Headache and Migraine
Chiropractic care of headache and migraine
If you are reading this, chances are you, or someone you know, suffers with headache or migraine. In fact, headache is a significantly common health problem (becoming more so with every decade), and, after neck pain and back pain, is the third most common reason for visits to a chiropractor.
Headache can be experienced as pain in the front, back, top or sides of the head, in the upper neck and in the sinus region. It can be felt as a constant dull ache, a sharp stabbing pain (a “splitting headache”) or a harsh throbbing sensation. Migraine, the severest and most debilitating form of headache, can also result in nausea, vomiting and other symptoms.
Besides spouses and teenaged kids, headaches may be the result of several factors, stress being one of the primary ones. Stress leads to tightness in neck and upper back muscles, and can cause dysfunction in the spinal joints of the neck. This is very important for headache sufferers to understand, as research reveals that most headaches are directly caused by mechanical problems in these joints, whether the joint dysfunction is the result of stress, trauma, poor posture or chronic wear and tear.
Our approach to headache treatment
When a patient comes to my office complaining of headache, my first goal is to determine the type of headache they have and what may causing it. If the headache appears to be the result of a biomechanical problem (think spinal joints, muscular tension or postural issues), and I believe I may be able to help them with this problem, I will outline a course of care. It is important to understand that chiropractic care may not be an appropriate option for treating all types of headaches. Should I determine that a patient's headache is not due to a mechanical issue that might be helped with chiropractic or TRIGENICS care, I will refer them to another health provider.
So, how do I treat headaches of mechanical origin? I'll keep this as simple as possible: I work to improve spinal joint motion and restore optimum muscle tone. Sometimes, poor spinal mechanics is caused by a flattening or reversed curve in the neck (as seen on x-ray). It is essential in these cases to utilize treatment methods that improve the curve. In my office the approach we use to improve spinal curves is a technique called Chiropractic Biophysics (CBP). CBP has the most peer-reviewed published research of any chiropractic technique, and numerous peer-reviewed studies in both chiropractic and medical journals have demonstrated the effectiveness of CBP in spinal curve correction.
I will often complement the chiropractic adjustment and CBP care with soft tissue techniques, such as TRIGENICS, to help relax overactive muscles in the shoulders, neck and head, and improve general muscle tone. In addition to chiropractic care and TRIGENICS treatment, I often guide patients in specific exercises to do at home and at work or school, as well as tips to improve posture.
The following are the five most common types of headache, and my recommendations for relieving them:
Cervicogenic and Tension Headaches
The most common type of headache is cervicogenic headache (headache caused by mechanical problems in the neck). The structures most likely involved in cervicogenic headache are the three uppermost nerves in the neck, and the joints, muscles, ligaments and blood vessels these nerves innervate. New research has shown that many headaches, perhaps as high as 80 percent, previously thought to be tension or migraine headaches, are actually cervicogenic headaches.
Roughly 80% of the population suffers from cervicogenic or tension headaches at some point in their lives, with women being nearly twice as likely to suffer from them. Besides mechanical problems involving the nerves and joints in the neck, a number of other factors can contribute to tension headaches, such as hunger, anxiety, stress, lack of sleep and posture.
So what does the research show to be the most effective treatment for cervicogenic and tension headache? That's right: correcting the mechanical problems in the neck that are the root cause of the pain. This is why chiropractic is often extremely helpful for most people who suffer from headache. Chiropractic spinal adjustments improve joint motion, relax muscle tension and restore normal nerve function.
Because tension headache is usually multifactoral, consider also making changes to your sleep habits, diet, or mood. Be honest with yourself and consider the following: Are you getting enough sleep? Are you eating enough meals and getting proper nutrition? How is your mood on a day-to-day or week-to-week basis? Try making changes wherever necessary, and make sure you get adjusted!
Shorter in duration than cervicogenic and tension headaches, cluster headaches can be extremely painful and occur daily for weeks or months at a time. A common identifier of cluster headaches is one-sided pain, either on the left or right side of your head, along with watering eyes or nasal congestion on that side of the face. Being seasonal in their nature, those who suffer from cluster headaches tend to battle them at similar times each year. This seasonal nature also leads to cluster headaches being incorrectly associated with allergies. While the cause is still largely up for debate, it is known that the trigeminal nerve, a nerve in the face, is involved with the occurrence of cluster headaches. In terms of severity, cluster headaches are comparable to migraines, but are typically of shorter duration.
As far as nerve pain is concerned, chiropractic care is an excellent option for treatment. Pain stemming from the trigeminal nerve can sometimes be related to joint dysfunction in the cervical region of the spine where the nerve originates. By improving joint motion in that region of the spine through chiropractic adjustments, the chances of future cluster headaches can be reduced if, indeed, poor joint function was the cause of the nerve pain.
Generally, these types of headaches come as a result of inflamed sinuses and are often joined by a fever, runny nose, or sometimes swelling in the face. Provided that the inflammation is a result of illness, sinus headaches aren’t generally chronic and subside when inflammation of the sinuses has been alleviated.
Nasal decongestants are often helpful in these instances if the problem is simply nasal congestion. To treat infections, it might make more sense to consider taking antihistamines or antibiotics. Non-medical treatments include considerable amounts of fluid, using a dehumidifier, or inhaling saltwater nasal spray.
Rebound headaches are often a result of overusing painkillers. Despite being commonly linked with overuse of Motrin, Tylenol, and/or Advil, prescription drugs have also been known to cause such headaches if overused.
Likely a form of withdrawal, these types of headaches can most easily be avoided by carefully monitoring the use of painkillers.
Frequently confused with tension headaches, migraines are actually quite different from any of the types listed above. Mainly differing in terms of pain intensity and symptoms such as vomiting or temporary vision loss, migraines can be not just painful, but debilitating. Other symptoms include pain (sometimes) being one-sided, pain in the temples, or extreme sensitivity to light.
In terms of causal nature, migraines and tension headaches are actually quite similar. Stress, sleep habits, diet, and muscular tension in the neck have all been known to impact the likelihood of migraines.
To prevent future onset, consider making positive alterations in the above areas. If improvements in your health aren’t made, consider consulting a doctor. Other preventative measures include chiropractic adjustments to relieve muscle tension in the neck. Over-the-counter drugs such as acetaminophen, aspirin or ibuprofen are also helpful. Be aware, however, that overuse of these drugs can lead to other health problems.