Headache Disorders Conditions We Treat
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Migraine
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Tension-Type Headache
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Cluster Headache
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Cervicogenic Headache
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Medication-Overuse Headache
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Post-Traumatic Headache
Migraine
Overview
A migraine is a complex neurovascular headache characterised by severe throbbing pain, usually on one side of the head, often accompanied by nausea, vomiting, or sensitivity to light and sound.
Symptoms
- Moderate to severe headache lasting 4–72 hours
- Throbbing or pulsating pain, often one-sided
- Nausea, vomiting, or dizziness
- Sensitivity to light, sound, or smells
- Visual aura (flashes, zigzag lines, or temporary vision loss)
Diagnosis
- Detailed medical and headache history
- Neurological examination
- Headache diaries to identify triggers
- MRI or CT to rule out structural causes
Treatment
- Acute Relief: Triptans, NSAIDs, or anti-nausea medications
- Preventive Therapy: Beta-blockers, anticonvulsants, or CGRP inhibitors
- Interventional: Occipital nerve blocks or sphenopalatine ganglion blocks
- Lifestyle: Sleep regulation, hydration, diet modification
Tension-Type Headache
Overview
Tension-type headache is the most common primary headache, often described as a dull, tight, or pressure-like sensation around the head caused by muscle tension, stress, or fatigue.
Symptoms
- Bilateral, band-like pressure around the forehead or scalp
- Mild to moderate intensity
- Tightness in neck and shoulders
- Difficulty concentrating
Diagnosis
- Clinical history and physical examination
- Exclusion of migraine or secondary causes
- Musculoskeletal assessment for trigger points
Treatment
- Medical: Analgesics, muscle relaxants
- Physiotherapy: Neck stretching, posture correction
- Psychological: Relaxation, mindfulness, CBT
- Lifestyle: Regular breaks from screens, hydration, adequate sleep
Cluster Headache
Overview
Cluster headache is an intense, one-sided headache that occurs in cyclical patterns, often centred around one eye, accompanied by tearing, nasal congestion, and restlessness.
Symptoms
- Sudden, severe pain around one eye or temple
- Red, watery eyes and nasal blockage
- Attacks lasting 15 minutes to 3 hours
- Restlessness during episodes
Diagnosis
- Clinical diagnosis based on attack pattern
- MRI to exclude other causes
- Headache diaries for pattern tracking
Treatment
- Acute Relief: Inhaled oxygen therapy, fast-acting triptans
- Preventive: Verapamil, corticosteroids
- Interventional: Sphenopalatine ganglion block, occipital nerve block
Cervicogenic Headache
Overview
Cervicogenic headache originates from the upper cervical spine due to joint, disc, or muscle dysfunction. Pain radiates from the neck to the head.
Symptoms
- Unilateral headache starting in the neck
- Neck stiffness or restricted movement
- Pain aggravated by head positions
- Shoulder or upper-back discomfort
Diagnosis
- Physical examination and cervical spine evaluation
- Imaging (X-ray or MRI)
- Diagnostic occipital or cervical facet block
Treatment
- Medical: Anti-inflammatory medications, muscle relaxants
- Interventional: Cervical facet injections, nerve blocks, radiofrequency ablation
- Physiotherapy: Postural retraining, neck mobilisation
Medication-Overuse Headache
Overview
Medication-overuse headache (MOH) occurs from frequent use of painkillers, leading to rebound headaches and dependency.
Symptoms
- Daily or near-daily headaches
- Dull, persistent pain on waking
- Poor response to medication
- Irritability, nausea
Diagnosis
- Review of medication history
- Assessment of underlying headache type
- Neurological evaluation
Treatment
- Medication Withdrawal: Gradual tapering of overused drugs
- Preventive Therapy: Migraine-prevention medication
- Behavioural Support: Counselling, stress reduction
Post-Traumatic Headache
Overview
Post-traumatic headache develops after a head or neck injury and can persist for weeks or months.
Symptoms
- Headache following head or neck trauma
- Dizziness, blurred vision
- Neck stiffness and tenderness
- Light or sound sensitivity
Diagnosis
- Detailed injury history
- Imaging (CT or MRI)
- Cervical spine assessment
Treatment
- Medical: Analgesics, neuropathic medications
- Physiotherapy: Neck and posture rehabilitation
- Interventional: Occipital nerve block, trigger-point injections
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FAQs
How do I know if my headache needs specialist care?
If headaches occur frequently, worsen over time, don’t respond to regular painkillers, or affect daily activities — consult a pain specialist.
What is a nerve block for headaches?
It’s a targeted injection of anaesthetic around specific nerves (occipital or sphenopalatine) to interrupt pain signals and provide relief.
Can lifestyle changes reduce migraines?
Yes. Regular sleep, hydration, stress management, and avoiding known triggers can significantly reduce migraine frequency.
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