Understanding Headaches with Principal Osteopath Chantal Prince

Chantal Prince, principal osteopath at ESO has completed a new training studying the classification of headaches. Equipped with deeper knowledge regarding the diagnosis, treatment and prognosis, Chantal can now better advise and help our patients living with the symptoms of headaches. 
Below we examine the key differences with headache symptoms so you’ll know when to discuss with your GP. Symptoms are categorised into primary (pain caused directly by headache) and secondary (pain caused by underlying illness) headaches. 

Common primary headaches

  • Migraine – can be a throbbing pain on either one or both sides of the head, with or without an aura (squiggly lights in your vision or change of your visual field). Last between five minutes and a few hours leaving the patient wiped out the next day. Frequency can be five attacks occurring fewer than fifteen days a month. 
  • Tension type headaches – a mild to moderate tightening pressure on both sides of the forehead, can last from thirty minutes up to seven days, frequency can be once a month over the course of a year. 
  • Trigeminal autonomic cephalalgies (cluster headaches) – severe eye or forehead pain, on one side of the head. Can cause eye redness, runny eye and nose, forehead flushing and agitation during an attack. These can last between 15 – 180 minutes, from once to eight times day. 

The following are examples of Red Flags – symptoms a healthcare professional scans for which may require further intervention

  • Pain worse in the morning or evening
  • Pain worse on exercise or straining 
  • Sudden onset of intense pain
  • Over 50 years of age 
  • Previous history of head trauma 
  • Any unusual symptoms associated with the headache such as weight loss, fever
  • Associated focal neurological deficit – such as numbness in an arm or leg, dizziness, slurred speech
  • The pain does not respond to any treatment 
  • If you describe your headache as: ‘Not like any other headache I have ever experienced before’ 
The chances of having a serious secondary cause of headache is rare. However, it’s important for a qualified practitioner to ask the relevant questioning to make sure you get the correct treatment to help your recovery. These red flags alone do not diagnose a more serious secondary headache, but coupled with a well trained healthcare professional, thorough case history, clinical examination and clinical tests, this will help keep you safe. 
If you would like to read more about this, please visit the 3rd International Classification of Headaches Disorders (ICHD-3) website here.
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