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Chronic/Pain Conditions  >>    Headaches

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In this video, Dr. Huntoon discusses the true cause of ALL headaches and what you need to be aware of if you have them.

If you have any questions or need help with your headaches, Dr. Huntoon is here to serve you.

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A Headache is defined as a pain in the head or upper neck. It is one of the most common locations of pain in the body and has many causes.

How are headaches classified?

Headaches have numerous causes, and in 2007 the International Headache Society agreed upon an updated classification system for headache. Because so many people suffer from headaches and because treatment sometimes is difficult, it is hoped that the new classification system will allow health care practitioners come to a specific diagnosis as to the type of headache and to provide better and more effective treatment.

There are three major categories of headaches:

  1. primary headaches,

  2. secondary headaches, and

  3. cranial neuralgias, facial pain, and other headaches

What are Primary Headaches?

Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache.

Tension headaches are the most common type of primary headache. Up to 90% of adults have had or will have tension headaches. Tension headaches occur more commonly among women than men.

Migraine headaches are the second most common type of primary headache. An estimated 28 million people in the United States (about 12% of the population) will experience a migraine headache. Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected. It is estimated that 6% of men and up to 18% of women will experience a migraine headache in their lifetime.

Cluster headaches are a rare type of primary headache affecting 0.1% of the population (1 in a 1,000 people). It more commonly affects men in their late 20s though women and children can also suffer these types of headache.

Primary headaches can affect the quality of life. Some people have occasional headaches that resolve quickly while others are debilitated. While these headaches are not life-threatening, they may be associated with symptoms that can mimic strokes or intracerebral bleeding.

What are Secondary Headaches?

Secondary headaches are those that are due to an underlying structural problem in the head or neck. There are numerous causes of this type of headache ranging from bleeding in the brain, tumor, or meningitis and encephalitis, as well as others.

What are cranial neuralgias, facial pain, and other headaches?

Neuralgia means nerve pain (neur= nerve + algia=pain). Cranial neuralgia describes a group of headaches that occur because the nerves in the head and upper neck become inflamed and become the source of the pain in the head. Facial pain and a variety of other causes for headache are included in this category.


What are the symptoms of Tension Headaches?

The pain symptoms of a tension headache are:

The pain begins in the back of the head and upper neck and is described as a band-like tightness or pressure.

Often is described as pressure encircling the head with the most intense pressure over the eyebrows.

The pain usually is mild (not disabling) and bilateral (affecting both sides of the head).

The pain is not associated with an aura (see below), nausea, vomiting, or sensitivity to light and sound.

The pain occurs sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people.

The pain allows most people to function normally, despite the headache.

What are the symptoms of migraines?

The symptoms of migraine headaches can occur in various combinations and include:

Type of pain

The pain of a migraine can be described as a pounding or throbbing. The headache often begins as a dull ache and develops into throbbing pain. The pain is usually aggravated by physical activity. 

Severity/Intensity of pain 

The pain of a migraine can be described as mild, moderate, or severe. Untreated the headache will become moderate to severe 

Location of pain 

The pain can shift from one side of the head to the other, or it can affect the front of the head or feel like it’s affecting the whole head. 

Duration of pain

Most migraines last about 4 hours, although severe ones can last up to a week. 

Frequency of headaches

The frequency of migraines varies widely among individuals. It is common for a migraine sufferer to get 2-4 headaches per month. Some people, however, may get headaches every few days, while others only get a migraine once or twice a year. 

Associated symptoms 

Sensitivity to light, noise and odors

Nausea and vomiting, stomach upset, abdominal pain

Loss of appetite

Sensations of being very warm or cold

Paleness (pallor)



Blurred vision

Diarrhea (rare)

Fever (rare)  

Warning signs 

Symptoms that signal the onset of a migraine are used to describe two types of migraine dysfunction: 

Migraine with aura (formerly known as "classic" migraine)

Migraine without aura (formerly known as "common" migraine)  

"Aura" is a physiological warning sign that a migraine is about to begin. 

What are the symptoms of migraines with aura? 

Migraines with auras occur in about 15-20% of migraine sufferers. An aura can occur before, during, or after the pain occurs and last from 15 to 60 minutes. The symptoms always last less than one hour. Visual auras include: 

Bright flashing dots or lights

Blind spots

Distorted vision

Temporary vision loss

Wavy or jagged lines  

There are also auras that can affect the other senses. These auras can be described simply as having a "funny feeling," or the person may not be able to describe the aura. Other auras may include ringing in the ears (tinnitus), or having changes in smell (such as strange odors), taste, or touch. 

Rare migraine conditions include these types of neurological auras:  

Hemiplegic migraine: temporary paralysis (hemiplegia) or neurological or sensory changes on one side of the body. The onset of the headache may be associated with temporary numbness, dizziness or vision changes. 

Retinal migraine: temporary, partial or complete loss of vision in one eye, along with a dull ache behind the eye that may spread to the rest of the head. 

Basilar artery migraine: dizziness, confusion or loss of balance can precede the headache. The headache pain may affect the back of the head. These symptoms usually occur suddenly and can be associated with the inability to speak properly, ringing in the ears, and vomiting. This type of migraine is strongly related to hormonal changes and primarily affects young adult women. 

Status migrainosus: a rare and severe type of migraine that can last 72 hours or longer. The pain and nausea are so intense that people who have this type of headache often need to be hospitalized. Certain medications, or medication withdrawal, can cause this type migraine syndrome.

Ophthalmoplegic migraine: pain around the eye, including paralysis in the muscles surrounding the eye. This is an emergency medical condition, as the symptoms can also be caused by pressure on the nerves behind the eye or an aneurysm. Other symptoms of ophthalmoplegic migraines include droopy eyelid, double vision, or other vision changes.

What are the symptoms of migraines without aura?

Migraines without auras are more common, occurring in 80 to 85 percent of migraine sufferers. Several hours before the onset of the headache, the person can experience vague symptoms, including:



Fatigue or tiredness


Cluster headache symptoms

A cluster headache strikes quickly, usually without warning. Common signs and symptoms include:

Excruciating pain, generally located in or around one eye, but may radiate to other areas of your face, head, neck and shoulders

One-sided pain


Excessive tearing

Redness in your eye on the affected side

Stuffy or runny nasal passage in your nostril on the affected side of your face

Sweaty, pale skin (pallor) on your face

Swelling around your eye on the affected side of your face

Drooping eyelid

The pain of a cluster headache is often described as sharp, penetrating or burning. People with this condition say that the pain feels like a hot poker being stuck in the eye or that the eye is being pushed out of its socket.

People with cluster headache appear restless. They may pace or sit through the attack. In contrast to people with migraine, people with cluster headache usually avoid lying down during an attack because this position seems to increase the pain.

Some migraine-like symptoms — including nausea, sensitivity to light and sound, and aura — may occur with a cluster headache, though usually on one side.

Cluster period characteristics

A cluster period generally lasts from six to 12 weeks. The starting date and the duration of each cluster period may be consistent from period to period. For example, cluster periods may occur seasonally, such as every spring or every fall.

Most people have episodic cluster headaches. In episodic cluster headaches, the cluster headaches occur for one week to a year, followed by a pain-free remission period that may last as long as 12 months before another cluster headache develops.

Chronic cluster periods may continue for more than a year, or pain-free periods may last less than one month.

During a cluster period:

Headaches usually occur every day, sometimes several times a day.

A single attack may last from 15 minutes to three hours.

The attacks often happen at the same time within each 24-hour day.

The majority of attacks occur at night, usually one to two hours after you go to bed.

The pain usually ends as suddenly as it begins, with rapidly decreasing intensity. After attacks, most people are completely free from pain, but exhausted.



What causes Tension Headaches?

While tension headaches are the most frequently occurring type of headache, their cause is not known. The most likely cause is contraction of the muscles that cover the skull. When the muscles covering the skull are stressed, they may spasm and cause pain. Common sites include the base of the skull where the trapezius muscles of the neck inserts, the temple where muscles that move the jaw are located, and the forehead.

There is little research to confirm the exact cause of tension headaches. Tension headaches occur because of physical or emotional stress placed on the body. These stressors can cause the muscles surrounding the skull to clench the teeth and go into spasm. Physical stressors include difficult and prolonged manual labor, or sitting at a desk or computer for long periods of time concentrating. Emotional stress may also cause tension headaches by causing the muscles surrounding the skull to contract.

What causes a migraine? 

The exact causes of migraines are unknown, although they are related to changes in the brain as well as to genetic causes. People with migraines may inherit the tendency to be affected by certain migraine triggers, such as fatigue, bright lights, weather changes and others.

For many years, scientists believed that migraines were linked to the expanding (dilation) and constriction (narrowing) of blood vessels on the brain’s surface. However, it is now believed that migraine is caused by inherited abnormalities in certain areas of the brain.

There is a migraine "pain center" or generator in the mid-brain area. A migraine begins when hyperactive nerve cells send out impulses to the blood vessels leading to the dilation of these vessels and the release of prostaglandins, serotonin and other inflammatory substances that cause the pulsation to be painful.

Certain brain cells that use serotonin as a messenger are involved in controlling mood, attention, sleep, and pain. Therefore, chronic changes in serotonin can lead to anxiety, panic disorder, and depression.

Causes of Cluster Headaches 

The exact cause of cluster headaches is unknown, but abnormalities in the hypothalamus likely play a role.

From an Alternative Perspective, these headaches are caused by an imbalance in the gall bladder/liver system related to repressed/unexpressed negative emotion.  Cluster attacks usually occur with clocklike regularity during a 24-hour day, and the cycle of cluster periods often follows the seasons of the year.

These patterns suggest that the body's biological clock is involved. In humans, the biological clock is located in the hypothalamus, which lies deep in the center of your brain.

Abnormalities of the hypothalamus may explain the timing and cyclical nature of cluster headache. Imaging studies have detected increased activity in the hypothalamus during the course of a cluster headache.

Unlike migraine and tension headache, cluster headache generally isn't associated with triggers, such as foods, hormonal changes or stress. Some people experience an aura or nausea similar to those experienced with migraine headaches.

Once a cluster period begins, however, consumption of alcohol can quickly trigger a splitting headache. For this reason, many people with cluster headache avoid alcohol for the duration of a cluster period.

Other possible triggers include the use of medications such as nitroglycerin, a drug used to treat heart disease.


Traditional Medical Treatment Options and Diagnosis

How are Tension Headaches diagnosed?

The key to making the diagnosis of any headache is the history given by the patient. The health care practitioner will ask questions to understand when the headache began, learn about the quality, quantity, and duration of the pain, and ask about any associated symptoms. The history of tension headache will include pain that is mild to moderate, located on both sides of the head, described as a tightness that is not throbbing, and not made worse with activity. There will be no associated symptoms like nausea, vomiting, or light sensitivity.

The physical examination, particularly the neurologic portion of the examination, is important in tension headaches because it should be normal to make the diagnosis. The only exception is that there may be some tenderness of the scalp or neck muscles. If the health care practitioner finds an abnormality, then the diagnosis of tension headache would not be considered until the potential for other types of headaches have been investigated.

How are Tension Headaches treated?

Tension headaches are painful, and patients may be upset that the diagnosis is "only" a tension headache. Even though it is not life-threatening, a tension headache can affect the activities of daily life.

Medical treatment for tension Headaches

Most people successfully treat the symptoms with over-the–counter (OTC) pain medications to control tension headaches. As with all medications (prescription or over-the-counter) there are side-effects that may be worse than the initial headache.  Discussing these with your medical doctor or pharmacist is warranted before beginning any medication. 

The following over-the–counter medications work well for most people:


ibuprofen (Motrin, Advil),

acetaminophen (Tylenol) and

naproxen (Aleve)

As with any medication, there are the potential for side-effects which can lead to other health concerns. Most notably, your liver will have to process the chemicals found in these medications. The effects of these medications can lead to arthritis and other joint related problems, abdominal bleeding and indigestion.

If these fail, other supportive treatments are available. Recurrent headaches should be a signal to seek medical help. Massage, biofeedback, and stress management can all be used as adjuncts to help with control of tension headaches.

It is important to remember that OTC medications, while generally recognized as safe, are medications and may have side-effects and potential interactions with prescription medications. It always is wise to ask your health care practitioner or pharmacist if you have questions about OTC medications and their use. This is especially important with OTC pain medications, because patients use them so frequently.

It is important to read the listing of ingredients in OTC pain medications. Often an OTC medication is a combination of ingredients, and the second or third ingredient may have the potential for drug interaction or contraindication with medications a patient is currently taking. For example:

Some OTC medications include caffeine, which may trigger rapid heartbeats in some patients.

In night time preparations, diphenhydramine (Benadryl) may be added. This may cause drowsiness, and driving or using heavy machinery may not be appropriate when taking the medication.

Other examples where caution should be used include the following:

Aspirin should not be used in children and teenagers because of the risk of Reye's Syndrome, a disease where coma, brain damage, and death can occur if there is a viral like illness when the and aspirin is  used.

Aspirin and ibuprofen are irritating to the stomach and may cause bleeding. They should be used with caution in patients who have peptic ulcer disease or who take blood thinners like warfarin (Coumadin) and clopidogrel bisulfate (Plavix).

Acetaminophen, if used in large amounts, can cause liver damage or failure. It should be used with caution in patients who drink significant amounts of alcohol or who have liver disease.

One cause of chronic tension headaches is overuse of medications for pain. When pain medications are used for a prolonged period of time, headaches can recur as the effects of the medication wear off. Thus, the headache becomes a symptom of the withdrawal of medication (rebound headache).

Medicines Two Choices for You

Medical treatment for Migraine Headaches 

Many medications are available to treat migraines.  Ask your doctor or pharmacist about these, as having an understanding of what to expect is warranted before starting any medication. 

Symptomatic relief: Symptomatic relief medications are used to relieve symptoms associated with headaches, including the pain of a headache or the nausea and vomiting associated with migraine.

Over-the-counter medications are effective for some people with migraines. The main ingredients in pain-relieving medications are ibuprofen, aspirin, acetaminophen, naproxen, and caffeine. Be cautious when taking over-the-counter pain-relieving medications, because sometimes they can contribute to a headache, or their overuse can cause analgesic-rebound headaches or a dependency problem. If you are taking any over-the-counter pain medications more than three times a week or daily, it’s time to see your health care provider, who can suggest prescription medications that may be more effective.

Anti-nauseants are often needed to relieve nausea that accompanies migraines.

Abortive medications are most effective when used at the first sign of a migraine to stop the process that causes the headache pain. By stopping the headache process, abortive medications help prevent the symptoms of migraines including pain, nausea, light-sensitivity, etc. Abortive medications work by constricting the blood vessels, bringing them back to normal and relieving the throbbing pain.

Preventive (prophylactic) medications may be prescribed when the headaches are severe, occur more than two or three times a month and are significantly interfering with normal activities. Preventive medications reduce the frequency and severity of the headaches and are generally taken on a regular, daily basis.

All of these treatments should be used under the direction of a headache specialist or physician familiar with migraine therapy. As with any medication, it is important to carefully follow the label instructions and your physician’s advice.


Biofeedback training can also help. People can learn to recognize stressful situations that trigger migraines so they can learn to control these situations. If the migraine begins slowly, many people can use biofeedback to stop the attack before it becomes full blown.

Medicines Two Choices for You

Medical Treatment for Cluster Headaches

There's no cure for cluster headaches from a medical perspective. The goal of treatment is to decrease the severity of pain, shorten the headache period and prevent the attacks.  And this will be ongoing for, possibly, the rest of your life.

Because the pain of a cluster headache comes on suddenly and may subside within a short time, cluster headache can be difficult to evaluate and treat, as it requires fast-acting medications.

Some types of acute medication can provide some pain relief quickly. Based on the latest studies, the therapies listed below have proved to be most effective for acute and preventive treatment of cluster headache.

Acute treatments

Fast-acting treatments available from your doctor include:

Oxygen. Briefly inhaling 100 percent oxygen through a mask at a minimum rate of at least 12 liters a minute provides dramatic relief for most who use it. The effects of this safe, inexpensive procedure can be felt within 15 minutes.

The major drawback of oxygen is the need to carry an oxygen cylinder and regulator with you, which can make the treatment inconvenient and inaccessible at times. Small, portable units are available, but some people still find them impractical.

Triptans. The injectable form of sumatriptan (Imitrex), which is commonly used to treat migraine, is also an effective treatment for acute cluster headache.

The first injection may be given while under medical observation. Some people may benefit from using sumatriptan in nasal spray form, but for most people this isn't as effective as an injection and it may take longer to work. Sumatriptan isn't recommended if you have uncontrolled high blood pressure or heart disease.

Another triptan medication, zolmitriptan (Zomig), can be taken in nasal spray or tablet form for relief of cluster headache. This medication may be an option if you can't tolerate other forms of fast-acting treatments.

Octreotide. Octreotide (Sandostatin), an injectable synthetic version of the brain hormone somatostatin, is an effective treatment for cluster headache.

Local anesthetics. The numbing effect of local anesthetics, such as lidocaine (Xylocaine), may be effective against cluster headache pain in some people when given through the nose (intranasal).

Dihydroergotamine. The intravenous form of dihydroergotamine (D.H.E. 45) may be an effective pain reliever for some people with cluster headache. This medication is also available in an inhaled (intranasal) form called Migranal, but this form hasn't been proved to be effective.

To have the medication administered through a vein (intravenously), you'll need to go to a hospital or doctor's office to have the medication administered through a vein (intravenously).


Dr. Huntoon's Alternative Medical Treatment Options

Alternative treatment for Tension Headaches 

Many Alternative Healthcare Practitioners such as a Holistic Chiropractor, Acupuncturist, Homeopath or Naturopath have had great success in treating headaches. Holistic Chiropractors look to understand the cause of your headaches by determining where you have nerve pressure and nerve interference related to the nerves that cause headaches.  Addressing the underlying reason for the nerve pressure (Subluxation) is the specialty of a Chiropractor.  This form of care is the best initial form of treatment and most times, no other treatment is necessary.

Alternative treatment for Migraine Headaches

Many Alternative Healthcare Practitioners such as a Holistic Chiropractor, Acupuncturist, Homeopath or Naturopath have had great success in treating headaches. Holistic Chiropractors look to understand the cause of your headaches by determining where you have nerve pressure and nerve interference related to the nerves that cause headaches.  Addressing the underlying reason for the nerve pressure (Subluxation) is the specialty of a Chiropractor.  This form of care is the best initial form of treatment and most times, no other treatment is necessary.

Working with an Acupuncturist, Homeopath or Naturopath is also warranted before seeking medication from your medical doctor. 

As with all medication, be aware of side-effects and complications associated with taking the medication. 

Alternative treatment for Cluster Headaches

Because cluster headaches can be so painful, you may be tempted to try alternative or complementary therapies to relieve your pain.

A survey of people with cluster headache who tried a number of alternative therapies — including acupuncture, acupressure, therapeutic touch, chiropractic and homeopathy — found these therapies effective.

Some natural medicines may be worth a try. In one study, extract from kudzu, a vine species originally found in Asian countries, was shown to alleviate the intensity, frequency and duration of cluster headache attacks. However, kudzu extract didn't decrease the length of the cluster cycle.

Melatonin also has shown modest effectiveness in treating nighttime attacks.

Coping and support

Living with cluster headache can be very difficult. Cluster headaches can be frightening to you and to your family and friends. The debilitating attacks may seem unbearable.

In addition to the physical symptoms, the chronic pain that often accompanies cluster headache attacks can make you anxious or depressed. Ultimately, it may affect your interaction with friends and family, your productivity at work, and the overall quality of your life.

Talking to a counselor or therapist can help you cope with the effects of cluster headache. Or you may find encouragement and understanding in a headache support group. Although support groups aren't for everyone, they can be good sources of information.

You may also find support groups are a good place for you to share your experiences and hear other group members' experiences. If you're interested, your doctor may be able to recommend a group in your area.

Medicines Two Choices for You

What to discuss with your doctor

Your doctor will likely ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on later. Your doctor may ask:

When did you begin experiencing symptoms?

Have your symptoms been continuous or occasional?

Do your symptoms tend to occur at the same time of day? Do they occur during the same season each year?

Does alcohol appear to cause your symptoms?

How severe are your symptoms?

What, if anything, seems to improve your symptoms?

What, if anything, appears to worsen your symptoms?

Prevention and Quick Tips

How Can Tension Headaches be prevented

Working with a Holistic Chiropractor who can address all the underlying causes of your tension headaches is warranted.  Developing a well-rounded, multifaceted approach is the best way to support the person who experiences tension headaches.  Removing any nerve pressure related to the tension headaches is the best form of care to help address the cause of the tension headaches.

How can migraines be prevented?

Working with a Holistic Chiropractor who can address all the underlying causes of your migraine headaches is warranted.  Developing a well-rounded, multifaceted approach is the best way to support the person who experiences migraine headaches.  Removing any nerve pressure related to the migraine headaches is the best form of care to help address the cause of the migraine headaches. 

Identifying and then avoiding migraine triggers should reduce the frequency of your migraine attacks. 

Recalling what was eaten prior to an attack may help you identify chemical triggers and make the necessary dietary changes to avoid these triggers in the future.  

Women who get migraines during their menstrual periods typically find relief during pregnancy and after menopause. Hormonal treatment of migraines has not been satisfactory, however. Generally, becoming aware of the menstrual cycle patterns as they relate to the onset of the headaches can help you take preventive action against the headaches. 

Stress management and coping techniques, along with relaxation training, can help prevent or reduce the severity of the migraine attacks. 

Migraine sufferers also seem to have fewer attacks when they eat on a regular schedule and get adequate rest. 

Regular exercise—in moderation—can also help prevent migraines.

How can cluster headaches be prevented?

Working with a Holistic Chiropractor who can help you understand your triggers and how to release those from your life is important.  Developing a plan for your specific life-style and triggers so you can avoid and overcome them is vital to resolving this uncomfortable and debilitating condition.

In addition, you may help reduce your risk of future attacks by avoiding alcohol and nicotine, which often cause cluster headaches.

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