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Assessment and treatment of headaches

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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About the Author

Dr. Nimchuk is one of a few full body certified Active Release Technique practitioners in the Okanagan Valley.  It has become known as the gold standard treatment for soft tissue injuries in athletics with almost every professional sports team in North America retaining the services of an ART certified Chiropractor.  Dr. Nimchuk has had the opportunity to work with many professional, Olympic and Ironman athletes.  ART is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART.  Dr. Nimchuk employs many different chiropractic techniques including manual and instrument adjusting along with ART.

In addition to private practice, Dr. Nimchuk is a frequent speaker and consultant to business organizations on topics such as ergonomics and workplace health.  Dr. Nimchuk is also registered as a Certified Exercise Physiologist with the Canadian Society of Exercise Physiology and has worked in many high performance and rehabilitation settings.

As part of his ongoing commitment to health and fitness, Dr. Nimchuk is a clinic instructor for marathon and 1/2 marathon clinics at the Kelowna Running Room and is also the Okanagan evaluator for the RCMP Physical Abilities Requirement Evaluation (PARE test).

To learn more about Dr. Nimchuk's treatments or to schedule a consultation, visit his website at momentumkelowna.com  or call 250-860-2212.


The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet presents its columns "as is" and does not warrant the contents.

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