Tension headache? Migraine? Cervicogenic headache?

By Dr Jenny Johnson – CC’s Staff

Tension headache? Migraine? Cervicogenic headache?

A splitting headache is awful no matter what you call it, but how do you know when it is “just” a bad headache or a true migraine?  There are a few diagnostic criteria in place that we use to help tell them apart. 

Migraine without aura: 

At least 5 attacks fulfilling the following 4 criteria:

• Headache lasting 4-72 hours (when untreated)
• Headache has at least TWO of the following
  • Unilateral (one sided)
  • Pulsating quality
  • Moderate or severe pain intensity
  • Aggravation by or causing avoidance of routine physical activity
• During the headache, at least one of the following
  • Nausea and/or vomiting
  • Sensitivity to light AND sensitivity to sound
• Not attributed to another disorder 

Migraine with aura: 

• At least TWO attacks fulfilling criteria B AND C
• One or more of the following fully reversible aura symptoms
  • Visual (lines, shapes)
  • Sensory (pins and needles or numbness in one area of face or tongue)
  • Speech and/or language
  • Motor (weakness)
  • Brainstem (vertigo, double vision, slurred speech, ringing in ears)
  • Retinal (flashes of light, blind spots, vision changes)
• At least TWO of the following 4 characteristics:
  • At least one aura symptom spreads gradually over 5 minutes, and/or two or more symptoms occur in succession
  • Each individual aura symptom lasts 5-60 minutes
  • At least one aura symptom is unilateral (one-sided)
  • The aura is accompanied, or followed within 60 minutes, by a headache

Tension Headache: 

• Headache lasting from 30 minus to 7 days
• Headache has at least TWO of the following:
  • Bilateral location
  • Pressing/tightening (non-pulsating) quality
  • Mild or moderate intensity
  • NOT aggravated by routine physical activity
• BOTH of the following
  • NO nausea or vomiting
  • NO more than one of light or sound sensitivity 

Cervicogenic Headache: 

• Pain localized to the neck and occiput (base of back of head), which can spread to other areas of the head, usually unilateral (one-sided)
• Pain is precipitated or aggravated by specific neck movements or sustained postures
• At least ONE of the following
  • Limited neck range of motion
  • Changes in neck muscle tone, or response to active/passive stretching and contraction
  • Abnormal tenderness of neck musculature

No matter what type of headaches you are experiencing, we are here to help you make a plan to get rid of them.  Treatment can include joint manipulations and soft tissue work, posture retraining, exercises you can do at home, as well as individualized plans to help manage any lifestyle factors to prevent those headaches or migraines from returning. Many times we include stress management, hydration or diet recommendations, and/or sleep hygiene and these make a huge difference.

Get more information on our treatment options here, and get in touch with a local dietitian we know and trust for recommendations on nutrition that suits you!