August 28th, 2012
Did you know there are approximately 200 kinds of headaches? The International Headache Society has listed them all but, to make it a bit easier, they have also broken them down into three main categories: Primary, Secondary and Cranial Neuralgia/Primary Facial Pain/Other. Learn about which ones can be helped by massage therapy and which may need a different kind of intervention.
By Linda Fehrs, LMT
When you have a headache, do you really care what type you have. All you know is that it hurts and you want relief. If you really want relief though, it may be worth the time and effort to take the time and find out just what is causing it and what the best remedy may be. What helps to ease the pain of one headache could actually make another one worse. Relief for headaches also differs from one person to another, so knowing yourself and your habits will also help to reduce the frequency of, or get rid of completely, those nasty headaches.
The International Headache Society has created a kind of dictionary of headaches, which includes approximately 200 types of headache disorders. For example, a migraine is broken down into six varieties, with each one of those broken down further into several causes or types. There can be a migraine without aura, a migraine with aura, a retinal migraine and so on.
To make things a bit easier for the consumer, they have taken those 200 or so headaches and classified them into three broad types: Primary, Secondary and Cranial Neuralgia/Primary Facial Pain/Other. In the United States, the National Institute of Neurological Disorders and Stroke (part of the National Institutes of Health) have simplified it even further into Primary and Secondary headaches, bringing together the neuralgia and facial headaches into one or the other.
Primary Headache Pain
Primary headache disorders consist of four main groups: migraine, tension, trigeminal autonomic cephalgia and miscellaneous. They occur independently and are not caused by any other medical condition. They come about because of various events occurring in blood vessels, nerves and muscles, but not because of disease or injury. The most familiar primary headaches are migraine, cluster and tension.
Secondary Headache Pain
Secondary headaches are actually symptoms of some other underlying disorder or disease. These disorders can press or push on nerve endings causing pain. Secondary headaches can be caused by such ailments as high blood pressure, head injury, stroke, tumors, nerve disorders and even psychiatric problems.
Cranial Neuralgia/Primary Facial Pain/Other
The third category, Cranial Neuralgia/Primary Facial Pain/Other, is a category recognized by the International Headache Society but not the National Institutes of Health. The National Institutes of Health puts these types of headaches mostly in the Primary Headaches category. The causes of these headaches are often unknown and affect the trigeminal nerve (CN-V) or other nerves which affect the face and head including the glossopharyngeal nerve (CN-XII). The headache pain can also be caused by a cold temperature stimulus (eating icy cold foods or being in extremely cold weather). Neuraligia is nerve pain occurring without stimulation of nociceptor (pain receptor) cells. It is, instead, produced by changes in neurological structure or function.
Massage for Headaches
Massage therapy in and of itself is not a cure for headaches. It can, however, help to reduce their occurrence, their frequency and their intensity. Determining what type of headache a person has is the first step in deciding what massage techniques can be used. This needs to be diagnosed by a doctor. The client who says he or she had been having migraines for years, may actually have deep sinus headaches or trigeminal nerve pain. Many individuals who experience regular headaches do not tell the doctor about them and self medicate based on what they have read or what friends tell them. Symptoms can often be similar among sufferers of varying types of headaches. Always make sure the client has a definitive diagnosis before proceeding with massage designed to alleviate headache pain.
Three Types of Headaches Massage May Help Ease
- Tension Headaches – It is estimated that tension headaches are experienced by as many as 90 percent of the population. A person will usually feel it on both sides of the head as a kind of pressing or tight sensation. There is no one cause, though it can be aggravated by stress – and massage therapy is well-known for relieving stress. Whether it be Shiatsu or Swedish massage, just about any slow movement techniques can help to reduce stress. Stay away from deep tissue or invigorating strokes.
- Migraines – Migraines are the second most reported primary headache. Approximately 12 percent of the U.S. population experience them, and they are the 19th most debilitating disease worldwide. About 18 percent of adult women experience them, compared to only about 6 percent of men. A migraine can last just a few hours or as long as three days, and can range from moderate to severe. If a person tells you he or she has a migraine and are out and about, functioning fairly well – the individual most likely does not have a true migraine. A migraine will usually incapacitate anyone who has one. Someone with a true migraine will most likely not want a massage at the time it is happening, but having a regular therapeutic massage may help reduce the frequency, duration and intensity of them over a period of time. A light touch Swedish massage once a week would be ideal, but even every other week or once a month can help. Cranial-sacral work, various Asian techniques and polarity therapy has also been found to help.
- Secondary headaches include a wise range of causes. Because the reasons are so varied, no one type of massage can be recommended. For these headaches, some basic knowledge of pathology is needed as well as a thorough understanding of contraindications and more than just a nodding acquaintance with pharmacology. A secondary headache can be caused by injury – such as head trauma. It can also be caused by infection, high fevers, dental problems, alcohol or drug withdrawal, caffeine (caffeine can be a cause or cure for headaches – if you drink a lot of coffee or caffeinated beverages, suddenly stopping can cause a headache whose cure is to drink more of them!), concussions, overuse or misuse of prescription medication, strokes, cerebral aneurisms and sinus infections – just to name a few. To determine which type of massage might be beneficial, look first to the root cause. A massage technique that may help a sinus headache may be contraindicated for someone with a headache cause by a concussion.
If a client comes to you complaining of persistent headaches, remember to do a thorough intake. You may even want to include a special section on your intake form for headaches. It will give you an indication of the cause as well as the technique that is safe to use and offer the greatest benefit. If the client says he or she has a certain type of headache, such as migraine, make sure you get an accurate diagnosis from a qualified physician.
If the cause is unknown and severe, or the client is experiencing pain on one side along with any numbness, slurring of speech, sudden vision problems or other signs of possible stroke – call 911.
“Headache: Hope Through Research.” National Institute of Neurological Disorders and Stroke, 01/03/2012. Web. 17 Jul 2012. http://www.ninds.nih.gov/disorders/headache/detail-headache.htm.
“IHS Classification ICHD-II.” International Headache Society, 2003. Web. 17 Jul 2012. http://ihs-classification.org/en/01_einleitung/02_einleitung/.
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