Woman suffering with headaches

Suffering With Headaches Is Disabling, But It Does’nt Need To Be


So, You Suffer With Headaches…

Our office has very high success in treating headache patients.  Our success in headache treatment is accomplished drug free and without invasive surgery.  We have had a myriad of success treating patients with migraine headaches as well as tension headaches, and chronic daily headaches.  In fact, the vast majority of our patients have failed with multiple drug therapies prior to contacting us, typically as a last resort.  If this sounds like you or someone you love, you should consider calling our office for a no obligation FREE consultation.  You can find out about our migraine treatment and treatment for tension headaches before making any commitment to treatment.

For those of you wishing to know more regarding various causes of headaches, read on…

Tension headaches

Tension headaches represent one of the top three reasons patients consult their doctor, (with vertigo and back pain making up the other two).  It is one of the most costly diseases because of its very high prevalence. Tension headaches are the most common type of headaches. It has also attached the synonymous name of stress headaches.

The International Headache Society defines tension headaches more precisely and differentiates between episodic and chronic types. The following is a modified outline of the IHS diagnostic criteria:

Episodic Tension Headaches

  • At least 10 previous headaches fulfilling the following criteria; number of days with such headaches fewer than 15 per month
  • Headaches lasting from 30 minutes to 7 days
  • At least 2 of the following pain characteristics:  Pressing/tightening (nonpulsating) quality of headaches
  • Mild or moderate intensity (may inhibit but does not prohibit activities)
  • Bilateral location, (headache on both sides of head)
  • No aggravation of headache from climbing stairs or similar routine physical activity
  • Both of the following:  No nausea or vomiting associated with headaches
  • Sensitivity of light and sound is absent or only one is present with headaches
  • Secondary headache types not suggested or confirmed

Chronic tension-type headaches

  • Average headache frequency of more than 15 days per month for more than 6 months fulfilling the following criteria
  • At least 2 of the following pain characteristics:  Pressing/tightening (nonpulsating) quality of headaches
  • Mild or moderate intensity headaches, (may inhibit but does not prohibit activities)
  • Bilateral location, (headache on both sides of head)
  • No aggravation from climbing stairs or similar routine physical activity
  • Both of the following:  No vomiting associated with headaches
  • No more than one of the following: nausea with headaches, avoidance of light and sound with headaches
  • Secondary headache types not suggested or confirmed

Although formerly conceived as muscular contraction headaches, the more likely cause of these headaches is believed now to be abnormal neuronal sensitivity and pain facilitation, not abnormal muscle contraction.  Headaches are not related directly to muscle contraction, and possible hypersensitivity of neurons in the trigeminal nucleus caudalis has been suggested.


In the US: Tension headaches are the most common type of headaches, and women are more likely to be affected with headaches than men.

History: Tension headaches are characterized by pain that is usually mild or moderate in severity and bilateral in distribution. Unilateral head pain may be occasionally experienced as well, however. Headaches are commonly reported as a constant, tight, pressing, or band-like sensation in the head.

Common to Tension Headaches

  • The majority of these headaches last less than 24 hours.
  • Headache pain differs from the typical pulsating/throbbing quality of migraine headaches.
  • Prodrome and aura prior to headaches are absent.
  • The deep steady headaches differ from the typical throbbing quality of migraine headaches.
  • Occasionally, the headaches may be throbbing or unilateral, but most patients do not report sensitivity to light and sound, or nausea, which commonly are associated with migraine headaches.
  • Some patients may have neck, jaw, or temporomandibular joint, (TMJ), discomfort or dysfunction.

Migraine Headaches

  • Migraine pain may be localized to one side of the head, behind the eye, the back of the neck, or about the face. The pain is associated with nausea and sometimes vomiting. Patients become sensitive to light (photophobia), sounds, (phonophobia), and certain smells (osmophobia). Intermittent dizziness may occur. Some patients, called migraineurs, may develop an “aura,” that is, a feeling that comes on before the headaches begin. These auras may be associated with visual changes, such as spots, (scintillating scotomas),  tunnel vision, or wavy lines, (fortification spectra). The headaches may last up to three days and may occur several times per week or as infrequently as once or twice a year. Women are more prone to migraine headaches than men.

Cluster Headaches

Cluster headaches are given their name based on the fact that the attacks of headache pain occur in clusters that may last several weeks to months. The head pain is agonizing and usually affects one side of the face, involving severe pain behind one of the eyes with associated nasal congestion and runny nose. Oddly, men tend to get these types of headaches more frequently than women.

Where Do I Begin?

Before you seek any treatment approach to your headache pain, it would be wise to make sure that the underlying cause of your headaches is correctly diagnosed. Evaluations for your headaches typically involve your PCP, (Primary Care Provider), however, examination by an appropriately trained neurologist is wise. Our office specializes in extensive neurologic evaluation of each patient prior to undertaking any headache treatment regimen.  It is important that you have your condition(s) properly diagnosed so that you do not waste valuable time should the underlying cause of your headaches be serious and/or progressive, or, should such headache treatment be contraindicated for any reason.  Additionally, any headache treatment that you receive, be it from an allopathic, chiropractic, or other integrative approach, will likely not be as beneficial if it is not diagnosis directed.  The fundamental healing axiom of “first do no harm” must be a guiding principle whenever a medical provider encounters a patient. Patients seeking any form of manipulation should do their homework on the proposed providers and techniques used in order to find competent practitioners capable of performing such procedures as safely as possible. The risks and benefits must be clearly discussed. Just as one chooses their surgeon carefully, so too must a patient evaluate any practitioner who would attempt manipulation. So too should a patient scrutinize any proposed drug therapy headache treatment, or other drug treatment for that matter, without a logical accompanying diagnosis.

During the course of any headache treatment, it would be extremely wise to maintain a log of temporal course and severity of your headaches.  Rate your headaches from 1-10 on severity, and mark a calendar when you have a headache with the severity rating and also how long it lasted.  This will later prove invaluable when determining the benefits, if any, of your headache treatment, as you will have something to reflect back on to demonstrate reduction of severity or frequency of the headaches.

Free E-Consultation Right Now!

Because of the duration of examination and complexity of treatment that we offer, we are naturally limited to the number of prospective patients which we can take into our programs.  We therefore only accept patients whom we truly believe we can help.  If you would like to be considered for treatment, please start by filling out the Headache consult form, (the password is help), and submitting it by email to our office.  The doctor will review it, make a determination as to candidacy for headache care, and we will call or email and notify you as quickly as possible.  If we do not have immediate openings, you may be placed on a waiting list and we will call you when an opening occurs.  We appreciate your patience in this regard, but we give each patient individual and uncompromised attention which allows us to continue to maintain optimal outcomes.

If you would like to schedule a free in office consultation with the doctor to discuss your headaches, or just have questions, please contact us using the form on our Contact Page. Lastly, we recommend reading our Guest Book page to see what other patients have had to see regarding their treatment with Dr. Scopelliti.

References available upon request

Dr. Scopelliti is a Functional Neurologist in Monmouth County NJ.