Headaches and Jaw pain

Tension headaches

These are caused when the neck muscles and muscles of the scalp become tense causing them to contract. This may be due to stress, prolonged or awkward head and neck positions when sitting, working or sleeping, depression, anxiety or following a whiplash-associated injury. They are the most common type of headache, and can significantly affect an individual's performance, quality of life and mood. Headaches that are found to originate from the neck and or shoulders are also termed 'cervicogenic headaches'.

They are often described as dull, vice-like headaches, presenting diffusely over most of the scalp, but commonly worse at the temples and the base of the back of the head near the neck. Muscular trigger points are often found on examination in the neck, shoulders and base of the skull, which are painful 'pressure points' that can reproduce the headache when pressure is applied to the area.

Tension headaches can therefore respond well therefore to physiotherapy intervention, working directly into the muscles and trigger points found to be at fault, along with providing advice and education (such as postural advice, use of heat, stretches, neck exercises and relaxation techniques), as to how to prevent these from happening again. Acupuncture can also be very effective in reducing the pain, tension and muscle spasm associated with cervicogenic headaches.

If you are experiencing headaches that are unusual to you, which cause you to be worried or feel unwell, or your headaches are accompanied by any of the following symptoms, please make an appointment with your GP immediately: dizziness, double vision, difficulty swallowing, altered speech, sudden fainting, nausea, uncontrolled eye movements, weakness in any of your limbs and problems with balance and co-ordination.

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Cluster headaches

These occur in specific, localised areas (usually on one side of the head), generally without warning and they can be extremely severe in terms of the level of pain experienced. Pain is usually reported around the eye or one temple, sometimes spreading to other locations on the same side of the head. The headaches can last between 30 minutes and 2 hours, peaking 5 minutes after its onset. Associated symptoms may include a droopy or red eye-lid on the side of the pain, and you may feel agitated and unable to lie down or rest when experiencing this type of headache.

Attacks usually occur in 'bouts', often at the same time of the day. Symptoms may present only every couple of day, or may be as frequent as up to eight times a day during a bout. Such attacks may be experienced for a few weeks or months at a time, and generally sufferers can have one or two bouts of these attacks per year.

It is proposed that there may be certain 'triggers' that lead a person to developing this type of headache, though the exact cause is not yet known. It is thought that sudden releases of chemicals such as serotonin and histamine, in response to individual triggers such as hot rooms, perfumes, bright lights and alcohol, may be involved. Another suggestion is that the hypothalamus in the brain is responsible, given its role in controlling the body's daily rhythms, and the likelihood of cluster headache attacks occurring around the same time of the day during a bout.

As the cause is believed to be related to a chemical response within the brain, the treatment for this condition is often through the use of prescribed medicines, including the use of oxygen. These do not offer a cure, but help to reduce the level of intensity of the attacks, and the length of time they last. A GP may also refer an individual with severe cluster headaches to a neurologist for a specialist examination and opinion.

Unfortunately, physiotherapy cannot prevent cluster headaches from occurring. However, relaxation techniques can be taught by a physiotherapist or another suitably-qualified professional, in order to equip individuals with the ability to relax during an attack and potentially reduce the level of pain and anxiety experienced. Anecdotally, acupuncture has been found to be of benefit to some sufferers. This may be by way of balancing the flow of blood and energy through the head, relaxing the surrounding muscles, and influencing the levels of serotonin the body produces.

If you are experiencing headaches that are unusual to you, which cause you to be worried or feel unwell, or your headaches are accompanied by any of the following symptoms, please make an appointment with your GP immediately: dizziness, double vision, difficulty swallowing, altered speech, sudden fainting, nausea, uncontrolled eye movements, weakness in any of your limbs and problems with balance and co-ordination.

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Migraines

These types of headaches can affect anyone of any age, but are more prevalent in females than males. It is estimated that 1 in 7 people in the UK suffer from migraines at one or more stages in their lives. Attacks may be temporary over a short period and then disappear, frequent with attacks occurring every week, or may be a persistent problem throughout an individual's life. Persistent migraines can be disabling to the sufferer, affecting their daily life and work.

Two types of migraines exist, a migraine with an aura (a warning sign before the migraine develops), and those without an aura.

Auras can vary between individuals, but common warning signs before a migraine develops include visual disturbances (such as flashes of lights, temporary blurring or loss of vision), pins and needles in the hand, arm and / or face / lips, speech alteration and sudden food cravings. Auras usually last several minutes before the migraine itself starts, but on occasion can last up to an hour. Even though some individuals do not experience an aura, commonly migraine sufferers know that they are going to develop a migraine, sometimes several days before its onset.

Symptoms common to both types of migraine include a throbbing headache (one sided or on both sides), nausea, vomiting, poor concentration, sweating, frequent urination, a feeling of being hot or cold, and commonly individuals develop a temporary sensitivity to bright lights and noises, requiring them to lie down in a dark room.

Migraines can last for between 4 and 72 hours, rarely continuing longer than this. Occasionally however, migraines can become persistent and occur for up to (and over) 15 days out of every month. These cases are severe, can lead to depression and anxiety and require careful management by a GP as continued use of strong migraine medication may lead to medication over-use. Persistent or chronic migraines may also be a symptom of other more serious underlying medical problems and therefore sufferers must consult their GP with such symptoms.

Though the exact cause is not known, it is believed that migraines may be a result of altered serotonin levels which causes blood vessels in the brain to widen. Triggers for this chemical reaction may be stress, altered sleep patterns, certain smells, certain food types or alcohol, bright lights, hormonal changes (during the menstrual cycle), dehydration or sudden strenuous exercise.

Migraines can be managed using specific medication, avoidance of known triggers, relaxation techniques, and acupuncture has also been found to help some sufferers.

If you are experiencing headaches that are unusual to you, which cause you to be worried or feel unwell, or your headaches are accompanied by any of the following symptoms, please make an appointment with your GP immediately: dizziness, double vision, difficulty swallowing, altered speech, sudden fainting, nausea, uncontrolled eye movements, weakness in any of your limbs and problems with balance and co-ordination.

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