Mississauga Chiropractor Presents: Cluster Headaches

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Here’s anothe blog from a Mississauga Chiropractor…

Cluster Headaches are defined by recurrent brief attacks of sudden, severe, unilateral periorbital head pain over a period of 4-8 weeks.

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Episodic Cluster Headaches:  Occurs in periods (clusters) lasting from 7 days to 1 year; clusters separated by pain-free intervals lasting at least 2 weeks; usually a cluster lasts 2 weeks to 3 months

 

Chronic Cluster Headaches: Occur for more than 1 year without remission or with remissions lasting less than 2 weeks;

 

Demographics:

  • Gender:  Males > Females (5:1)
  • Age: 20-50 years

 

Triggers may include:

  • Stress, glare or bright lights
  • Allergies
  • Alcohol, tobacco
  • An increased incidence of peptic ulcer & coronary heart disease has been noted with male patients; may be a genetic predisposition

 

History:

  • Sudden onset of severe unilateral periorbital head pain
  • Pain is often described as “excruciating”, “piercing”, “boring”, “deep”, or “penetrating” & is rarely throbbing
  • Headache attacks:
    • Short duration (5 min-3 hours)
    • Frequency from once every other day to 8 times a day
    • Nocturnal attacks are more common, disrupting sleep
    • Autonomic symptoms: facial sweating & flushing, tearing, blockage of nose
    • Patients prefer to pace or sit
    • Heavy use of alcohol or tobacco is common
  • May be triggered by stress, relaxation, extreme temperatures, glare, allergies & sexual activity
  • Distinctive cluster headache face is described as follows: “lion-like facial appearance, multifurrowed & thickened skin with prominent folds, a broad chin, vertical forehead creases & nasal dilation.

 

Management:

  • Myofacial trigger point techniques (upper trapezius, splenius, suboccipitals, SCM)
  • Stretching exercises
  • Cervical adjustments to the upper cervical spine
  • Postural and ergonomic evaluation
  • Acupuncture to the local cranial, cervical & suboccipital points

 

Prognosis:

  • 80% of patients with episodic variant tend to maintain the episodic form; 4-13% of the patients will transform into the chronic cluster headache
  • Chronic cluster headaches are more relentless and may persist in this form in up to 55% of the cases, although they may remit into an episodic form
  • Males with a late onset and a history of episodic variant will predict a less favourable prognosis.

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