Headaches are a common cause of pain. And severe or chronic headaches and migraines — considered headache disorders — can affect your quality of life.
If you suffer from frequent or severe headaches or migraines, you might think medications are your only option for relief. And for some people, medications do work.
But others may find relief through a broader approach to treatment. This approach includes lifestyle modifications, physical therapy and certain types of injections.
Jennifer Chung, MD, with The Christ Hospital Physicians – Physical Medicine & Rehabilitation, treats people with headache disorders. She uses a range of treatment options to relieve pain and help people get back to doing the things they love.
“There are many ways to treat headaches because there are many headache causes and triggers," Dr. Chung says, “Getting the right diagnosis and determining the origin of your headaches or migraines is an important first step in getting relief."
Types of headaches
Doctors recognize many types of headaches, but all types fall within one of two categories:
- Primary headaches, including migraine, tension and cluster headaches, and
- Secondary headaches caused by another medical condition, like high blood pressure, sinus or allergy problems, or structural issues within the brain.
“The most common headaches I see in my office stem from a problem in the neck or spine," Dr. Chung says. “These are called cervicogenic headaches and can be caused by spinal disease, arthritis and even poor posture."
Dr. Chung also treats migraines. These headaches often produce a throbbing pain on one side of the head. Migraines may also have several other symptoms, including:
- Auras (sensory disturbances)
- Sensitivity to light.
“Getting the right diagnosis and treatment early can keep a headache disorder from progressing," says Dr. Chung.
Diagnosing headaches and migraines
Your doctor will take a medical history and perform a physical exam as the first step in diagnosing a headache disorder. Your medical history helps your doctor understand your headaches' frequency, duration and intensity.
A physical exam can identify any underlying medical conditions contributing to your headaches.
Dr. Chung recommends keeping a headache diary to help with your diagnosis. She asks many patients to keep track of headaches with details like:
- Date, time and duration of headaches
- Headache intensity
- Potential triggers (including certain foods and alcohol)
- Sleep patterns
- Other accompanying symptoms.
In some cases, you may need additional tests to confirm your diagnosis. These tests may include blood tests, neuroimaging (such as MRI or CT scans) or a lumbar puncture (spinal tap).
Treatments for headaches and migraine
Many new medications and other treatments can help relieve headaches and migraines. Headache treatments vary by diagnosis but may include:
Making specific lifestyle changes can help you manage headaches and migraines. These may include establishing a regular sleep pattern, managing stress through relaxation techniques, maintaining a healthy diet, and avoiding triggers such as certain foods, strong odors or bright lights.
Posture correction can also help to alleviate certain types of headaches. Wearing corrective shirts or braces or strengthening your back and neck muscles can help correct your posture.
Sometimes, simply making changes to your workspace can help correct your posture and relieve your headaches.
“We often forget how much our work setup can affect our spine," Dr. Chung says. “With how much time we spend at our workstations, it's really important to adjust them so that the computer is at eye level and our arms are parallel to the floor."
You can often relieve mild-to-moderate headaches with over-the-counter pain medications like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. However, seeking medical care right away is important if these options don't offer relief.
“Self-medicating with over-the-counter options can lead to rebound headaches or make a headache disorder worse," Dr. Chung says. “If you've tried an over-the-counter option and it's not working for you, it's time to see a doctor."
Your provider may recommend prescription medications for more severe or chronic headaches and migraines. They can offer daily medications to treat chronic headache disorders and other as-needed medicines to take at the beginning of a headache.
The Food and Drug Administration has approved Botox injections as a preventive treatment for chronic migraines. These injections block the release of chemicals from the nerves at the onset of migraine.
Typically, you'll receive Botox injections every three months.
Trigger point injections
Trigger point injections can treat headaches caused by “knots" in your back or shoulder muscles. These injections include muscle-relaxing and anti-inflammatory chemicals to improve blood flow and relieve headache pain.
Don't Suffer in Silence
Dr. Chung says there's no reason to try to manage headaches on your own.
“If headaches or migraines affect your days and impact your quality of life — even if they aren't frequent — it's time to take action," says Dr. Chung.
If you are experiencing headaches or migraine and would like to see a specialist with The Christ Hospital Physicians – Physical Medicine & Rehabilitation, you can schedule an appointment online or call 513-585-3000.