Cedar Wood Chiropractic
Total Body Health Care
Chronic Headaches - April 28, 2011
By Dr. Michelle KmiecDo you or someone you know have chronic headaches? See how Chiropractic Care can Help!
People often visit a chiropractor to seek relief from their headaches, usually only after exhausting the route of pharmaceuticals drugs and becoming concerned with the negative side effects of their long-term use. Often the cause of headaches is spinal ‘misalignments’ with muscle spasms in the neck. Chiropractic care remedies headaches by removing the tension, which causes interference of the nerve roots which is the principal reason for the pain. After chiropractic care the headaches are much improved, allowing the patient to discontinue the use of the medicines.
There has been much research about chiropractic cervical (neck) adjustments and the reduction of many types of headaches. The increasing body of evidence strongly supports that headaches can be safely diminished without the dangerous side effects of NSAIDS (Non-Steroidal Anti-Inflammatory Drugs) and other pain-relieving medications that are too often prescribed by chiropractic care.
Basically there are two types of headaches that are most common: tension and migraine. Tension headaches (cervicogenic headaches) are the most common resulting from contraction of head and neck muscles. They can occur in isolated incidents but all too often become chronic. Some possible causes of muscle contraction associated with tension headaches include stress and fatigue. Although migraine headaches are not as common as tension headaches, they can be debilitating to those who suffer from them. This type of headache occurs when blood vessels of the head and neck constrict, resulting in a decrease in blood flow to the vessels and the consequential throbbing pain, most often on one side of the head with an associated feeling of sickness and sensitivity to light and sound. The cause of migraines is more a mystery than tension headaches but, nonetheless, modern thinking considers it a result of prolonged muscle tension and stress, triggered by allergic reactions, and / or hormones.
One of the principal tools used by a chiropractor to establish the vertebral level that requires the cervical adjustment is done by manual palpation. The doctor manipulates the neck to determine the ROM (range of motion), pain, muscle tenderness and inflammation, and often the reproduction of the headache itself. The question here would be the effectiveness of the palpation. The study by Dr. Hanten et al. considers palpation as a reliable tool in identifying a tension / cervicogenic headache in symptomatic patients. Upon the diagnosis of the subluxated vertebra(s), there is an indication of the chiropractic adjustment. This can be executed by many technique. The most used technique, as well as most popular, is the diversified approach. The adjustment is done by a high-speed, low-amplitude thrust (HSLAT) to the segment identified as subluxated. The study by Dr. Nilsson et al. (1997) was to determine whether such an adjustment had any effect on cervicogenic (tension) headaches. The conclusion indicates that the adjustment done as HSLAT had significant reduction in the intensity of pain as well as a reduction of the duration of the headache. The study substantiates another study done earlier by Dr. Nilsson (1995), when he wanted to establish whether HSLAT adjustments are an effective treatment on cervicogenic headaches. He determined that the adjustments had possible positive effects but the methodology was skewed resulting in the later 1997 study.
One idea that intrigues is the decrease of the subjective pain associated with headaches as it relates between chiropractic care and medical pain relievers. One such study was done by Dr. Boline et al. They wanted to compare the effectiveness of chiropractic treatments with amitriptyline — pharmaceutical treatment prescribed for chronic pain syndromes. They found Amitriptyline slightly more effective in reducing the pain but was associated with adverse side effects at the end of the treatment, which lasted for a six-week period. Some common side effects can range from: dizziness; drowsiness, dryness of mouth, headache, and increased appetite (may include craving for sweets), nausea, tiredness or weakness, unpleasant taste, and weight gain. Those who received the spinal manipulative therapy experienced sustained therapeutic benefit without the negative side effects.
What remains a question is: How many visits to the chiropractor does it take for headaches to go away? Dr. Haas et al. asked the same question and found there was relief from headache pain in nine to twelve visits, although more than twelve visits may be required for maximum relief.
Conclusion
Chiropractic care has come a long way since its entrance in 1895 by the founder D. D. Palmer. What chiropractic has lacked is the research to prove the efficacy of the chiropractic system and the benefits of its use. As time has passed, more and more research has been done to validate the effectiveness of chiropractic care and although the iceberg has barely been scraped, progress is starting to be made. The research done chiropractic care and its effect on headaches has proved positive and certainly warrants more research including long-term studies.
References
Rasmussen B. “The epidemiology of headache.” Cephalgia, 1995. 15. 45-68.
Hanten W., Olson S., Ludwig G.M. “Reliability of Manual Mobility Testing of the Upper Cervical Spine in subjects with Cervicogenic Headache.” The Journal of Manual & Manipulative Therapy, 2002. 10(2). 76-82.
Nilsson N., Christensen H.W., Hartvigsen J. “The effect of Spinal Manipulation in the Treatment of Cervicogenic Headache.” JMPT, 1997. 20(5). 326-330.
Nilsson N. “A Randomized Controlled Trial of the Effect of the Spinal Manipulation in the Treatment of Cervicogenic Headache.” JMPT, 1995. 18(7). 435-440.
Sinnott R.; Chiropractic Books: “The Green Books”, 1997. Chapter 7. 117-118.
Phongphua C., Hawk C., Long C., Young C., Gran D.F. “Feasibility Study for a Clinical Trail of Chiropractic Care for Patients with Migraine
Headaches Using Different Chiropractic Techniques.” The Journal of Chiropractic Education, 1999. 13(1). 75. http://bipolar.about.com/cs/sfx/a/sfx_elavil.htm
Boline P.D., Kassak K., Bromfort G., Nelson C., Anderson A.V. “Spinal Manipulation vs. Amitriptyline for the Treatment of Chronic Tension-type Headaches: A Randomized Clinical Trail” JMPT, 1995. 18(3). 148-154.
Vernon H., Jansz G., Goldsmith C., McDermaid C.”A Randomized, Placebo-controlled Clinical Trail of Chiropractic and Medical Prophylactic Treatment of Adult Tension-type Headache.” Focus on Alternative and Complementary Therapies, 2003. 8(4). 548.
Haas M., Groupp E., Aickin M., Fairweather A., Ganger B., Attwood M., Cummins C., Baffes L. “Dose Response for Chiropractic Care of Chronic Cervicogenic Headache and Associated Neck Pain: A Randomized Pilot Study.” JMPT, 2004. Nov/Dec. 547-552.
