Headaches | Alexandria VA | DC

Woman with headachePain in any region of the head is generally referred to as a headache. There are many different types of headaches, the foremost difference in classification is whether a headache is caused by an underlying illness or disease. Headaches that occur as a symptom of an underlying illness or disease are known as secondary headaches; those that are not are known as primary headaches.

The International Headache Society recognizes 14 distinct categories of headache, distinguished by a hierarchical system of specific diagnostic criteria. Of these categories, we will discuss tension-type headaches (TTH), migraines, cluster headaches, and cranial neuralgias in greater detail below.

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Cranial nerve neuralgias

A neuralgia causes pain in a nerve because of a dysfunction in the structure or function of a nerve. There are many types and causes of neuralgia, and these influence the intensity of pain.

Cranial neuralgias cause recurrent pain in the same localized area of the head, face, or scalp. The pain may vary by episode and by individual, but it is likely to reoccur until it is treated. Craniofacial pain dentists like Dr. Singer treat cranial nerve neuralgias.

Tension-type headaches (TTH)

These headaches are the most common of all headaches. They affect people of all ages, and are equally prevalent among both sexes. It is estimated that between 30 to 78% of the general population have experienced this type of headache at least once.

Tension-type headaches are described by the International Headache Society as “infrequent episodes of headache that last from 30 minutes to 7 days” with pain that is “located bilaterally, characterized by a feeling of pressing or tightening, and of mild to moderate intensity.” The headache may be accompanied by sensitivity to light or sound, but is not usually worsened by physical activity. Jaw issues, sleep disorders and poor posture can all lead to tension-type headaches.


Though less common than tension-type headaches, about 28 million people in the US suffer from migraines, 3 out of 4 of are women.

Migraines are caused by changes in the size of the arteries in and outside of the brain. The International Headache Society describes these as a “recurrent headache lasting 4-72 hours” characterized by “pulsating pain of moderate to severe intensity, often on one side of the head” that is made worse by physical activity. The headache is often accompanied by vomiting or feelings of nausea and a heightened sensitivity to both light and sound.

Migraines may be experienced with or without an aura. Auras are sensory disturbances that are experienced as symptoms of a migraine before, during, or after and episode. Migraines that do not include auras are termed common migraines, and account for 70 to 80% of all migraines. Migraines that do not include the experience of auras are termed classic migraines.

Cluster headaches

Cluster headaches occur in about 1% of the population, and are more prevalent among men than women. The average age of onset is between 20 and 40 years of age. Experience of cluster headaches may be related to an underlying sleep disorder, such as obstructive sleep apnea.

Cluster headaches are described by the International Headache Society as “attacks” of “severe and sometimes excruciating pain around the eye or along the side of the head” and may persist anywhere from 15 minutes to 2 hours in duration. These headaches are associated with nasal congestion, sweating of the face and forehead and tearing or swelling of the eye on the affected side of the head.

There are 2 types of cluster headaches based on the frequency of the attacks. A cluster headache is referred to as episodic if it occurs 2 or 3 times a day for about 2 months and then subsides for no less than 1 year. If it occurs chronically, it is referred to as a chronic cluster headache.

Migrane Prevention chart

Headaches and TMJ disorders are often predictive of each other.

Headaches are one of the most frequently reported symptoms associated with TMJ disorders. Secondary headaches, especially tension-type headaches and migraines, are common in people who have moderate to severe TMJ disorders.

Interestingly, research seems to indicate that the association between headaches and TMJ disorders goes both ways; that is, people with TMJ disorders often report having headaches and people with chronic headaches are more likely to have TMJ disorders. In several clinical studies, as many as 55% of people who sought treatment for chronic headaches had additional symptoms of a TMJ disorder. 

Before your appointment, document your headaches.

Because headaches may be indicative of many different ailments, many doctors recommend keeping a diary that includes specific details about each headache. Information such as how long each headache lasted and activities/stressors that may have triggered it could be helpful in reaching an accurate diagnosis.  Keeping a food diary is also recommended to assist in identifying possible foods and substances that set head pain.

Call for a consultation and holistic treatment with TMJ and sleep dentist, Dr. Singer at Alexandria Office Phone Number 703-239-6475

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