One of the most common conditions that patients present to chiropractors with is headaches. Headaches are prolific through society and billions are spent each year on treatment with painkillers and muscle relaxants. Usage of ibuprofen, acetaminophen and naproxen can provide temporary relief, however they don’t do anything to address the actual cause of what is happening. People who suffer from repeated headaches are best served from getting an assessment about the cause of headaches and a chiropractor is an excellent place to start.
Classification: Primary vs. Secondary
Headaches are group into Primary and Secondary (headache due to another condition: trauma, disease, cancer, substance abuse, infection, metabolic disorders). During an initial assessment, if a headache of secondary nature is suspected, it is often a cause for referral to either hospital or another medical provider. Signs and symptoms that indicate a headache is not appropriate for manual treatment include: fever, rash, abnormal mental status or what is known as a “thunderclap headache” (which is worst or first headache ever with sudden onset and very intense).
The majority of headaches however are primary headaches and include migraines, tension type headaches, and cluster headaches. Cluster headaches are quite rare (0.4% of all headaches), more dominant in males and are attributed to vasodilation. Migraine headaches are more frequent in females than in males and most people develop migraine headaches during adolescence or young adulthood. Despite years of research there is no unified hypothesis as to the cause of migraine headaches although it is theorized that migraines are vascular. There are two classifications of migraine headaches:
- Common: 80%; frontal (uni- or bilateral) no aura, 1-3 days
- Classic: 10%, unilateral, auras present, 2-6 hours, often vomiting
Migraine headaches are also unilateral (one-sided) and also have a pulsating quality. They are also aggravated by light, routine physical activity such as walking or for some lying down. Migraines are what are considered moderate to severe in intensity. Many patients respond quite well to chiropractic care when dealing with migraine headaches.
Tension-type headaches are by far the most common and fortunately the ones that tend to respond most readily to chiropractic treatment. Tension headaches are also known as cervicogenic headaches, which means referred to the head from either bony structures or soft tissues of the neck. Causes of cervicogenic headaches include: whiplash, arthritis, sports injuries, poor ergonomics, repetitive activities and weakness of neck muscles. A typical pain pattern for a cervicogenic headache is neck pain and stiffness that would start in the occipital region and travel overhead to the frontal region.
Treatment for cervicogenic headaches includes soft tissue treatment of the postural muscles of the neck and upper back such as the sub-occipitals and levator scapulae. Often times, treatment of these areas will temporarily reproduce the headache symptoms which is indicative that you are treating the right areas. Joint mobilization or manipulation of the upper back and cervical spine can also be a very effective treatment in treating headaches.
While active treatment from a chiropractor is a very effective treatment for headaches, it is also important to make preventative changes to your daily activities such as increasing the strength of your postural muscles and taking a long, hard look at your workspace to determine if those are contributing to your headaches. Again, your chiropractor is a great place to start to seek advice in these areas.
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