There are five main types of headaches: migraine, tension, cluster, medication overuse and hormonal. Each type of headache has different causes, triggers and symptoms but none should be ignored or masked with pain medication on a regular basis. Chiropractors can help find the underlying causes of headaches and provide treatments to help alleviate them.
How do you define a migraine, and what are some common triggers?
Dr. Gregg Rubinstein: All right, we’re starting off light, I like it. Typically, the pain of a migraine is usually more severe than a regular headache. They typically include things like people describe throbbing on one side of the head that frequently gets worse with activity. And unlike some of the other headaches and other symptoms, you tend to see nausea, vomiting, sometimes vision difficulties, like flashing lights, blurry vision, light or sound sensitivity, even tingling along the head and some sensations that often accompany a migraine. So, those are the main things that differentiate those migraine headaches. They’re going to see more neurologic, more nausea, and more vision stuff, and they’ll usually complain that it’s very severe and throbbing.
And you were asking about some of the common triggers. One of the big ones, believe it or not, is poor hydration. They say kids might need eight ounces of water every day. Every kid’s a little bit different, but those healthy fluids, water, juice and anything like that is going to help keep them hydrated. But sometimes drinking these caffeinated or sugary beverages, they’re not healthy, and it makes it even more difficult to control kids’ headaches as well.
Another big trigger for a lot of folks is lack of sleep or poor sleep habits. Having a regular sleep routine is really important, to establish a good eight hours of sleep somewhere in that area. That can vary due to age, kids who snore excessively or can be restless during sleep. Those are things that can also trigger to it. So, if you have kids with poor sleeping habits and they’re complaining of headaches, that might be something you want to look into.
There’s a bunch of food triggers also: caffeine, chocolate, nuts, sometimes aged cheeses, cheeses, nitrates in meats, things like in hot dogs and bacon and stuff like that. So those things, sometimes they use elimination diets to find things out. Excess salt, artificial sweeteners, a lot of people look to those triggers for migraines. Skipping meals, especially breakfast, and we know kids are sometimes big meal skippers.
And then stress, overcrowding your schedule or a child’s schedule, those signs of distress will start to accumulate and really contribute to the headaches or migraines more commonly.
Are tension headaches the most common type of headache? And what are some causes?
Dr. Gregg Rubinstein: It’s definitely a common type of headache. We see a lot of them in New York City, I guess because people are stressed out, but stress is pretty common everywhere, and stress is a major contributory factor to headaches.
Tension headaches usually feels like a steady headache. It’s in the head, sometimes in the neck or scalp. They’re often associated with muscle tension, stress. And it can occur at any age. You’ll see them more in adults and teens. And then as we go into full-on adulthood, the more stress we have, common triggers will include those tension headaches like stress, depression, anxiety, hunger, lack of sleep. So, not too far off the other types of headaches, but definitely a different presentation with the tension headaches. Yeah, I would say they’re probably the most common. We certainly see a lot of them, and they all respond super well to chiropractic care.
What makes cluster headaches so painful, and why are they so different than other types of headaches?
Dr. Gregg Rubinstein: They’re a little bit more rare. It’s one of the more uncommon types of headaches. It typically has one-sided head pain, which may involve pain behind the eyes. Sometimes you’ll even see a tearing of the eyes, a droopy eyelid, stuffy nose. And these attacks with these cluster headaches can last anywhere from 15 minutes to three hours. Sometimes they can occur daily, and almost for weeks or months. So, when someone’s in pattern with cluster headaches, it’s a real problem, because sleep doesn’t really alleviate the cluster headaches.
Men are more likely to have cluster headaches than women, and most people who develop these cluster headaches are usually a little bit older. We don’t see them too much in kids, more between the ages of 20 and 50. They can start at any age, but it’s much more common as they’re a little bit older. And yeah, they’re just a little bit more rare, a little bit less studied. So, the ideology in the common occurrence, you don’t see it as much, so they definitely tend to be a little bit more of an enigma. People suffer a little bit longer and it can take a while for people to figure that out.
Can you explain the connection between hormones and headaches for women?
Dr. Gregg Rubinstein: Absolutely. And hormones and headaches can occur in men as well, but the one you’re specifically referring to, which is a headache that can be triggered at any time, usually related to a fluctuation of estrogen levels, including when there’s a dip in estrogen around the time of your menstrual cycle.
Women may also experience more headaches at the start of menopause, or when they undergo a hysterectomy, because then those hormonal levels change. Pre-pubescent girls and boys both get headaches at the same rate. However, they occur a little bit more in girls once they reach puberty, then their menstrual cycle begins. And they can tend to level off sometimes after menopause.
A woman’s cycle is going to fluctuate, and those estrogen levels are going to go up and down. And that’s typically what causes those types of hormonal headaches that we see, and more common in women, especially around menstrual cycle days.
What is a medication overuse headache, and is a rebound headache the same thing?
Dr. Gregg Rubinstein: The medication overuse I just think is because medicine’s so expensive now you get a headache paying for it. But the reality is rebound headaches and medication overuse headaches, they do kind of get lumped into the same thing. An overuse of over-counter medications like Tylenol, Motrin, Excedrin, and Ibuprofen, all those things, you really got to limit the use of those medications to no more than three doses per week to reduce the risk of what they call those rebound headaches.
But what’s interesting is when people are taking all these medications, you’re really only covering up the symptoms, because headaches aren’t really a deficiency of Tylenol or Motrin or Excedrin or anything like that, right? There’s something else going on. And I’m not going to say that these medications don’t have an effect. You certainly are going to feel better for a little while. But as we’ve talked about before is when you take medications to cover up symptoms, that’s basically like if your house is on fire and the smoke alarm goes off, you can pull the battery out of the smoke alarm and I don’t hear that blaring noise, but the house is still on fire. So, it’s really important to make sure that you get yourself checked or your kids checked, and not end up just putting them on all these medications.
I can’t tell you how many times I sit in an interview with someone and they’re like, “Oh yeah, I just have the regular headaches.” And I’ve never heard of a regular headache. Maybe that’s common for them, but I wouldn’t call it regular. And they’re like, “Oh yeah, the Tylenol takes care of it.” And I literally say to them, “So, you think you have a Tylenol deficiency, and that’s why you’re getting the headaches?”
Look, these medications, although they’re over-the-counter, there are significant side effects to taking these medications for long periods of time. You take aspirin, it’s going to rip up your stomach; you take the NSAIDs, it’s going to affect the kidney and liver. So, it’s important to make sure that we’re not popping these Tylenol and medicines like candy. I’m not saying that they don’t work, but it’s no way to live and it’s going to cause rebound issues and problems later on in life.
RC: All right, thank you, Dr. Rubinstein. We know you’re busy, so I just want to thank you today for all of your time and help.
Dr. Gregg Rubinstein: Liz, I really appreciate that. And the one thing that’s interesting about all these different types of headaches is that most of them do respond to chiropractic care. Getting some of the pressure off the nerves, and rebalancing the hormones, and allowing the body to run, regulate naturally is really an important way to keep the body free from the interference that causes those headaches, and making sure that people aren’t staying on these medications for the rest of their lives. So, there’s really a lot of other options out there other than medication, chiropractic being one of my favorites, but I might be a little biased.
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To speak with Dr. Gregg Rubinstein, visit www.ChiropractorMidtown.com or call (212) 977-7094 to schedule an appointment.
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