HEADACHES & MIGRAINES & TREATMENT

Many people suffer from chronic headaches. Some headaches can be attributed to stress or tension, but the latest medical literature1 reports that some cases of chronic headache are caused by a problem in the neck—and that they are often misdiagnosed or unrecognized by physicians.

Chiropractic for Headaches. These headaches are known as “cervicogenic headaches,” since they have their “genesis” in the cervical spine. They arise when the nerves, joints, or muscles of the neck are injured or strained. Pain signals from the neck can get mixed with nerve pathways of the head and face, and can create pain in seemingly unrelated parts of the body.

Cervical spine dysfunction can cause pain in any part of the head, and cervicogenic headaches are usually focused on one side. These types of headaches can last for many hours or days, and are usually described as a dull, aching pain. Neck movement, injuries, or an awkward posture can trigger these headaches. Medication may relieve pain temporarily, but if the root cause of the pain is not eliminated, the symptoms will just return down the road. The first step in chiropractic treatments for headaches is to take a careful history and perform a thorough physical exam. This will help us determine the precise source of your pain, and help us design an effective treatment plan. Chiropractic can be a great way to treat headaches, since we work specifically with the spine to make sure that it is functioning properly. If you suffer from regular headaches, contact our office for an appointment. Biondi DM. Cervicogenic headache: a review of diagnostic and treatment strategies. JAOA 2005;Supplement 2;105(4):S16-S22.

Tension headaches are the most common type of headache accounting for 90% of all headaches. The pain from a tension headache is constant and it can be diffusely spread throughout one or more areas in the head. You may have pain in your neck and upper back from sore muscles or even dizziness from a tension headache. The most common causes of tension headaches are anxiety, stress, depression and anger as well as food allergies, poor posture, and improper breathing. Though common OTC pain relievers such as aspirin, ibuprofen or acetaminophen can mask the pain from a tension headache, they carry unwanted side effects if you reach for that bottle too often. Stomach problems and liver damage can occur if OTC pain relievers are used too often. More importantly, treating a tension headache with a pain reliever is much like sticking your finger in the hole in the dam rather than fixing the hole. Tension headaches occur mainly because of stress and poor posture that fatigues and strains the muscles that support your head. If you are unable to relieve these two tension headache-producing factors, you will continue to suffer from tension headaches. Massage can reduce stress and soothe sore muscles. A pilot study printed in the Journal of Manual and Manipulative Therapy suggest a decrease in both primary and secondary headache pain measures with two 45 minute weekly massage sessions in patients with chronic tension-type headaches.1 The patients reported less intensity and frequency of headaches after undergoing the massage that focused on myofascial trigger points. If you’re tired of taking pain medicine for your tension headaches and are looking for a real solution, please call a licensed massage therapist today. 1. Moraska A, Chandler C. Changes in Clinical Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study. J Man Manip Ther. 2008;16(2):106-12.

Migraine headaches are estimated to cost the U.S. over $17 billion each year. While it is clinically recognized that migraines can be related to cervicogenic conditions, the exact nature of this relationship is unknown. This study set out to test the effectiveness of chiropractic treatment for migraines. 123 participants diagnosed with chiropractic migraines according to the International Headache Society standard completed the study. Each participant experienced a minimum of 1 migraine per month, and had at least 5 of the following indicators: inability to maintain normal activities/need to seek dark and quiet, pain located around the temples, “throbbing” pain, symptoms of nausea, vomiting, aura, photophobia or phonophobia, migraine triggered by weather changes, migraine worsened by head or neck movement, diagnosis of migraine by a specialist, and a family history of migraine. The study consisted of three stages. In the pretreatment stage, researchers collected data on migraine incidence, intensity, duration, disability and use of medications, this data was used as a baseline to compare with study results and data collection continued throughout the trial. For the second stage of research participants were split into a control group (40) that received a placebo treatment using electrodes and an experimental group (83) that received a maximum of 16 treatments of chiropractic spinal manipulative therapy (CSMT). The last 2 months of the study involved data collection for comparison purposes. Results showed that those that received chiropractic treatment had significant improvement in migraine frequency, duration, disability and lowered medication use in comparison to the control group. Improvements in migraine frequency and duration for the chiropractic group are illustrated below. The area of greatest improvement was medication use, with a significant number of participants reporting that their medication use was down to zero by the end of the trial. Five participants reported that migraine symptoms were worse after 2 months of CSMT, but they did not report intensified symptoms at the post treatment stage. The authors report that their study with a 6-month duration is more valid than some previous studies because studies with shorter durations are too short to allow for the cyclical nature of migraines. Limited sample size and lack of consideration for what aspect of CSMT caused the improvements are some limitations of this study. Researchers also suggest that an improved study method might be to treat the control group with a sham form of CSMT rather than a treatment that does not mimic chiropractic. Despite some limitations this research adds to the body of evidence that suggests chiropractic manipulative therapy can be an effective treatment for migraine and headaches. The authors conclude: “A high percentage (83%) of participants in this study reported stress as a major factor for their migraines. It appears probable that chiropractic for migraines care has an effect on the physical conditions related to stress and that in these people the effects of the migraine are reduced. However, further studies are required to assess how chiropractic SMT may have an effect on migraine morbidity.” Tuchin PJ, Pollard H, Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of Manipulative and Physiological Therapeutics 2000;23(2):91-95.

Headaches are a common complaint that can be caused by a range of factors. Those that can be traced to disorders in the neck are called cervicogenic headaches, and this type of headache may affect as many as 20 percent1 of patients experiencing chronic head pain. Although their symptoms are similar to those of tension headaches and migraines, cervicogenic headaches are often a result of injury or other trauma. Because cervicogenic headaches often restrict a patient’s range of motion, this condition can seriously impact physical abilities and overall quality of life. New research published in Chiropractic & Osteopathy supports the case for using chiropractic spinal manipulation to treat cervicogenic headaches. A team of researchers from the University of Pittsburgh and the University of Western States in Portland, Oregon, compared the effects of spinal manipulation treatment to light massage on a group of 80 patients suffering from cervicogenic headache. They found that over a 12-week period, 42% of study participants who received spinal manipulation treatment reported significant pain reduction compared to just 23% of those who received massage. During that same period, the chiropractic group experienced a greater reduction in the number of headaches (64% versus 46%) and reported that pain interfered less with their daily activities. After 24 weeks, patients in the chiropractic group continued to experience greater benefit from their treatment, with 56% reporting that their head pain was less disabling compared to 38% improvement among the control group. Over three-quarters of participants who received spinal manipulation treatment noted some reduction in the number of headaches during the course of the study. The study’s authors conclude that, “Spinal manipulation had a clinically important advantage over light massage in headache pain, number, and disability.” Their research shows that chiropractic treatment can have substantial and lasting benefits for a significant percentage of people suffering from cervicogenic headaches. Haas M, Schneider M, Vavrek D. Illustrating risk difference and number needed to treat from a randomized controlled trial of spinal manipulation for cervicogenic headache. Chiropractic & Osteopathy 2010; 18:9

[1] Haldeman S, Dagenais S. Cervicogenic headaches: a critical review. Spine J.2001; 1(1):31 -46.