Headaches: A Self-Assessment of Function

Headaches are a very common problem seen in chiropractic offices.  Most types of headaches are manageable without requiring an extensive workup.  Headaches can vary from mild and barely noticeable to extreme, so much so that it results in total disability restricted to bed rest in a dark, quiet room. 

The ability to track the treatment or care approach being received is difficult.  This is because there are not any good, reliable tests for most types of headaches, especially the most common tension-type of headache.  Even vascular headaches such as migraine and cluster varieties are not associated with reliable tests that can track progress or change.  One inexpensive, reliable method that is self-administered is called the “Headache Disability Index” (HDI).  This is a 25-question form that the headache sufferer completes and a total score is calculated.  In the list of 25 questions, there are three choices for scoring: a “YES” response = 4 points, a “SOMETIMES” response = 2 points, and a “NO” response is not worth any points.  The highest possible score = 100 (4 points x 25 questions).  Therefore, if the patient’s headache total score, for example is 38 points, the percentage is 38%.  When patients present for chiropractic treatment, this method of assessment is often utilized and can be very helpful to determine the effectiveness of the care being provided, especially because of the lack of special tests that exists for most types of headaches.  Here is a list of questions that are included in the HDI:

E1.  Because of my headaches I feel handicapped. F13.  I am concerned that I am paying penalties at work or at home because of my headaches.
F2.  Because of my headaches I feel restricted in performing my routine daily activities. E14.  My headaches place stress on my relationships with family or friends.
E3.  No one understands the effect my headaches have on my life. F15.  I avoid being around people when I have a headache.
F4.  I restrict my recreational activities (e.g. sports, hobbies) because of my headaches. F16.  I believe my headaches are making it difficult for me to achieve my goals in life.
E5.  My headaches make me angry. F17.  I am unable to think clearly because of my headaches.
E6.  Sometimes I feel that I am going to lose control because of my headaches. F18.  I get tense (e.g. muscle tension) because of my headaches.
F7.  Because of my headaches I am less likely to socialize. F19.  I do not enjoy social gatherings because of my headaches.
E8.  My spouse (significant other), or family and friends have no idea what I am going through because of my headaches. E20.  I feel irritable because of my headaches.
E9.  My headaches are so bad that I feel I am going to go insane. F21.  I avoid traveling because of my headaches.
E10.  My outlook on the world is affected by my headaches. E22.  My headaches make me feel confused.
E11.  I am afraid to go outside when I feel that a headache is starting. E23.  My headaches make me feel frustrated.
E12.  I feel desperate because of my headaches. F24.  I find it difficult to read because of my headaches.
  F25.  I find it difficult to focus my attention away from my headaches and on other things.

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