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The causes for headaches are as varied as people’s descriptions of them.  A headache, as you know, can be simply an annoyance or a symptom of something much more serious.  Fortunately for most of us, a headache is usually just an annoyance and the medical statistics back this up. But, how do you know what kind of headache you’ve got? Well, you have to ask yourself the same questions the doctor would ask.  There are six basic questions that help differentiate the kind of headache your having. 1. Location, or where does it hurt? 2. Duration, or how long does it hurt? 3. Frequency, or how often does it hurt? 4. Intensity, or how bad does it hurt?  5. Nature, or how does it hurt? I.e. Throbbing, squeezing, stabbing, so on. 6. And, association, or is your headache associated with any other problem or symptom?  For simplicity’s sake I will use the most common example, the Tension Headache.  The vast majority of people who experience headache are having a Tension Headache.  As the name suggests, this type of headache is directly or indirectly related to physical or psychological tension. If you have a Tension headache the questions would be answered as follows: 1. The headache feels like it starts around the temples and spreads over the head or starts at the base of the back of the skull and spreads over the top of the head. 2. The headache never lasts more than 10 or 12 hours.  3. The headache is intermittent, in other words it does not come every day.  4. On a scale of 1 to 10 where zero is no pain and 10 is the worst pain imaginable, the pain never exceeds a 5.  5. The pain feels like a dull ache or a squeezing around the head.  6. The headache can’t be associated with an activity, an injury, or a food.  It does not come with other symptoms such as nausea, hives, ear pain, neck pain, or anything else.  This is the general outline of the common Tension Headache.  It is alleviated easily with over the counter analgesics.  But, what you might be disturbed to know is that your tension headache probably would have gone away by itself before your cure kicked in.  Research indicates most headaches subside before most over the counter analgesics start working. 


Even if your headache did not neatly fall into the outline for a tension headache your headache is most likely still a far cry from life threatening.  In fact, the vast majority of headaches are categorized as extracranial and not intracranial.  In English, this means they are caused by things outside your head and not in it.  For example, stress causes muscle contraction.  Have you ever noticed that when your are very agitated you tend to shrug your shoulders.  Everyone does it. If you remember to catch yourself you will be surprised how far your shoulders drop when you relax.  There are muscles all over one’s head that react the same way, that are just not as easy to relax.  Tension in these muscles impedes blood flow and puts pressure on small nerves. The next thing you know, headache. Muscle tightness in the neck and shoulders do the same thing.


Other common non-life threatening headaches include, Migraine, toxic, and Cluster.  In a Migraine headache one may experience what is called a prodrome.  Although many people  claim to have a Migraine headache, they usually do not.  The culprit is most likely a rather severe tension headache.  The Migraine sufferer often experiences a prodrome or non-headache symptoms usually associated with the Migraine before the headache.  The can have a variety of symptoms such as; nausea, vomiting, visual disturbances, light sensitivity, mood changes, or even numbness.  The symptoms come on before the headache as a warning of sorts and then the symptoms persist during the headache and usually get more severe.  If we were to go through our six questions: 1.  The pain can start like that of a tension headache or start on one side of the head.  2.  These headaches last about the same amount of time as the tension headache up to 10 or 12 hours.  3.  Intermittent, but the sufferer has similar attacks over an extended period of time. 4. The pain can be mild to severe.  5.  The pain feels generalized or throbbing. 6. It can be associated with a prodrome.  The general feeling of most professionals is that Migraines are caused by a dilation of arteries in and around the head.  Medications that treat Migraine are vasoconstrictors, or decrease this blood flow.  Migraines are more prevalent in females.


The Cluster headache is a headache that is severe and behind one eye and may effect one side of the face.  If you experienced this type of headache you’d know it.  It is felt by most professionals that the causes for this type of headache are similar to that of Migraine and they are treated the same way.  Cluster  headaches are more prevalent in males.


Toxic headaches are really more of a category of headache.  They include headaches caused by infections, alcohol, and poisons.  They are all “toxic” to our systems.  They can be intracranial, extracranial, or both.  They present like a tension headache that keeps getting worse.  They are almost always associated with other symptoms and would therefor fail question 6.

The real important thing to remember is the basic outline for a tension headache if you want to eliminate a serious cause of headache. A simple headache should never last longer than 12 hours, never hurt more than a 5 on a scale of 1 to 10, and never be associated with other symptoms. If your headache presents as more severe in any way, see your doctor.  He or she will most likely tell you its a bad tension headache after some simple tests to make sure.           

Dr. Kevin S. Steele, D.C.

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