Headaches and Migraines

Headaches and migraines are one of the main reasons people come to my office for care. They range from a dull nagging ache to pain that is so severe you wish you could die to end the pain. It is especially rewarding to me when I see patients return to normal lives after suffering for years with these conditions.

Many of those entering my office have already been to their family doctor and several specialists. While the medications may offer some relief, the headaches continue to disrupt their lives or they see no long term improvement. Many are concerned about the side affects of the drugs they are taking, especially with the current news about the safety of many of the drugs on the market.

Chiropractic has a great record of successful treatment of headaches and migraines for over 100 years. If you or someone you know suffers headaches, consider getting an examination by Dr. Wray to discover if you may become our next success story.

The following is a brief overview of some of the information available regarding headaches and is not meant to be a complete discussion of the topic. I firmly believe that people can only make proper decisions about their health when they have as much information as possible.

What CAUSES Headache Pain?

While the specific causes may vary depending upon the type of headache, this is what generally happens:

1. Nerve roots are sensitive and are stimulated by unusual postures, physical stress, trauma, &/or other triggers of headache pain.

2. This pain message is changed to an electrical impulse which also results in the release of certain chemicals in the body. These chemicals may also result in headache pain and other symptoms.

3. This impulse travels along nerve cells to the spinal cord and brain.

4. The brain interprets the pain message and responds with muscle spasm, headache pain, dilated blood vessels and other sensations such as physical/mental or emotional sensations.

What Kind of Headache do You Have?

There are over 100 different headache classifications. However, the main portion of this article will deal with the four most common types of headaches: tension, migraine, sinus and cluster headaches. I will also briefly discuss a few of the other types of headaches that you may research on your own if they pertain to your specific headache.


This is the most common type of headache. Although they are sometimes noticed during times of stress, most experience headache pain even when there is no or little stress present.

They happen when nerve roots and other soft tissues in the neck &/or upper back are irritated, swollen and/or inflamed.

Chronic tension headaches may be set off by many factors, some of the most common being bending the neck forward doing paperwork or working on the computer for extended lengths of time, unusual neck postures (especially forward head posture covered later in this article), jolting of the head and neck, old traumas to the neck such as whiplash type injuries, alcohol  mental stress and/or emotional stress.

Tension headaches are often described as a dull, steady ache or pressure or a band around the head, often occurring on both sides of the head, the forehead and often extending bandlike to the rear of the head. It is common for the neck and shoulders to ache and there may be stiffness of the neck or a feeling of heavy headedness. The pain is usually mild to moderate, but may be severe in some cases. It may be accompanied by mild sensitivity to light or noise, but seldom both.

The frequency of tension type headaches is most commonly rated as occasional to frequent lasting up to several hours.


Migraines are often classed under vascular type headaches with the two most common being migraine and cluster headaches. There are numerous subclassifications of migraines and it is beyond the scope of this brief article so I will give a general overview.

The pain of migraine is often one-sided and may spread to other areas of the head as it progresses. However, just because the headache is not just one-sided does not mean it is not a migraine.

Pain from a migraine is usually moderate to severe and may be throbbing in nature. It is important for family and friends to understand that the pain from a severe migraine may be worse than the pain that results from a major fracture of a bone. It is often accompanied by nausea or vomiting and sensitivity to light, noise, or movement.

Approximately 10% of migraine sufferers experience a prodrome which consists of various symptoms that precede the migraine. They may see flashes of light, blind spots, or zigzag lines, feel tired, etc.

Some of the possible triggers of migraines include alcohol (especially red wine and dark beer), allergies, stimulation (including bright or flashing lights and strong odors), exercise, hormonal changes (that occur during menstruation, pregnancy or menopause, or when using oral contraceptives),  additives and foods, notably aged cheese, chocolate, pickled or fermented food,  aspartame, monosodium glutamate/MSG (found in soy sauce, meat tenderizer and many processed foods), hot dogs and other foods containing nitrites, cold foods such as ice cream, caffeine (coffee, tea and soda), and even hunger due to low blood sugar.

Other possible migraine triggers include irregular eating or sleeping patterns, medications—especially nitroglycerin, hydralazine, reserpine and asthma medicine—stress or weather changes.


This form of vascular headache occurs approximately 9 times more common in men than in women. Most often it is located behind one eye or one temple. It is described as severe or excruciating, a sharp/stabbing type pain. It is often accompanied by a watery eye, drooping eyelid or runny nose, all on the affected side.

Cluster headaches may occur several times a day for several weeks or months, usually lasting 30 to 60 minutes. I have had patients who have had 15-20 cluster headaches a day. They may last for several weeks or months and then disappear for months or years.

Triggers are basically the same as with migraines, but beverages containing even a small amount of alcohol may be enough to trigger an attack. Also, attacks often occur during periods of rest or sleep.


Sinus headaches may occur on one or both sides of the forehead and/or one or both cheek bones. The pain may be mild to severe and is described as a dull ache or pressure. It is often accompanied by fever, watery eyes, green or yellow discharge, cough sore throat, or tenderness under the eyes. They are often worse in the mornings. The may occur once or more a day and last of a week to several months.


Below I have briefly described a few of the other forms of headaches. Again, this is not an all inclusive list, but it may assist you in looking for other causes of your headaches.

Analgesic Rebound Headaches:

Continued use and often increasing usage of analgesics (pain relieving medications) may result in what is termed a rebound headache. When you look at the possible side effects of almost all headache medications (prescription and over the counter), they list headaches as one of the possible side effects. In some patients I have found that when the patient discontinues taking the drugs, the headaches improve considerably or go away. This is understandably a scary thought for someone suffering from recurring headaches, but it is definitely something that must be considered if you are taking pain pills on a regular basis.

Note: do not stop taking prescription medications without discussing this with your family doctor as some medications must be withdrawn slowly or you may have serious consequences.

Arthritis Headaches:

The location of the headache from arthritis is usually located in the back of the head and comes from the neck and spine. This form of headache usually responds very favorably to chiropractic adjustments, therapy and exercises directed at improving the range of motion of the spinal joints and strength of the cervical and upper back muscles.

Caffeine Withdrawal Headaches:

The body can become dependent on caffeine and if you reduce or stop the intake of caffeine you may experience generalized head pain that is of moderate to severe intensity, irritability, nausea, depression and other side effects. As your body adapts to the decrease in caffeine, the headaches and other symptoms should improve as long as there is nothing else contributing to your headaches.

Coexisting Headaches:

Some people experience an intertwining of tension and migraine headaches that makes it very difficult to tell what is going on. Many of these people use analgesics or ergotamine products and have a tendency to overuse these. Ineffective medication issues must be discussed up front.

Depression and Headaches:

This form of headache is generally similar to tension type headaches. Does depression cause the headache or does the headache cause depression? It probably works both ways. While many of my patients with this condition respond very favorably under chiropractic care, it may be necessary to work with your family doctor, and in severe cases a psychologist or psychiatrist, to get these headaches under control.

Environmental Headaches:

Numerous environmental issues may contribute to headaches including: odors, chemicals, “sick building syndrome,” etc. These are often difficult to discover and may take extensive research on the part of the patient and the doctor to find the cause.

Eyestrain Headaches:

Usually described as a dull ache in the front of the head and behind the eyes. It may be accompanied by tired, burning, itchy eyes, sore neck, or blurred or double vision. Watching when your headache occurs helps determine if this may be what is causing your headache. Get your eyes examined and obtain a proper prescription if needed and pay special attention to workstation ergonomics and lighting.

Exertional Headaches:

Usually a sharp pain of short duration after some type of physical exertion. Dilation of the blood vessels during exertion may cause headache pain. There may be an impairment of blood flow to the brain and in some rare cases exertional headache may be a symptom of ischemic heart disease. Therefore, if you experience exertional headache I recommend discussing this with your physician as additional testing may be indicated.

Giant Cell Arteritis (Old Term—Temporal Arteritis):

This is usually described as a dull, throbbing pain at one or both sides of the forehead. Fever is often present, jaw pain, loss of appetite, tenderness of the temples, and sometimes blurring or loss of vision. It usually occurs in people over the age of 55. This is a serious condition and requires prompt medical attention. If left untreated it can lead to vision loss.

Glaucoma Headache:

It is a mild to severe throbbing pain behind the eye or in the    forehead. Blind spots, slurred vision or progressively decreasing peripheral vision may occur as well as nausea or vomiting. Everyone should be tested regularly for glaucoma, but if you the above symptoms it is important to be tested as further vision loss can be prevented with appropriate treatment.

Hangover Headache:

As far as I am concerned, enough said.

Hormonal/Menstrual Headache:

This form of migraine may occur during menstruation or during ovulation. Usually a throbbing pain on one or both sides of the head with pain that is severe enough to disrupt normal routine. Nausea, vomiting, sensitivity to light and sound, visual, olfactory (smell) or other sensory disturbances may occur. For many women, determining the food triggers and avoiding these (particularly just before the time of your cycle when headaches usually occur) may help prevent the headaches.

Hypoglycemic Headache:

A generalized headache with other symptoms that may vary from person to person which may include: irritability, dizziness, confusion, anxiety, tremors, cold sweats and cravings for sweets. The diagnosis of this condition is made with simple blood tests and the treatment can be as simple as modifying your diet or you may need medication if it is more advanced. I have found that many of my patients improve with modifying their diets and adding a nutritional product called Carb-Aid to their daily routine.

MSG/Monosodium Glutamate Headache:

Eating foods containing MSG may trigger a migraine type of headache. It can be accompanied by muscle tightness, numbness or tingling, general weakness and/or flushing. Analgesics and other medications can be used to treat it. Avoiding MSG should be avoided as much as possible. However, this is difficult as it is in so many products: It is used in Chinese restaurants, canned soups, soy extract, processed meat, spices and seasonings, frozen dinners, dry-roasted nuts, and many other foods. Check package labeling of processed foods carefully. However, MSG may    masquerade as “hydrolyzed vegetable protein,” autolyzed yeast extract: or even “natural flavoring.”

Organic Headaches:

Symptoms will vary according to the cause of the headache. When it is caused by a brain tumor the pain is often of gradual onset. It tends to get progressively worse and then it becomes persistent and focused in one are. There may be a feeling of a tight band squeezing the head. Also, there are usually other symptoms that accompany the headache which may include: vomiting, personality changes, drowsiness, difficulty speaking, weakness, loss of balance, seizures or fainting.

A very small percentage of all headaches (less than 1%) is caused by a brain tumor. Other organic causes that are equally rare include aneurism, hematoma, brain cyst or abscess, brain  infection, hydrocephalus, or cerebral hemorrhage. These are very serious and require medical attention.

Post Traumatic Headache:

Headaches due to trauma range in severity and severity is not necessarily associated to the severity of the trauma. They may be tension type or migraine. It often is described as a sense of tightness around the head like a “tight heat-band” or “vise” sensation. The muscles of the neck and shoulders are often tense and tender to the touch. Additional symptoms may include: difficulty concentrating, difficulty sleeping, increase in headache pain with noise or bright light, dizziness, loss of memory, reduced motivation, tinnitus (ringing in the ears) and blurred vision. They may be acute or chronic. Most traumatic headaches do not appear to be caused by an actual blow to the head. Some post traumatic headaches may last for years after the initial trauma.

Do not take anything stronger than acetaminophen so as not to mask symptoms that may indicate bruising or bleeding around the brain during the acute phase. Aspirin and other NSAIDS should not be taken as this may increase bleeding. In cases where there is seizure, fainting or other altered consciousness, fever over 101 degrees F, or blood or clear fluid coming out of your ears or nose, get emergency medical attention immediately.

In my office I have treated 100’s of cases of post traumatic headaches and have had considerable success in the majority of the cases. Many of these headaches had been present for many years and with proper chiropractic care and home treatment, the relief was phenomenal. If you are involved in an accident and are having headaches, it is extremely important to come in as soon as possible as early treatment may prevent the headaches from becoming chronic.

Stroke Headache:

Usually sudden, severe and persistent. The location of the pain will vary according to the area of the brain affected. Other symptoms may include: vomiting, dizziness, confusion, weakness or paralysis on one side of the body; sudden severe numbness in any part of the body, visual disturbances including sudden loss of vision, difficulty walking including staggering or veering; coordination problems in the arms or hands; slurred speech or inability to speak; sudden deviation of the eyes toward one direction; seizures; irregular breathing; stupor; and coma.

Stroke is an immediate medical emergency and requires medical treatment at once.

TMJ/Temporomandibular Joint Headaches:

There is often an aching discomfort in front of the ear, popping or clicking sounds of the jaw on motion, loss of mobility of the jaw joint, and/or pain on movement of the jaw. The pain may radiate to the temples, back of the head or into the neck.

There are several possible causes of TMJ problems and the treatment will depend on the cause. Moist heat applied to the jaw or massage may give temporary relief in mild to moderate cases. Anti-inflammatory medication may help in some cases. Therapy may also be indicated for some people and if there is a problem with your bite (malocclusion), a dentist specializing in this condition may be necessary.

There is also a bite-guard that can be used at night for people who grind their teeth as this can aggravate the condition.

For very persistent cases, injections with lidocaine or a steroid may be effective. For non-responsive cases that are severe, referral to an oral surgeon may be necessary to repair or remove the disc within the joint. High failure rates are associated with this procedure and complications are not uncommon, however, arthroscopic surgery may provide relief for some people and it may be the only option available if the condition progresses to this point.


  • Headache is SUDDEN AND SEVERE, striking out of the blue. The worse headache you ever had.
  • ACCOMPANIED BY visual loss or blurring, confusion, loss of consciousness, numbness, convulsions or any similar changes.
  • WAKE you up during the night.
  • Become more FREQUENT or more SEVERE or LASTING LONGER.
  • Follow a BLOW TO THE HEAD.
  • Occur with a FEVER of 103 degrees and/or a stiff neck.
  • Lasts longer than 24 hours.
  • Is provoked by exertion.
  • Daily or frequent headaches (3 times a week).
  • DAILY use or increasing use of over-the-counter or prescription drugs. Need to use combinations of medications to get the same results as before.

If your headaches interfere with you activities of daily living at home or at work, or with your family life, professional help is indicated.

Medical Treatment of Headaches:

Now that we have covered the basics, I will go on to cover treatment options for headaches.

I feel it is important for you to understand my philosophy in regards to treating headaches. The first thing I want to make sure you understand that I am not against drugs or surgery. I am against the abuse of drugs and surgery. Also, it is important to understand that all of the medications have potential side effects that can be avoided under the more conservative care of chiropractic, when that care is appropriate.

Also, in most cases, medications only mask the symptom of the headache and do not get to the CAUSE of the headache. In my office, I will attempt to determine what is causing the headache and then let you know what needs to be done to correct it.

With this being said, some cases will need both chiropractic and medical care at the same time. I will work with your physician to ensure that you get the best possible care from both professions in order to ensure you have the best chance possible of obtaining the results we all desire.

What CAUSES Most Headaches?

Fortunately, the majority of headaches are not caused by some of the serious conditions discussed earlier. However, it is important to have a consultation and examination to rule out these potential problems. If any of these are indicated in your case, I will refer you out for appropriate medical care and follow-up.

Once these have been ruled out, my examination proceeds to find out if your headache may be caused by a physical condition called vertebral subluxation or nerve impingement syndrome. Very briefly, this is where the joints of the spine have lost their normal motion &/or position and are interfering with the normal function of the nervous system.

Vertebral subluxations may cause headaches in different ways. The irritation to the nerve may cause the muscles to be tighter than normal, resulting in headaches. New research has found a previously unknown muscle in the skull that may cause headaches when a subluxation occurs. It the subluxation has existed for some time, there may be other factors that need to be addressed. These include, but are not limited to forward head posture (extremely common with both tension and migraine headaches) and degenerative disc disease. If these are present, your treatment plan would include special procedures to help correct or manage them specifically.

As stated previously, I am not against drugs or surgery. However, each of us is bombarded 100’s of times a week with ads that tell us if you have a symptom—pop a pill. In most cases the drugs do nothing to correct the cause of the problem. In addition to the possible side effects, they only cover up the symptom, leaving the cause to fester, potentially causing additional health problems later. An analogy would be to place a paper bag over a railroad crossing sign—you might get through most of the time, but the condition is still there and sooner or later you will pay for it.

At Afford A Care Chiropractic, I take a different approach. After a thorough consultation, examination and x-rays (if indicated) I will attempt to find the cause of your headaches. Only after this can we set up a plan that is specifically designed for you to get the best results possible.

If you or someone you know suffers with headaches I would like to encourage you to consider chiropractic as a way to


Call me at 330.448.0111 TODAY

None of the information contained in this publication is meant to diagnose, treat or cure any health condition. It is supplied as general health information. Please discuss your specific condition Dr. Wray or your family physician.