• Tension Type Headache
• Sinus Headache
• Migraine (Vascular) Headache
• Tension Type Headache
• Cluster Headaches

Headache is one of the most common ailments affecting thousands of Americans every day. Migraine alone directly affects about 12% of the population. The symptoms and pain associated with the various types of headache can be difficult for your doctor to recognize. This makes it hard to pin point exactly what type of headache is the problem and the best treatment for it.

Most of our patients at Allied Medical & Rehabilitation suffer from what is called a "mixed" headache. That is, a combination headache, for example a sinus/tension headache or a rnigraine/sinus headache. The diagnosis of headaches is not easy, however by asking the right questions the staff at Allied can effectively come up with the best conservative treatment plan for you, the individual.

Almost everyone gets headaches, but not all headaches are the same. Some are mild twinges while others are so severe you cannot function.

There are different types of headache, each bought on by different causes and requiring different treatments.

A headache is rarely the symptom of a severe disorder, such as a brain tumor. However, it does mean something is wrong, so it should not be ignored. It's particularly important to seek medical help if your headaches are severe or keep coming back.

You don't have to just 'live with' headaches. Effective treatment is available for all types of headache, even migraine. By recording when and how your headaches occur, you can help your doctor diagnose and find the right treatment for them.

• Symptoms: Tension headaches are usually felt on both sides of the head or in the base of our skill and neck. The pain is dull and persistent, varying in intensity. It is often described as a feeling of pressure, heaviness or tightness in a band around the head.
• Frequency & Duration: Episodic tension type headaches can last from 30 minutes up to a week. They usually occur infrequently, but can progress to what is known as a chronic condition, where headaches occur all the time, with sufferers enduring headaches of varying intensity all day, every day, and can be woken by them at night.
  Generally, tension type headaches are diagnosed as being chronic when they are present for more than 15 days per month. In this case, a sufferer will notice the headache at the start of the day, and it will remain as a dull ache throughout the course of the day.
• Possible Causes: Tension type headaches may be triggered by emotional or physical stress (i.e an argument, fatigue, prolonged reading, dehydration or sitting for a long time with bad posture), or by environmental factors such as loud music.
• Treatment: Lifestyle - Combat stress by keeping fit, getting regular sleep and exercise and eating a balanced diet. Some people find that learning specific relaxation techniques or posture
• Medication: Episodic tension type headaches can be treated with mild, over- the -counter analgesics such as aspirin. However analgesic overuse has been associated with chronic headaches. According to a study in the May 11, 2004 issue of Neurology, daily or near daily use of analgesics is associated with chronic headaches, especially chronic migraines, and to a lesser extent, with other common, chronic pain conditions, such as neck and back pain. If the headache continues, you should take a shower or bath, apply a warm compress to your forehead and get some sleep.

• Your headache lasts more than 24 hours or occurs more than three times a week.
• You are woken by headaches, or they are worse in the mornings
• Your headache starts when you exercise, strain or cough
• Your headache gets progressively worse over several days.

• Symptoms: A sinus headache usually occurs as a gnawing pain over or under both eyes. It usually accompanies blocked sinuses caused by bad cold, flu or allergies and can be associated with a rise in temperature. The affected area may be painful when touched. The headache gets worse as the day goes on and increases in intensity if you bend forward.
• Frequency: Sinus headaches can occur at any time.
• Possible Causes: Sinuses are air-filled spaces in the facial bones around the nose, which are part of the respiratory system. Sinus headaches are one symptom of sinusitis, where your sinuses become infected and inflamed. Allergies can also cause sinus headaches as well as heating or air conditioning in you house or place of work.
• Treatment: Lifestyle: If possible stay indoors in a room with an even temperature, as a dry overheated environment could make your high temperature and nasal congestion symptoms worse. Steam inhalation may be useful to try and clear the sinuses.
• Medication: Over the counter sinus medication can be effective. If your symptoms persist, you may need to see your doctor to be prescribed a broad spectrum antibiotic to combat the sinus infection and possibly a nasal decongestant to unclog your nose. If your sinusitis does not clear up, you may need to undergo a minor operation to remove any obstruction from your sinuses.

• Symptoms: The main migraine symptom is a moderate to severe throbbing pain, usually on just one side of the head. This is often accompanied by nausea (feeling sick), cold hands, vomiting and sensitivity to light and sound.
  A migraine where people suffer an 'aura' or warning, 10 to 30 minutes before the migraine begins, only occurs in one in five cases. The aura may take many forms: lines or spots before the eyes, total darkness, tingling or numbness in the limbs and speech impairment. This can be a frightening experience.
  Eighty percent of migraines have no aura, although a few days beforehand you may feel irritable, lethargic and experience food cravings.
• Frequency & Duration: A migraine attack occurs on average once a month and usually lasts between 4 and 72 hours.
• Possible Causes: There is a wide range of possible triggers associated with migraine.
  They include:
  Bright or flashing lights irregular sleeping or eating patterns
  - Loud noises and strong smells sudden weather or altitude changes
  - Emotional factors, such as stress, fatigue or excitement.
  Women may find fluctuating hormone levels (due to ovulation, menstruation, or birth control pills) are a contributing factor.
  Your diet can also make you vulnerable to migraines; red wine, cheese, chocolate, nuts, soy sauce, citrus fruit, alcohol, excess caffeine (i.e. cola, tea, coffee) and some food additives (monosodium, glutamate, sodium nitrate) are all possible triggers.
• Treatment: Lifestyle - One way to manage headaches is to learn to recognize if there are 'triggers', so they can be avoided. Keeping a diary will help by highlighting suspect events, moods or foods. Given that stress is one of the most common triggers for migraines, relaxation such as yoga or meditation may be helpful.
  However, only a minority of people with migraine can clearly identify what triggers their attacks and even if triggers can be identified, they can not always be avoided.
• Medication: Until recently, doctors were relatively limited in managing migraine. However, modern medicines are now available that can help minimize the disruption migraine makes to your everyday life.
  Mild migraine pain can be treated with analgesics , antihistamines and anti-emetics (to combat nausea).

• Symptoms: Head pain is described as persistent, waxing and waning throughout the day, and may occur anywhere on the head, although it is often over the temples. It may be severe, burning and throbbing in the early course of the disease and non-throbbing later. Other symptoms are eyesight problems, mild fever, weight loss and jaw pain when chewing.
• Frequency & Duration: Once diagnosed long term management can prevent recurrences.
• Possible Causes: Temporal arteritis is caused by inflammation of the arteries which supply your head with blood.
• Treatment: Medication: If your symptoms are suggestive your doctor will perform a blood test and possibly a biopsy (the removal of a small piece of tissue under local anesthetic for testing). Prompt and appropriate anti-inflammatory medication is essential to reduce the inflammation of the affected arteries and protect eyesight.

• Symptoms: Severe pain developing around or behind one eye, which usually occurs at nights and wakes the sufferer from sleep. Congestion of the eye and nose on the affected side produces tears and nasal blockage and discharge on that side.
• Frequency & Duration: Cluster Headache usually lasts between 15 and 90 minutes and can occur almost daily in groups or "clusters" for days or weeks at a time. Then they may disappear for a year or more.
• Possible Causes: There is some evidence that excessive smoking and /or alcohol consumption can trigger an attack.
• Treatment: Medication: The migraine medication sumatriptan (Imigran) has proven effective in injection form for treating cluster headache. Pure oxygen inhalation is also used to alleviate an attack.

While there are many types and causes of headache, help is available. Perhaps your headaches cannot be cured, however the staff at Allied would love to help you manage your headaches so that they do not interfere with your life and family.