Exeter Headache Clinic

We specialise in the treatment of the following headaches using osteopathy, acupuncture or/and with basic exercises:

Headache

Migraines (pain relief and prevention), Tension type headaches (pain relief and prevention) and Cervicogenic type headaches (treatment)

Most of our patients have previously been diagnosed by their G.P and self manage their symptoms with analgesics and lifestyle choices.

A thorough subjective and objective examination and will be taken prior to commencing treatment in order to have a correct diagnosis. We will always refer you to your G.P if we feel it is necessary for further investigations or a second opinion.

What are headaches?

There are numerous types of headaches all of which involve pain in some part of the head. This can include the face, sinuses, scalp and inside of the head. Pain is triggered by the aggravation of pain sensitive structures.

Headaches can be categorised into two types:

Primary headaches – these exist independent of any other medical condition. Examples include migraine, cluster and tension type headaches.

Secondary headaches – these result from an underlying medical issue. Numerous causes exist and examples include meningitis, brain tumours, infection, head injuries and cervicogenic headaches.

Types of headaches treated

What are Migraines?

MIGRAINE

This affects 15% of the UK population (Steiner et al, 2010).

SIGNS AND SYMPTOMS

• Often associated with a predrome phase – mood change, loss of appetite, nausea
• Often accompanied with nausea and vomiting
• Pain is moderate to severe
• Often one sided throbbing/pulsating, but can be bilateral
• Can last several hours to several days
• Sensitive to light odors and sound
• May have a visual aura, but don’t have to.
• Want to hide in a dark room.

CAUSES:

There are many triggers for migraine including emotional, physical, dietary, environmental and medicinal factors.

The exact mechanism of migraine is not fully known. It is understood to have a neurovascular component. Some kind of trigger initiates abnormal firing within the cerebral cortex of the brain known as cortical spreading depression.

This abnormal firing may lead to hyperactivity of the occipital/visual cortex of the brain resulting in visual aura disturbance. Other areas of the brain may also be activated such as the sensory cortex leading to signs of numbness or tingling.

The pain associated with migraine is thought to arise from stimulation of the trigeminal nerve and inflammation of the meninges resulting from the cortical spreading depression. It is also thought to be due to overactive nerve groups within the brain stem.

TREATMENT:

• Eliminating triggers
• Stress behavioural intervention
• Medications for acute: may include NSAIDS, triptans, asprin, paracetamol
• Medications for prevention: may include topiramate, propranolol gabapentin (NICE, 2012)
• Both manual therapy and acupuncture have been shown to provide pain relief and prevent migraine. From September 2012, NICE guidelines now recommend a course of acupuncture as a form of treatment for migraine prevention.

What are tension type headaches?

WHAT ARE TENSION TYPE HEADACHES?

Tension type headaches (TTH) affect 80% of the UK population (Steiner et al, 2010).

CAUSES:

• The exact cause of TTH is not fully understood and is thought to be multifactorial.
• One commonly accepted theory is that it the pain results from sustained tension from the neck and scalp muscles, however studies have also shown that TTH can still exist without the muscular tension (Porth 2007). These are often referred to as cervicogenic headaches.
• Overactive pain pathways. This is called central sensitisation of the central nervous system where inadequate endogenous antinociceptive circuitry has been shown (Kaniecki, Robert, 2012)
• They are often associated with psychogenic stress or muscular stress.

SIGNS AND SYMPTOMS

These are characterised by:

• Mild to moderate pain
• Sensation of a tight band around the head
• Lasts 30 minutes to several days
• May be worse at the end of the day.

TREATMENT:

• Analgesics such as aspirin, paracetemol and NSAIDs
• Behavioural and psychological interventions
• Acupuncture has been shown to provide pain relief and prevent TTH. From September 2012, NICE guidelines now recommend a course of acupuncture as a form of treatment for TTH prevention.

What are cervicogenic headaches?

WHAT ARE CERVICOGENIC HEADACHES?

These are secondary headaches that are characterized by unilateral head pain and have signs and symptoms of neck involvement.

SIGNS AND SYMPTOMS:

• Gradual onset of neck pain or stiffness.• Dull ache usually situated at the back of the head.• Pain, pins and needles and numbness may also be felt in the upper back.• Symptoms are usually worse for moving and/or palpation of trigger points.

CAUSES:

• It is likely the pain is referred from one or more muscular, neurogenic, osseous (bone), articular (joints), or vascular structures in the neck.
• is often a sequela of head or neck injury but may also occur in the absence of trauma (Biondi).

TREATMENT:

Antidepressants
Antiepileptic Drugs such as gabapentin
Analgesics such as aspirin, paracetemol and NSAIDs
Physical and manual therapy such as osteopathy are important therapeutic modalities for the rehabilitation of cervicogenic headache, due their structural biomechanical origin.
Behavioural and psychological interventions

To Make An Appointment
CLICK HERE

What can we treat?

Migraines & Tension Headaches
Neck Pain
Shoulder Pain
Elbow or Wrist Pain
Back Pain
Hip Pain
Knee Pain
Joint Pain
Digestive Problems
Circulatory Problems
POSTURAL IMBALANCES

Meet the practitioners

Anna Nikova M.Ost Osteopath
BSc (Hons) Osteopathy, Acupuncture MBAcC