Health Update: Headache – What Can You Do?

Headache – What Can YOU Do?

Headaches are one of the most common complaints for which patients seek chiropractic care. Chiropractic is especially helpful in the treatment of headaches because the three nerves that exit the top of the spine (upper neck) are often the cause of or directly related to headaches. These three nerves travel into the head and have to pass through a very thick group of muscles in the upper part of the neck near where these muscles attach to the base of the skull. This is why when you have headaches and rub the back of the neck, the muscles may feel tight and or tender. In fact, if enough pressure is applied over one of these three nerves, pain will radiate into the head following the course of the nerve, sometimes all the way into the eyes. When chiropractic treatment is applied in the upper neck region, a reduction of the headache and neck pain occurs because the muscle tension is decreased and joint motion is restored.


The International Headache Society (IHS) has classified headaches into two main categories, primary and secondary. Primary headaches occur for no known reason and there are four groups of these: 1) migraine, 2) tension-type, 3) cluster, and 4) “other” primary headaches. Secondary headaches are those with a specific cause such as sinus/allergy headaches, those associated with eye strain, a known medical condition or those due to cold or flu. Both migraine and cluster headaches are “vascular” (related to the blood vessels expanding inside the head) resulting in a unique set of symptoms that includes nausea, vomiting, pounding/throbbing and can be quite debilitating.

The most common type is the tension-type of headache. A thorough history is necessary because there is no specific diagnostic test (lab or blood test) for tension-type headaches. Hence, the concept is to make sure the headache is not related to some other condition that is diagnosable by a blood or lab test and if present, having that condition properly managed. So, assuming all the tests come back “normal” and all other causes have been eliminated or “ruled out,” the most common type of tension-type headache is “episodic” or, occurs off and on, lasting minutes to days. The pain is usually described as, “…my whole head hurts.” There is typically tightness or tension (NOT throbbing) described in the neck muscles and the intensity ranges from mild to moderate, not usually severe, where laying down is needed. Physical activity does not usually make it worse and there is no sickness to the stomach (nausea/vomiting), and no intense reaction to bright lights or noise (like there is with migraine & cluster types of headaches). There are sub-types of tension headaches that can occur simultaneous with migraines headaches, but the classic “aura” (a before the headache warning associated with migraine headaches) is usually not present.

Chiropractic treatment typically includes manipulation and mobilization of the neck, muscle release techniques, physical therapy modalities like electric stimulation, ultrasound, and others, exercise, stress and diet/nutritional management.

If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service. We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and we look forward in serving you and your family presently and in the future.

Health Update: Headaches

What Is It and What Can I Do About It?

“I woke up this morning with an excruciating headache.  I thought the top of my head was going to blow off!”  “I notice as the day goes on, tightness in my neck worsens and I get a headache usually by 2-3pm.” “I don’t know if I can do my work with my headaches.”

These are common patient history entries we frequently receive at our clinic.  Headaches are one of the most common complaints prompting patients to visit a health care provider.  Many patients ask, “...what is a headache?”  The National Institutes of Health (NIH) describe four types of headache: vascular, muscular contraction or tension, traction and inflammatory.

The most common form of a vascular headache is migraine.  Migraine sufferers usually complain of severe pain on one or both sides of the head, nausea or vomiting and sometimes visual changes.  There is often a heightened sensitivity to light or noise prompting migraine sufferers to lay in a dark, quiet room until the migraine passes.  Women are more likely to suffer from migraines than men and the severity of symptoms can be so extreme that all activity must be stopped until it passes.

The next most common type of vascular headache is the toxic headache produced by a fever.  Other vascular headache types include “cluster” headaches, which are characterized by repeated episodes of intense pain that start in one spot and spread out from that spot.  These may only last a few minutes to an hour but carry a very high level of pain and activity intolerance.  Another common type of vascular headache is that resulting from high blood pressure.

Muscle contraction or tension headaches involve tightening of the facial and neck muscles.  These often start in the neck and radiate over the top or to the sides of the head.  The muscles in the neck are usually extremely tight and tender and often, moderate pressure applied with the finger or thumb to these muscles will prompt radiating pain into and/or over the top of the head.  This can also result in significant activity intolerance but usually not as severe as migraine or cluster headaches.

Traction and inflammatory headaches result because of other conditions that range from a sinus infection to a stroke.  These types of headaches can serve as a warning sign of a more significant or serious condition.  Another example is meningitis as well as other conditions affecting the sinuses, spine, neck, ear, and teeth.

The NIH suggests, when headaches occur ≥3 times a month, that “… preventive treatment is usually recommended.” Certainly, in some cases, medication may be indicated but only after ruling out a more serious condition and after exhausting less invasive treatments that carry fewer side effects.

The American Chiropractic Association recommends:
1) avoid long time periods of staying in one position (computer, sewing machine, reading, etc.) and take stretching/neck range of motion exercise breaks every ½ to 1 hour
2) Exercise – walking, low impact aerobics
3) Avoid teeth clenching (due to straining the temporomandibular – TMJ, or jaw joint)
4) Drink lots of water – stay hydrated.

Chiropractic care may include spinal manipulation (adjustments), nutritional advice (dietary suggestions, vitamin/mineral options such as a B complex), exercise, posture retraining, and relaxation techniques.  If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.  If headaches are a problem, doesn’t a trial of chiropractic make sense prior to utilizing a more risk oriented treatment option?  We look forward in serving you and your family.

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ACUPUNCTURE AND MIGRAINES

Migraine attacks are severe headaches that last from 4 to 72 hours. The pain is often on one side of your head, throbbing and gets worse when you move. You may also have other symptoms, such as feeling and being sick or being extra-sensitive to sound or light. About 1 in 6 people who have migraines get what's called an aura. This can cause symptoms like temporary problems with your vision, or pins and needles or numbness in parts of your body. You may be more likely to get a migraine attack if you are tired, hungry or stressed, or eat or drink certain foods. Migraines are common. About 1 in 10 people will have a migraine attack in any one year and nearly 1 in 5 people will have an attack at some point in their life. Women are more likely to have migraine attacks than men.

How acupuncture can help?

Traditional acupuncture theory sees pain as being largely due to obstruction of the body’s vital energy or qi. Acupuncture needles are thought to act like switches in the body’s energy circuits, freeing up stagnant energy and getting it flowing.

Research has shown that acupuncture is significantly better than no treatment and also at least as good, if not better than, standard medical care for migraine. From a biomedical perspective, acupuncture can help in the treatment of migraine by:

• providing pain relief – by stimulating nerves located in muscles and other tissues, acupuncture leads to release of pain killing endorphins and changes the processing of pain in the brain and spinal cord.

• reducing inflammation – by promoting release of various biochemical substances.

• increasing blood flow in and around the brain.

• affecting the brain levels of a chemical called serotonin, which has various functions, including control of appetite and mood.

Traditional acupuncture takes a holistic approach to health and regards illness as a sign that the body is out of balance. The exact pattern and degree of imbalance is unique to each individual. The traditional acupuncturist’s skill lies in identifying the precise nature of the underlying disharmony and selecting the most effective treatment. The choice of acupuncture points will be specific to each patient’s needs. Traditional acupuncture can also be used as a preventive measure to strengthen the constitution and promote general well-being.

An increasing weight of evidence from Western scientific research is demonstrating the effectiveness of acupuncture for treating a wide variety of conditions. From a biomedical viewpoint, acupuncture is believed to stimulate the nervous system, influencing the production of the body’s communication substances - hormones and neurotransmitters. The resulting biochemical changes activate the body's self-regulating homeostatic systems, stimulating its natural healing abilities and promoting physical and emotional well-being.

by Dr. Maria Phillips, DAOM, L.Ac.

New Headache Study Shows the Benefits of Chiropractic Care by Dr. Joseph Cilea


Headaches are a common complaint in patients presenting for professional care, including chiropractic management. Patients with headaches seek chiropractic care because they find manipulation or adjustments applied to the cervical spine and upper back region are highly effective in reducing the intensity, frequency and duration of the headache pain. This is because the cervical spine / neck, is often the origin of the headache as the three nerves in the upper neck (C1, 2 and 3) pass through the thick, overly taught neck muscles in route to the scalp / head. When the muscles of the neck are in spasm, the nerves get “pinched” or squeezed by the overly tight muscles resulting in headache pain. Each nerve runs to a different part of the head and therefore, pain may be described as “…radiating over the top of head (sometimes into the forehead and eyes),” or, into the head and over the ear, sometimes reaching the temple. Also, an area located in the back and side of the head is the area where the C1 nerve innervates, so pain may also be reported in that location. When more than one of the C1-3 nerves is pinched, the whole side to the top of the head may be involved.

In the October 2009 issue of The Spine Journal, Western States Chiropractic College, Center for Outcomes Studies, reported benefits are obtained with the utilization of spinal manipulation in the treatment of chronic cervicogenic headaches. The word “chronic” means at least 3 months of headache pain has been present. This new study compared 2 different doses of therapy using several outcome measures including the pain grade, the number of headaches in the last 4 weeks and the amount of medication utilized. Data was collected every 4 weeks for a 24 week period and patients were treated 1-2 times/week and separated into either an 8 or a 16 treatment session with half the group receiving either spinal manipulative therapy or a minimal light massage (LM) control group.

The results of the study revealed the spinal manipulation group obtained better results than the control group at all time intervals. There was a small benefit in the group that received the greater number of treatments with the mean number of cervicogenic headaches reduced by 50% in both pain intensity and headache frequency.

The importance of this study is significant as there are many side effects to medications frequently utilized in the treatment of headaches. Many patients prefer not taking medications for this reason and spinal manipulation therapy (SMT) offers a perfect remedy for these patients. Couple SMT with dietary management, lifestyle modifications, stress management, and a natural, vitamin/herbal anti-inflammatory (such as ginger, turmeric, boswellia) when needed, a natural, holistic approach to the management of chronic headaches is accomplished.

We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and look forward in serving you and your family presently and in the future.

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