Headaches are classified into three categories, primary, secondary, and other which can include cranial neuralgia and facial pain. Primary headaches include migraine and tension headaches. The pain of headaches can be mild to very severe in intensity and can impact the quality of daily life. Many patients are debilitated by migraine headaches.
Tension headaches are the most common type of primary headache. They are often times caused by stress, poor cervical posture and contraction of the muscles overlying the skull. Location sites of tension headaches include the base of the skull where the cervical muscles of the neck inserts, the temple where muscles of the jaw are located, and the forehead. Patients describe the pain as a band like tightness or pressure. It is bilateral often feels like it encircles the head. Treatment of tension headaches involves anti-inflammatory medications, therapy reducing the strain and pain on the neck musculature. If patients fail conservative therapy they may benefit from trigger point injection therapy to help directly stop the muscle spasms of the head and neck.
Migraines are more severe form of headache that has symptoms associated with nausea, photophobia, and severe pain usually unilateral. Women are affected more often than men. Migraines can be managed with migraine medications, but those who fail to respond will benefit from botox therapy. Dr. Desai has worked with botulinum toxin injection therapy for treatment of migraine headache patients for over 5 years in practice.
Occipital headaches are another form of neuralgia with related pain in the posterior aspect of the skull in the distribution of the occipital nerve. Patients often describe the pain as sharp, stabbing, burning pain in the posterior skull. The pain is exacerbated with lying on the back or placing pressure against the nerve. Treatment for occipital neuralgia or headaches is steroid injection therapy. The steroid injections can quickly calm the nerve pain and alleviate these forms of headaches/ neuralgia.