If you are suffering from chronic headaches in Edmonton and the surrounding area, you may not be sure how to address them or what to do to make the pain just go away. We want to be honest with you upfront –at the Unpain Clinic, we don’t treat all types of headaches. If you have a type of headache we can treat, we will definitely try our best to help you find some relief. If you have a different type of headache, we want to help guide you to the right kind of healthcare provider or treatment for you. With that in mind, read on to learn more about headaches and our approach to headaches here at the UnPain Clinic Edmonton.

Headache pain can be very easy or very difficult to diagnose and treat, as there are many possible reasons that people can have headaches. Broadly, we classify headaches into two groups, primary headaches and secondary headaches.

• Primary headaches are those headaches where the pain in your head is not coming from another source or something your body is dealing with like an illness, injury or allergies. Common primary headache types include[h1] :
  • Migraine headaches
  • Tension type headaches
  • Cluster headaches
  • Ice pick headaches
  • Thunderclap headaches
  • Hemicrania continua

• Secondary headaches are usually a symptom of something else going on in your body, for example dehydration, allergies, illnesses such as a cold or a flu, withdrawl headaches related to substance misuse or even fluctuations in hormone levels. Sometimes your secondary headache can become chronic if the trigger or reason for your headaches is not addressed. In most cases treating the underlying cause of your headache can generally provide pain relief. 

Headaches in each category can be classified as either:

• Episodic (acute) headaches that generally do not occur for more than 15 days in any month. These headaches generally last anywhere from 30 minutes to several hours or even days.
• Chronic headaches that are more consistent and generally occur more than 15 days in a month. In the case of chronic headaches, making a pain management plan with a healthcare provider is usually necessary.

A headache is considered chronic when it occurs on more than 15 days of any given month, regardless of the duration of the headache during that day. Any type of primary or secondary headache can become chronic. In cases of chronic headache it is important to see your medical doctor to determine the cause of the headache and create a treatment plan to manage your pain and symptoms. 

What type of headache am I experiencing?

Each type of headache has some distinct signs and symptoms and patterns of pain distribution, however, there is also a great deal of overlap in how headaches can present and it is possible to have more than one type of headache in a given month. You can check out The International Classification of Headache Disorders – ICHD-3 website to read more about the different kinds of headaches however we don’t recommend self-diagnosing as there can be some serious underlying causes for headaches that need to managed and treated by a healthcare provider.

To help your doctor make a better diagnosis for your headaches, pay attention to and consider making notes on the following:

• intensity of the headache
• what part of your head you feel the headache pain in
• the character of the headache –is it throbbing, squeezing, stabbing, shooting or something else
• how long the headache lasts and how many days of the month has it happened on
• what triggers the headache (if anything) –e.g. stress, certain foods, changes in weather, where you are in your hormonal cycle
• are there any other symptoms that happen before, during or after the headaches –e.g. nausea, dizziness, blurred vision, neck or shoulder pain or others

What are the causes of my chronic headache?

That depends on the kind of headaches you suffer from. Secondary headaches are symptoms of something else happening in your body and can be easier to diagnose and treat. The causes and mechanisms of primary headaches are more complex. At this point, we know that the nerves and blood vessels in the head and neck, chemical activity in the brain, and problems in pain-sensitive structures in the head (or a combination of these factors) can all play a role in why we have primary headaches. In addition, some people may be more inclined to developing headaches because of their genes.

Can Physiotherapy Help with Chronic Headache

Physiotherapy may be helpful for managing some types of chronic headaches such as cervicogenic headache, tension type headache or some types of migraines. Before beginning physiotherapy or other types of care such as massage, acupuncture or chiropractic, it is important to have a correct diagnosis for your headache. 

Is a Chronic Headache Dangerous?

While they can greatly affect your function and quality of life, many types of chronic headache are not dangerous. With headaches, monitoring the type of headache you are having and any changes to the quality or symptoms you are experiencing is very important.

See your MD immediately or go to the ER if: 

• You are having your worst headache ever
• You are having your worst migraine attack ever

• The pain of your headache lasts more than 72 hours with less than a solid four-hour, pain-free period while awake
• You experience a headache or a migraine attack with unusual symptoms that are abnormal for you and frightening
• Your headache is accompanied by the following symptoms:
  • Unresolved loss of vision or double vision
  • Loss of consciousness
  • Uncontrollable vomiting
  • Slurred speech
  • Paralysis in part of your body
  • A new rash
  • Intense neck stiffness
  • A fever of 38°C or higher

How can I relieve my chronic headache in Edmonton?

It depends on the type of headaches you suffer from. No matter the headache, having the right healthcare provider(s) is important. The right provider can help you determine the reason for your pain and the right kind of treatments to cure your pain or provide symptom relief. In some cases a multi-disciplinary approach is the best way to tackle tough chronic headaches, so having healthcare providers who are willing to work with or as a team is important. At Unpain Clinic we are always happy to work with other clinics or individual healthcare professionals to give patients great care.

Treatment for Chronic Headache

There are many possibilities for headache treatment and they need to be tailored to the cause of your headache, however, some common treatments for some types of headaches can include:

• Medication -depending on the cause of your headache your medical doctor may prescribe some medication or make recommendations on over-the-counter medications that can help. If you have a secondary headache then medications may be given to treat the underlying condition causing your headache and also manage any headache pain.

• Physiotherapy or chiropractic –can be used to treat headaches caused by painful muscles and joints or irritated nerves. Some types of treatments provided by these practitioners include:
  • manual therapies (mobilizations, adjustments, assisted stretches)
  • specific exercises and rehab plans designed to improve muscle strength, flexibility and endurance and cardiovascular health
  • education on posture and body mechanics
  • soft tissue therapies such as massage or myofascial release
  • dry needling or clinical acupuncture
  • pain relieving modalities such as TENS or shockwave therapy

• Surgery –sometimes surgery is necessary to correct the underlying cause of a headache, for example those that may be related to tumors, sinus problems or vascular issues, but most headaches do not require surgical intervention. Your medical doctor will educate you and refer you to the correct surgeon if any type of operation is required. 

Frequently Asked Questions:

What is the cause of headache everyday?

The cause of any headache is as unique as the person experiencing the headache. To better understand what is causing your daily headaches, you might need to do some reflecting on your general health and lifestyle, how your headaches are presenting, what symptoms you have and what you have been doing or been exposed to prior to the onset of the headache. Sometimes increases in stress levels and emotional disturbances have also been linked to headaches. Looking for patterns in the presentation of your headaches and making notes can really help your doctor to determine the cause of your pain.

How do you cure chronic headaches?

It depends on the type of chronic headache you are having and the underlying cause for your headache. Getting your headache properly diagnosed helps your healthcare team to choose the best types of treatment and management plan for you. In some cases of chronic headache a full cure may be possible, but with others there is no way to completely get rid of the headaches.

Fortunately there are many types of treatments and healthcare providers who may be able to help you manage your headache symptoms and research into new and better headache treatments is always ongoing. A good plan of management that includes a variety of clinical treatments and at home symptom relief strategies can improve your ability to function and cope with your headaches. 

What kind of doctor do you see for chronic headaches?

The best place to start if you have a chronic headache is to visit your medical doctor. They will be able to diagnoses you or refer you to other specialists and healthcare professionals if needed. To determine the cause of your headache your medical doctor may also order lab tests, imaging like an X-ray, MRI or CT scan or even advanced procedures like a lumbar puncture. 

Is Botox for migraines covered by Alberta Health Care?

Yes. Botox treatment for chronic migraines for eligible patients is now an insured service under the Alberta Health Care Insurance Plan (AHCIP). Eligible patients are 18 to 65 years of age who have suffered from migraine headaches for 15 days or greater each month, with each episode lasting four hours or longer. The Unpain Clinic currently does not have any providers who perform botox injections for headache.

Can a physical therapist help with chronic headache pain?

It depends on the reason for your chronic headache. Some types of headaches (cervicogenic headaches, tension headaches) which are related to painful structures in the neck like tight muscles, aching joints or irritated nerves can be treated by a physiotherapist.

Can a chiropractor help with chronic headache pain?

It depends on the type headache pain you are are suffering from. There is some preliminary evidence that spinal manipulation may be an effective therapeutic technique to reduce migraine days and pain/intensity from migraines.* Additionally chiropractors may also be able to help treat cervicogenic headaches related to painful structures in the neck.

What methods does Unpain Clinic use to treat chronic headache?

At the Unpain Clinic we can help to provide symptom relief or treatment for those types of headaches which fall under the scope of physiotherapists and chiropractors (headaches related to muscle, joint or some kinds of nerve pain).

Our practitioners may use some or all of the methods listed below (depending on their training and scope):

• manual therapies (mobilizations, adjustments, assisted stretches)
  • specific exercises and rehab plans designed to improve muscle strength, flexibility and endurance and cardiovascular health
  • education on posture and body mechanics
  • soft tissue therapies such as massage or myofascial release
  • dry needling or clinical acupuncture
  • pain relieving modalities such as TENS or shockwave therapy

One element that sets us apart at the Unpain Clinic is that we may also use extracorporeal shockwave therapy to treat myofascial pain related to or causing headaches. There is evidence that shockwave therapy is effective at treating active trigger points in muscles, specifically in the trapezius muscles and can allow for a reduction in pain and inflammation. **

Can exercise help my chronic headache?

150 minutes of moderate to vigorous intensity cardiovascular exercise are recommended each week for all Canadians 18-64 years old. Stretches and strengthening exercises can also be beneficial for our health and to reduce the pain of injury or other conditions. When we have headaches however, we may not feel like exercising.  According to physicians, if you are actively experiencing a mild headache it can be safe to exercise as long as the exercise does not intensify your pain. Exercises can also be beneficial for headaches related to painful muscles and joints and can be performed at times when you are not experiencing headache pain. The best rehab plans come from trained professionals, but here are some examples to try at home:  

• Practice standing with good posture
  • Pretend a string is pulling you upwards from your head and allow yourself to grow taller
  • Lift your breast bone up as your grow
  • Tuck your chin in slightly (like nodding ‘yes’)
  • Hold this position and then draw your shoulder blades down and back at the same time
  • Keep this position as long as you can and relax.
  • Practice doing this as many times as you can throughout the day for as long as you can hold it. Over time your ability to stand with good posture for long periods will improve.

• Chin tucks
  • Lay on your back with a small rolled towel under your neck
  • Don’t lift your head, just tuck in your chin like you are nodding yes.
  • Try and keep the larger neck muscles relaxed while nodding
  • Hold for a few seconds, release and repeat 10-20 times, once per day.

• Neck extensor stretch
  • Sit or stand with good posture and your hands clasped behind your head
  • Slowly bring your chin towards your chest until you feel a gentle stretch
  • If comfortable you can use your arms to pull your head a little further until you feel a bit more stretch

Is a Physiotherapist covered by Alberta Health Care?

Yes and no.  Confusing, right?  Alberta Health Care holds contracts with specific clinics – so you could have a perfectly good physiotherapist in a private practice who is not covered under Alberta Health Care since they do not negotiate contracts with them.  It usually comes down to cost.  If a clinic is offering a more specialized service that is more expensive to offer, it is not typically covered by Alberta Health.  There are, however, many reputable clinics out there that provide excellent traditional care for clients under Alberta Health Care contracts. Unpain Clinic does NOT bill to Alberta Health Care at this time.

How much does physiotherapy cost in Edmonton, Alberta?

Physiotherapy in Edmonton can range anywhere from $50-$400+ per visit.  The price depends on the therapist, the clinic, and the technology or treatment being offered.

Do you need a referral to see a physiotherapist in Edmonton, Alberta?

No. Physiotherapists are considered primary healthcare providers, along with medical doctors, chiropractors, naturopathic doctors and acupuncturists. These professionals do not require a referral from a medical doctor for you to see them. At Unpain Clinic we always accept and appreciate referrals from medical doctors and other healthcare providers and are happy to collaborate and communicate with them to ensure you get the best care possible.  

Be aware that your extended health benefits plan may require a doctor’s prescription in order for you to claim your visit. The best way for you to know if you need a referral is to call your benefits provider or check out their website.