Overview of The Headache (Migraine with/without aura, Tention type headache, Cervicogenic headache)

Updated: May 11, 2021

Headaches are common occurrence. It is defined as pain in any part of the head, including the scalp, face, and interior of the head. Primary headaches(such as migraine, cluster headache, and tension-type headache) are those for which no other causative factor can be found. Secondary headaches can have numerous causes cerebral hemorrhages, viral infections, caffeine withdrawal, and dehydration.


Different Types of Headaches



Primary headache


1 Migraine

Migraines are often severe. They are episodic and can occur as often as once or twice a week but not daily. The International Headache Society has established the following diagnostic criteria for migraines.



Migraine without aura

  • A At least two attacks fulfilling criteria B-D

  • B Headache lasting 4-72 hours

  • C Headache has at least two of the following characteristics:

1 unilateral location

2 pulsating quality

3 moderate or severe pain intensity

4 aggravated by or causing avoidance of routine physical activity

  • D During headache, at least one of the following:

1 nausea, vomiting

2 photophobia and phonophobia


Migraine with aura


Migraine with aura (also called classic migraine) is a recurring headache that strikes after or at the same time as sensory disturbances called aura. These disturbances can include flashes of light, blind spots and other vision changes or tingling in your hand or face.


Migraine aura symptoms include temporary visual or other disturbances that usually strike before other migraine symptoms — such as intense head pain, nausea, and sensitivity to light and sound.

Migraine aura usually occurs within an hour before head pain begins and generally lasts less than 60 minutes. Sometimes migraine aura occurs with little or no headache, especially in people age 50 and older.


2 Tension-type headache


Tension-type headaches typically are felt as a steady ache rather than throbbing and usually affect both sides of the head. They are often associated with response to stressful events. Tension headaches may be chronic, occurring frequently or even daily. The International Headache Society has established the following diagnostic criteria for migraines.


  • A Infrequent

  • B Lasts from 30 mins to 7 days

  • C At least two of the following characteristics:

1 Bilateral location

2 pressing/tightening quality

3 mild to moderate intensity

4 not aggravated by physical activity such as walking or climbing stairs

  • D Both of following:

1 nausea, vomiting

2 Not attributed to another disorder


3 Cluster headaches


Cluster headaches, which occur in cyclical patterns or cluster periods, are one of the most painful types of headaches. A cluster headache commonly awakens you in the middle of the night with intense pain in or around one eye on one side of your head.

Bouts of frequent attacks, known as cluster periods, can last from weeks to months, usually followed by remission periods when the headaches stop. During remission, no headaches occur for months and sometimes even years.


Fortunately, cluster headache is rare and not life-threatening. Treatments can make cluster headache attacks shorter and less severe. In addition, medications can reduce the number of cluster headaches you have.


Common signs and symptoms during a headache include:

  • Wxcruciating pain that is generally situated in, behind or around one eye, but may radiate to other areas of your face, head and neck

  • One-sided pain

  • Restlessness

  • Excessive tearing

  • Redness of your eye on the affected side

  • Stuffy or runny nose on the affected side

  • Forehead or facial sweating on the affected side

  • Pale skin (pallor) or flushing on your face

  • Swelling around your eye on the affected side

  • Drooping eyelid on the affected side


Secondary Headache


1 Headache attributable to head and neck trauma

Headache is the most common symptom following car accidents and fails. The headache can be dull, constant, and aching. Other symptoms may accompany the headache, such as faintness, poor memory, inability to concentrate, anxiety, fatigue, insomnia, irritability, depression, tinnitus, and vertigo. About 85% of chronic post-traumatic headache sufferers will recover completely but this can take many months or even years. The International Headache Society has established the following diagnostic criteria for migraines.

  • A Headache, no typical characteristics known, fulfilling criteria C-D

  • B Head trauma with at least 1 of the following:

1 Loss of consciousness for over 30 mins

2 Glasgow Coma Scale >13

3 Post-traumatic amnesia for > 48 hours

4 Imaging demonstration of a traumatic brain lesion

  • C Headache develops within seven days after head trauma or after regaining consciousness following head trauma

  • D Headache persists for >3 months after head trauma.

2 Headache attributable to a substance or its withdrawal

One example of this type of headache arises from headache medication overuse including ergotamine intake. Headache is present on 15 or more days a month. Clients describe regular overuse for more than 3 months of one or more drugs that can be taken for acute and/or symptomatic treatment of headache withdrawal headache and analgesic overuse.


3 Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structures

The most common headache in this category is cervicogenic headache which is estimated to account for 14-18% of all chronic headaches. Cervicogenic headaches are also among the most responsive to remedial massage treatment.


Cervicogenic headache

Cervicogenic headaches may be related to a number of mechanisms including cervical facet dysfunction, cervical degenerative joint disease, musculotendinous lesions, entrapment neuropathy of the occipital nerves, and a connective tissue bridge between rectus capitis posterior minor and the dorsal spinal dura. Pain is typically felt in the suboccipital region, unilaterally or bilaterally, and radiated to the head behind the eyes or into the face. The pain is usually dull and aching and is often worse on rising. The headache usually eases as the day goes on but may be aggravated by the neck and head movement s or by jolting. The international headache society has established the following diagnostic criteria:

  • A Pain referred from a source in the neck and perceived in one or more regions of the head or face, fulfilling criteria C-D

  • B Clinical, laboratory, and imaging evidence of a disorder or lesion within the cervical spine or soft tissues of the neck known to be, or generally accepted as , a valid cause of headache

  • C Evidence that the pain can be attributed to the neck disorder or lesions, based on at least one of the following:

1 demonstration of clinical signs that implicated a source of pain in the neck

2 abolition of headache following diagnostic blockage of a cervical structure or its nerve supply using placebo or other adequate controls


  • D Pain resolves within 3 months after successful treatment of the causative disorder or lesion


More Information:

How does massage treat the headache

Exercise, stretching, and tips for headache after massage



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