We speak to a panel of experts to find out how to tell the difference between a headache and a migraine. As well as how the treatment may be different.
The WHO has ranked headaches (including migraine) as one of the top five most disabling conditions affecting women. And one of the top 10 affecting men. This is alarming considering there are effective ways to prevent and treat regular headaches. Fortunately, only a handful of causes are responsible for the majority of headaches.
- Neurologist – Dr Prakash Kathan is a Neurologist practising at the Wits Donald Gordon Medical Centre.
- Chiropractor – Dr Chanelle Scott-Crossley is a chiropractor in private practice
- Dentist – Dr Zak Schabort is a specialist dentist with an interest in aesthetic medicine in private practice
The Difference in a Nutshell
Dr Kathan explains that: “Headache is the subjective experience of pain, relating to the head. A migraine is a type of headache, that occurs with specific symptoms.”
Fast Fact: “9 million (16%) of South Africans suffer with regular headaches,” shares Dr Scott-Crossley.”
So Now That We Know A Migraine Is A Type Of Headache What Are The Other Types?
Dr Scott-Crossley shares the most common types of headaches:
- Cervicogenic – problems within the neck
- Muscle-tension- neck and upper back muscular spasms
- Post-traumatic- following head/neck trauma, i.e. whiplash
- Drug-induced- from analgesic overuse
What Are The Causes And Risk Factors?
Fast Fact: “Scientists have identified over 300 causes for headaches,” shares Dr Scott-Crossley.
Dr Kathan explains: “Some headaches have no specific cause and are called primary headache disorders. Such as migraine and tension type headaches. Others can be caused by various diseases such as meningitis, brain tumours and brain trauma which cause headaches by damage or irritation of nerves of the nerves in the tissues that cover and protect the brain. The risk factors depend on the cause.”
Dr Kathan explains: “Migraine is a primary headache, that has no specific cause in most people. Rarely, some people have specific genetic disorders that cause migraines. However, although it is common for migraines to run in families, this is usually not as a genetic disorder.”
Migraines may also have triggers, which are sensory stimuli that could induce a migraine. Common triggers are:
The Three C’s
- Cheese (and other dairy)
- Coffee (and other caffeine containing substances)
As well as:
- Red wine
- Strong Smelling perfumes
How Can You Tell The Difference Between The Symptoms?
Dr Kathan describes the following:
“Headache has the symptom of pain, although the nature of the pain may vary with different types of headache, as well as the associated symptoms.”
“Migraine is classically, a throbbing or pulsatile pain that is usually on one side of the head. And may be associated with nausea, light sensitivity and sound sensitivity. It also may have an aura, or symptoms that would predict the migraine. Auras are commonly visual (blurry vision, wavy lines, areas of decreased vision), but can also include, language disturbances, dizziness and other symptoms.”
Your Teeth Could Be The Cause
Dr Schabort explains: “The link between one’s dentition and migraine/headaches falls into three general categories that are interrelated. These three areas would be tooth decay, bruxism and malocclusion.”
“In short, we all know that tooth decay can cause pain, but this in turn can cause severe nerve related pain and inflammation that can transition into severe infections and systemic sickness. With a final result of a full body infection that may have all the related symptoms including headaches.”
“Bruxism is the second area and it is the word used to describe night time/subconscious clenching and/or grinding on one’s teeth. It’s a truly devastating habit on the dentition but also on the joint of the jaw due to the extreme pressure exerted during these cycles of grinding. This unconscious habit is strongly associated with tension headaches and neck and back pain that tends to be more severe in the morning.”
“The last area is malocclusion. This in short describes teeth that for multiple reasons (decay, loss or unusual eruption patterns) are not correctly aligned. These malalignments have been shown to be related to headaches in multiple studies.”
How Do You Know If Your Teeth Are The Cause?
“It would be necessary to do a consultation to determine the root cause. This would involve radiographs and direct observation of your dentition to determine if there is decay or evidence of night time grinding as well as joint pain or misaligned teeth,” says Dr Schabort.
Does Age Play A Part?
“Age does play a role in headaches, as some headaches occur at different stages of life. Such as hypnic headaches which occur later in life, during the early hours of the morning,” Dr Kathan explains. “Migraines typically begin during adolescence and early adulthood, and are commoner in females. Migraines tend to improve as migraine sufferers get older.”
Dr Scott-Crossley adds that: “The incidence of headaches and migraines tend to rise from puberty and peak around our thirties and forties, which is normally when we reach our prime economic productivity.”
Dr Schabort explains how age affects headaches with regard to teeth: “As we get older the dentition does as well. Malalignments usually worsen with age and untreated bruxism prolongs the time that the jaw has undergone extreme pressure and damage. Additionally, so with decay, where untreated decay may progress substantially over time to invade not only the tooth but also the surrounding bone.”
What Are The Treatment Options?
“Headaches are treated individually, depending on the cause. In general, it is best to avoid general pain medication for the treatment of chronic (long standing) headaches.”
Migraine treatment is approached in 2 methods, prevention and treatment of a migraine.
“If migraines are frequent, they should be prevented. This could be done by avoiding triggers and medication.”
Examples of medication that may help for migraines are:
- Beta Blockers
“Triptans, such as Rizatriptan, are able to relieve a migraine, but they should be taken as early as possible. Occipital nerve blocks are also effective in migraine prevention (as well Occipital neuralgia),” Dr Kathan says.
“Calcitonin gene-related peptide blockers or antagonists are a novel treatment option for migraine that seems to be effective but it has been noted that it does increase our liver enzymes, and is still being studied,” Dr Kathan explains.
Dr Scott-Crossley says: “Doctors of chiropractic successfully help thousands of individual’s everyday obtain safe, effective, long-term relief from their headaches. This is because most headaches have a spinal, muscular, or habitual / postural component which the chiropractor has been trained to identify and treat.”
She notes: “Recent studies released by the European Journal of Physical and Rehabilitation Medicine show that while massage alone may be effective in tension-type (muscle related) headaches, neck manipulation or spinal alignment by chiropractors shows a significant reduction in overall frequency and intensity of tension-type headaches.”
She explains: “When you receive an adjustment from a chiropractor the pressure on the spinal joints and surrounding nerves is reduced significantly. This adjustment increases joint mobility, promotes normal nerve function and aids in the reduction of inflammation and muscle tension.”
“In terms of treatment, we as dentist first would provide a consultation to determine which of the areas, if not all, may be contributing to the headaches. Once we have determined the cause we may proceed to provide 3D scanned and milled crowns or fillings or root canals to deal with tooth decay. Or provide bite splints to deal with night time grinding that would effectively reduce the pressure on the join and muscles as well as protect the teeth. In addition, our treatment could also effectively align teeth through digitally planned orthodontics (not only reducing your headaches but effectively reducing your shyness in smiling),” Dr Schabort says.
“We have all the means at our disposal with the addition of modern digital systems to treat underlying dental problems that may be causing headaches. From 3D scanned crowns to computer generated orthodontics, we really have it all. In fact, we have something in the pipeline that should come to fruition in 2017 that will be a major breakthrough in the field of bruxism…and that’s all we can say about that,” shares Dr Schabort.
“Healthy eating plays a role in everything. Decreasing the amount of sugar in one’s diet prevents tooth decay and in turn prevents malocclusions that may develop from lost teeth in childhood and adult life. High levels of sugar and caffeine may also induce headaches because they push our bodies into areas that require effort to recover from through insulin and vascular related changes. I could go on all day about health eating but in short, preventing dental related problems due to excess sugar can definitely reduce the consequences of those issues, such as headaches,” explains Dr Schabort.
Dr Kathan shares that: “Exercise is an excellent preventative of migraine and is a viable method that does not need any medication.”
The Final Word:
“It is important to note that headaches have a multitude of causes and the first step for practitioners to aid patients with finding relief is to correctly identify the different types of headaches as well as the different causes for those headaches,” says Dr Scott-Crossley.
Original article: Longevity Article