Institute Of Sports Compressed

Institute of Sports and Spines

1566 Wynnum Road Tingalpa 

Institute of Sports and


1566 Wynnum Road Tingalpa

By Don Williams

Its national migraine month. No-body likes headaches, so we thought we would discuss some of the different types of headaches that we see and that people suffer from.

Headaches range from the benign to the catastrophic. Good healthcare practitioners should be able to identify and differentiate the different headaches into what are treatable with conservative measures and which required urgent referral to higher levels of management and care.

Types of headaches

A very basic classification is whether headaches are simple or serious. There are probably more than 30 different types of headaches and close to 10 different types of migraines. They all have their own characteristics.

Firstly, Pathological Headaches

These are related to tumours, bleeds, clots, dural lesions, vascular lesions and other serious conditions.

Mostly, these pathological headaches will have signs and symptoms, called Red Flags, which will alert your healthcare practitioner to the seriousness of the condition that warrants further investigation. When you have never had headaches before, or that type of headache, descriptions such as, “worst headache in my life”, “my head is exploding”, “thunderclap” are all serious indicators. Loss of consciousness, loss of vision, vomiting, dizziness are also important signs. If you have these signs, further investigation is needed, and generally, urgently.

We have unfortunately seen quite a number of pathological headaches over the years who have not been correctly diagnosed or managed by their help professionals, which has had significant consequences, including death as a result. As a practitioner, if I suspect a bleed or a tumour, I generally am happy to refer for brain scans early rather than adopt a wait and see position. Not too many patients are concerned about a couple of hundred dollars if it might save their life.

Simple headaches

There are loads of different simple headaches; sinus, stress/anxiety, sensitivity, cluster and cervicogenic to name a few. So lets focus on Cervicogenic headaches.

These are benign and are related to tension in the neck and base of skull. They will usually respond well to conservative treatment; Chiropractic can be useful in treating joint restrictions in the upper cervical spine, and research has now shown that the correlation between cervical manipulation and stroke is either non-existent or extremely low (1 in 2 million). Additional, Remedial massage, acupuncture and physiotherapy may be helpful.


The international Headaches society classifies migraines as having at least two of; one sided, moderate to severe, throbbing and aggravated by movement and having one of; nausea, vomiting, photophobia or phonophobia and the headache lasts for 4 to 72 hours.

The simple reason that migraines have symptoms that mimic stroke is that they are thought to cause a vasoconstriction of the blood vessels in the brain, which starve the are of blood, this then causes an impact in the area that that region of the brain supplies.

As mentioned earlier, there are loads of different types of migraines; common, classic, basilar artery, hemiplegic, opthalmoplegic, cluster, Saturday morning, abdominal, silent. Each type of migraine has its own signs and symptoms.

Saturday morning migraines are interesting, common in work-a-holics and often present on the weekend or start of a holiday when the stress comes off, the system feels overloaded. Evidently, simple solution if to work out how to address the stress and tension.

Classic Migraines – these usually have an aura, which is a visual disturbance (flashing, spotting, tunnelling of vision) which starts around 15 minutes before the migraine itself. These types of migraines will sometimes respond to upper cervical spine treatment. However, they will commonly have chemical or environmental triggers. (caffeine, alcohol, dark chocolate, aged cheese, MSG, almonds, altitude changes, weather changes, flickering lights, strong smells). It can be tedious, but doing an elimination diet to try to get stability then reintroducing foods, triggers to identify the cause can be very effective.

Common migraines are similar to classic, but usually don’t have an aura and far less commonly have chemical triggers. They will usually respond well to conservative treatment.

So, this has been a very brief look at headaches and migraines. If you have any questions about migraines or headaches and the potential of responding to treatment or requiring further investigation make an appointment with us to talk it through.