A headache is a pain or discomfort experienced in the head, scalp, or neck. It can range from a mild, dull ache to severe, debilitating pain. It may occur as a primary condition or symptom of an underlying issue. There are generally two types:

Primary Headaches:

An underlying condition does not cause these headaches and include:

– Tension Headaches: Result from muscle tension in the head, neck, or shoulders

– Cluster Headaches are Characterized by severe, piercing pain, typically around one eye, that often occurs in cyclical patterns or clusters

– Exertional Headaches: Triggered by physical activity

– Migraine: Marked by intense, throbbing pain (often on one side of the head), accompanied by symptoms such as nausea, vomiting, and sensitivity to light or sound

Secondary Headaches:

An underlying medical condition causes these headaches and include:

– Cervicogenic Headache: Pain originating from the neck, such as poor posture or cervical arthritis

– Medication Overuse Headache: This occurs due to the frequent use of pain-relief medications

– Head Injury: Trauma to the head can lead to persistent headaches

– Dehydration: Insufficient fluid intake often results in dull and throbbing pain

– Eye Strain: Prolonged screen time or uncorrected vision problems can cause discomfort

– Trigeminal Neuralgia: Intense, stabbing facial pain, often mistaken for a headache

– Lifestyle Factors: Sleep problems, stress, and anxiety

Assessment and Diagnosis:

To effectively manage headaches, a thorough evaluation is crucial for identifying the underlying cause. This includes the following components:

• Comprehensive history and assessment
• Investigation: MRI, X-ray, CT scan
• Follow-up for the personalised multimodal management plan
• Review of the agreed-tailored pathway outcomes

Multimodal Treatment:

The underlying cause determines treatment and may include:

• Initiation of oral analgesics
• Physiotherapy, massage, acupuncture
• Relaxation techniques such as deep breathing, meditation, or yoga
• Cognitive Behavioural Therapy (CBT) for stress or anxiety
• Injections to the occipital nerves
• Trigger point injections with local anaesthetic and steroids
• Botox injections to the forehead, temples, neck, and shoulders
• Spinal injections to the medial branches of the cervical facet joints
• Radiofrequency denervation or ablation of the medial branches of the cervical facet joints

Surgical consultation, if necessary