbbing pain on one side of the head

• Nausea and/or vomiting

• Sensitivity to light and/or sound

• Pain is worse with physical activity

• Prodrome symptoms 24-48 hours before the headache, including excessive yawning, fatigue, mood changes, and changes in thirst or appetite,

• Aura symptoms about 1 hour before the headache, including flashing lights, ringing in the ears, or weakness and numbness on one side of the face or body

• Postdrome symptoms for 24-48+ hours after the headache, including exhaustion, dizziness, and difficulty concentrating

3) Cervicogenic Headaches

Cervicogenic headaches are headaches caused by structural issues in the neck (cervico- means “neck”, and -genic means “production”, so cervicogenic means “produced by the neck”). These headaches account for up to 25% of all headaches. They’re often related to trauma, like a car accident or blow to the head, but can also be related to chronically tight muscles, poor posture, and daily activities.

Cervicogenic headaches can be caused by a number of structures in your neck, including your joints, muscles, ligaments, and nerves. If any of these tissues are tight or damaged, they can create pain in the neck that can travel to the head. Many of the nerves that innervate your scalp and head travel come out between the vertebrae at the top of your neck, so if the joints or muscles near that area aren’t working well, they can put pressure on those nerves, creating pain. Additionally, your very first vertebrae, C1, is intricately connected to the nerves that innervate your face; if there’s an issue at C1, it can show up as tenderness or pain in the face, jaw, and forehead.

There are a few things that can contribute to cervicogenic headaches. Certain activities or jobs, including hair styling, carpentry, and driving, can create postures and positions that stress your neck and shoulder muscles, making them tighter than they should be. Poor posture can also contribute to tight muscles and imbalances, particularly if you’re spending a lot of time looking down at a screen or with your head turned one way. Having neck muscles that are too weak can also contribute to cervicogenic headache, increasing the risk of injury while also tightening muscles to compensate for that weakness.

Symptoms of a cervicogenic headache include:

• Dull, achy, one-sided headache

• Pain in the neck, shoulders, or arms

• Pain worse with certain positions or movements

• Stiffness, tension, or limited movement in the neck

4) Sinus Headaches

Sinus headaches are related to congestion and pressure in your nose and sinuses, related to allergies, sinus infections, and chronic congestion. Your sinuses are cavities or open areas in your skull. Normally they’re mostly empty and help to warm and humidify the air you breathe in. When you’re sick or dealing with allergies, they often fill up with mucus, creating pressure and a feeling of fullness in your face and head.

Mucus is a key aspect of your body’s initial line of defense against illness. It coats the walls of your respiratory tract, catching dirt, pollen, and germs before they can reach your lungs. Unfortunately, it’s not a perfect system, and sometimes things get past this initial barrier, and you get sick. When you get sick or have a flareup of allergies, your immune system boots up and starts trying to battle whatever is invading your body. Your mucus gets thicker as bacteria and your immune cells go to war, leaving behind waste products and cellular debris. Thicker mucus doesn’t flow as well as normal mucus and will contribute to many symptoms of a sinus or respiratory infection, like congestion and coughing.

Congestion can be caused or triggered by a number of things. Seasonal allergies are one of the most common causes of congestion and can increase the risk of developing a sinus infection or other respiratory illness. Exposure to mold and other fungi ramps up your immune system and is related to 96% of cases of chronic congestion. Cranial issues, like a deviated septum, can impair how well your sinuses drain and promote congestion. Foods that you’re sensitive or allergic to can also contribute to congestion; common food sensitivities include dairy, gluten/wheat, chocolate, and refined or processed sugar.

Symptoms of a sinus headache include:

• Pain, pressure, and fullness in the cheeks, face, or forehead

• Worsening pain if you bend forward or lie down

• Stuffy nose, congestion, and thick mucus

• Fatigue

• Achy feeling in the upper teeth

5) Cluster Headaches

Cluster headaches are one of the most severe headaches, mostly affecting men. Thankfully, the condition is relatively uncommon compared to other types of headaches, but it’s still a large burden for those dealing with them.

Cluster headaches are complex and not well understood. They are neurovascular in nature, similar to migraines. Essentially, a certain area of the brain that processes sensations from the face gets activated in the wrong way or at the wrong time. This activated area creates pain, causes dilation of blood vessels in the brain and around the face, and activates other parts of your nervous system, creating symptoms like tearing of the eye, runny nose, and facial sweating. Current research has also noted changes in the hypothalamus, the part of your brain related to your circadian rhythms (your internal clock) and homeostasis (maintaining a stable internal environment).

Cluster headaches can be a bear to manage and control, particularly because they aren’t strongly associated with any triggers and don’t often have a definite cause. They seem to occur more often in the spring and fall, implying that there may be an association with allergies. Stress, bright lights, and the use of alcohol may bring on attacks, though this is highly variable between patients. Cluster headache patients may also have negative changes in their gut microbiome, though whether the headaches cause the gut changes or the gut changes cause the headaches is unclear.

Symptoms of a cluster headache include:

• Rapid onset of one-sided pain, usually around the eye or the temple, like an icepick being stabbed in your eye or face

• Pain is excruciating and lasts 15 minutes to 3 hours

• Can happen at any time of day but often occurs 2 hours after going to bed

• Tearing, red eyes, puffy eyelids, stuffy/ runny nose, facial sweating, and drooping eyelids

• Occur in clusters with headaches occurring frequently over the course of several weeks, usually followed by a headache-free interval of 6 months to a year

Can A Chiropractor Help With Headaches?

Most headaches are complex, with multiple factors contributing to the pain that you feel. For many people, it’s hard to figure out which of these factors is most relevant to them, so they don’t know where to start managing their pain. A chiropractor can help you determine what’s actually causing your headaches and where you can start making the most effective changes.

Chiropractic care is also highly effective for many types of headaches, particularly tension-type headaches, cervicogenic headaches, and migraines. One study found that chiropractic care can decrease the frequency of symptoms by 50%, while another found that 80% of patients get significant relief from their headaches within 10 visits. A study done with migraine patients found that nearly 50% experienced a significant reduction in symptoms with chiropractic care, while around 25% experienced a 90% reduction in symptoms with chiropractic care.

Chiropractors are well-equipped to manage headaches. We take a holistic view of your body and your health, allowing us to see the variety of factors that might contribute to your headaches. By addressing things like your muscles, your joints, your sleep habits, your stress levels, your diet, and your daily activities, we can create significant changes in your life without the use of drugs or surgery. (At least, this is true at Northbound. We can’t make promises about chiropractors elsewhere, though this is true for most.)

Closing Thoughts

Headaches are super common, but they are not remotely normal. They don’t need to just be a part of your life. You didn’t ask for a lifetime of headaches, so you should at least give yourself the chance to avoid that future. Your pain is real, it’s there, and it’s not all in your head.

At Northbound Chiropractic, we want you to understand what your condition is, why it’s happening, and how we’re going to address it. If you understand your condition, it will be easier for you to follow your treatment plan and reach your health, wellness, and performance goals.

If you or someone you know is struggling with headaches, we’re here to help. Every patient gets a treatment plan designed specifically for them and their wants, needs, and goals. Call or text us at 763-373-9710, or click here to set up your appointment and get back on the right track!

Wishing you the best,
Dr. Nicholas Carlson
Northbound Chiropractic
Serving Delano, MN, Maple Plain, and the rest of Wright and West Hennepin Counties