Headaches can manifest on their own but are also a very common symptom in neck pain patients as more than 60% of patients with a primary neck pain complaint report having concordant episodes of neck pain. Therefore it’s essential to find out what kind of headache the patient is suffering from.
To start off let’s differentiate between primary and secondary types of headaches. But what does this mean? Simply put, primary headaches are a “disease themselves” whereas, in secondary headaches, the headache is a symptom of another condition. So primary headaches would be migraines, tension-type headaches & cluster headaches. Secondary-type headaches are headaches caused by tumors, hemorrhage, other trauma, TMJ dysfunction, substance overdose, or neck pain aka the Cervicogenic headache.
Now let’s take a closer look at migraines, which are primary types of headaches. Migraines have a mean 1-year prevalence of 11.2% around the world with women being more often affected than men in an age range between 20-50. Migraines exist in two distinct forms: That is either With or without the presence of a phenomenon called Aura. But we will get to that later.
Diagnostic criteria for migraine without aura (A-D need to be fulfilled):
A. At least 5 attacks fulfilling criteria
B. Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated)
C. Headache has at least 2 out of the following 4 characteristics:
Moderate or severe pain intensity
Aggravation by or causing avoidance of routine physical activity (e.g.walking or climbing stairs)
D. During headache at least one of the following:
Nausea and/or vomiting
Photophobia and phonophobia
E. Not better accounted for by another ICHD-3 diagnosis
In order for a headache to be classified as migraine with aura, a patient has to present with the previously mentioned criteria AND one or more reversible Aura symptoms. These are disturbances in the following subsystems:
Imagine vision changes, numbness, dizziness, confusion, etc.
Furthermore, at least 2 of the 4 characteristics have to apply:
At least one aura symptom spreads gradually over ≥ 5 minutes, and/or two or more symptoms occur in succession
each individual aura symptom lasts 5-60 minutes
at least one aura symptom is unilateral
the aura is accompanied, or followed within 60 minutes, by headache
While the Aura symptoms resemble those of a CVA, they build up much slower. Over 5 minutes compared to within seconds in a CVA.
100% FREE HEADACHE HOME EXERCISE PROGRAM
Tools you can use to assess the impact of a headache on your patient are the HIT-6 questionnaire which you can find in the video description. Also note that it can be difficult for a patient to answer all of the questions on duration, intensity, and characteristics of their headache during your assessment. Therefore asking them to complete a headache diary can help in the assessment and management of the headache and you should be aware that there can be overlap between multiple headache disorders.
If you would like to learn how to diagnose other common forms of headaches, check out the posts below:
What others say about the Online Course "Headache Treatment in Clinical Practice"
Headache Treatment in Clinical Practice QUALITY GUARANTEED
First time using Physiotutors; a very user friendly way of learning. An in depth theoretic background to start off with, before continuing to a more practical approach. After every chapter, you’re invited to do a little quiz and thus test yourself. Highly applicable course for your practice.
GREAT LEARNING EXPERIENCE INFORMATIEVE CURSUS
First time doing a full online formation on a subject and it was amazing, great way to move through the different topics.
The assessment and quizz keeps you accountable and you have a great, practical tool that you can apply directly into your practice like next day in.
Ingeborg Dols-de Jonge
Headache Treatment in Clinical Practice INFORMATIEVE CURSUS
Leuke en interessante hoofdpijn cursus waarbij gebruik gemaakt wordt van up to date wetenschappelijke onderzoeken. Er wordt een mooie afwisseling gemaakt tussen theorie en praktijk. Na deze cursus kun je goed onderscheid maken tussen verschillende soorten hoofdpijn en weet je wat de beste behandelmethode is.
Headache Treatment in Clinical Practice QUALITY COURSE
I highly recommend this course. You will get many tips of articles who are relevant for diagnostic and treatment of the most common headaches and migraine. Castien is also a great teacher, and explain the stuff in a good way. He has also informative videos.
Headache Treatment in Clinical Practice DETAILED AND VERY INFORMATIVE
This course is ideal to expand one’s knowledge on headaches and how to effectively treat them.
The instructor is extremely knowledgeable and provides very practical information, easily applicable in the clinic.
I would highly recommend taking this course to anyone interested in becoming an expert at treating headaches.
Headache Treatment in Clinical Practice GREAT COURSE
Good didactic qualities of the teacher with clearly noticeable theoretical knowledge
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