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Headaches
Most people describe a tension headache as a feeling of a tight band or dull
ache around the head or behind the eyes. A common cause of tension headaches is
subluxations in the upper back and neck.
Headaches affect just about everyone at some point and they can present
themselves in many different ways. Some people only experience pain in one part
of their head or behind their eyes, some people experience a pounding sensation
inside their whole head, and some people even experience nausea, while others do
not. The pain itself may be dull or sharp and may last for anywhere from a few
minutes to a few days. Fortunately, very few headaches have serious underlying
causes, but those that do require urgent medical attention.
Although headaches can be due to a wide variety of causes, such as drug
reactions, temporomandibular joint dysfunction (TMJ), tightness in the neck
muscles, low blood sugar, high blood pressure, stress and fatigue, the majority
of recurrent headaches are of two types: tension headaches (also called
cervicogenic headaches) and migraine headaches. There is a third, less common,
type of headaches called a cluster headache that is a cousin to the migraine.
Let’s start out by taking a look at each of these three types of headaches.
Tension Headaches
Tension type headaches are the most common, affecting upwards of 75% of all
headache sufferers. Most people describe a tension headache as a constant dull,
achy feeling either on one side or both sides of the head, often described as a
feeling of a tight band or dull ache around the head or behind the eyes. These
headaches usually begin slowly and gradually and can last for minutes or days,
and tend to begin in the middle or toward the end of the day. Tension headaches
are often the result of stress or bad posture, which stresses the spine and
muscles in the upper back and neck.
Tension headaches, or stress headaches, can last from 30 minutes to several
days. In some cases, chronic tension headaches may persist for many months.
Although the pain can at times be severe, tension headaches are usually not
associated with other symptoms, such as nausea, throbbing or vomiting.
The most common cause of tension headaches is subluxations in the upper back
and neck, especially the upper neck, usually in combination with active trigger
points. When the top cervical vertebrae lose their normal motion or position, a
small muscle called the rectus capitis posterior minor (RCPM) muscle goes into
spasm. The problem is that this small muscle has a tendon which slips between
the upper neck and the base of the skull and attaches to a thin pain-sensitive
tissue called the dura mater that covers the brain. Although the brain itself
has no feeling, the dura mater is very pain-sensitive. Consequently, when the
RCPM muscle goes into spasm and its tendon tugs at the dura mater, a headache
occurs. People who hold desk jobs will tend to suffer from headaches for this
reason.
Another cause of tension type headaches comes from referred pain from
trigger points in the Sternocleidomastoid (SCM) or levator muscle on the side of
the neck. These are much more common in people who suffer a whiplash injury due
to the muscle damage in the neck region.
Many of those who suffer from migraines experience visual symptoms called an
"aura" just prior to an attack that is often described as seeing
flashing lights.
Migraine Headaches
Each year, about 25 million people in the U.S. experience migraine
headaches, and about 75% are women. Migraines are intense and throbbing
headaches that are often associated with nausea and sensitivity to light or
noise. They can last from as little as a few hours to as long as a few days.
Many of those who suffer from migraines experience visual symptoms called an
"aura" just prior to an attack that is often described as seeing
flashing lights or that everything takes on a dream-like appearance.
Migraine sufferers usually have their first attack before age 30 and they
tend to run in families, supporting the notion that there is a genetic component
to them. Some people have attacks several times a month; others have less than
one a year. Most people find that migraine attacks occur less frequently and
become less severe as they get older.
Migraine headaches are caused by a constriction of the blood vessels in the
brain, followed by a dilation of blood vessels. During the constriction of the
blood vessels there is a decrease in blood flow, which is what leads to the
visual symptoms that many people experience. Even in people who don’t
experience the classic migraine aura, most of them can tell that an attack is
immanent. Once the blood vessels dilate, there is a rapid increase in blood
pressure inside the head. It is this increased pressure that leads to the
pounding headache. Each time the heart beats it sends another shock wave through
the carotid arteries in the neck up into the brain.
There are many theories about why the blood vessels constrict in the first
place, but no one knows for sure. What we do know is that there are a number of
things that can trigger migraines, such as lack of sleep, stress, flickering
lights, strong odors, changing weather patterns and several foods; especially
foods that are high in an amino acid called ‘tyramine.’You can reduce the
likelihood of migraine headaches by making some lifestyle changes.
Cluster headaches are typically very short in duration and are usually felt
on one side of the head behind the eyes.
Cluster Headaches
Cluster headaches are typically very short in duration, excruciating
headaches, usually felt on one side of the head behind the eyes. Cluster
headaches affect about 1 million people in the United States and, unlike
migraines, are much more common in men. This is the only type of headache that
tends to occur at night. The reason that they are called ‘cluster’ headaches
is that they tend to occur one to four times per day over a period of several
days. After one cluster of headaches is over, it may be months or even years,
before they occur again. Like migraines, cluster headaches are likely to be
related to a dilation of the blood vessels in the brain, causing a localized
increase in pressure.
Chiropractic Care for Headaches
Numerous research studies have shown that chiropractic adjustments are very
effective for treating tension headaches, especially headaches that originate in
the neck.
A report released in 2001 by researchers at the Duke University
Evidence-Based Practice Center in Durham, NC, found that "spinal
manipulation resulted in almost immediate improvement for those headaches that
originate in the neck, and had significantly fewer side effects and
longer-lasting relief of tension-type headache than commonly prescribed
medications." These findings support an earlier study published in the Journal
of Manipulative and Physiological Therapeutics that found spinal
manipulative therapy to be very effective for treating tension headaches. This
study also found that those who stopped chiropractic treatment after four weeks
continued to experience a sustained benefit in contrast to those patients who
received pain medication.
Each individual’s case is different and requires a thorough evaluation
before a proper course of chiropractic care can be determined. However, in most
cases of tension headaches, significant improvement is accomplished through
manipulation of the upper two cervical vertebrae, coupled with adjustments to
the junction between the cervical and thoracic spine. This is also helpful in
most cases of migraine headaches, as long as food and lifestyle triggers are
avoided as well.
Headache Trigger Points
Trigger point therapy for headaches tends to involve four muscles: the
Splenius muscles, the Suboccipitals, the Sternocleidomastoid (SCM) and the
Trapezius. The Splenius muscles are comprised of two individual muscles – the
Splenius Capitis and the Splenius Cervicis. Both of these muscles run from the
upper back to either the base of the skull (splenius capitis) or the upper
cervical vertebrae (splenius cervicis). Trigger points in the Splenius muscles
are a common cause of headache pain that travels through the head to the back of
the eye, as well as to the top of the head.
The Suboccipitals are actually a group of four small muscles that are
responsible for maintaining the proper movement and positioning between the
first cervical vertebra and the base of the skull. Trigger points in these
muscles will cause pain that feels like it’s inside the head, extending from
the back of the head to the eye and forehead. Often times it will feel like the
whole side of the head hurts, a pain pattern similar to that experienced with a
migraine.
The Sternocleidomastoid (SCM) muscle runs from the base of the skull, just
behind the ear, down the side of the neck to attach to the top of the sternum
(breastbone). Although most people are not aware of the SCM trigger points,
their effects are widespread, including referred pain, balance problems and
visual disturbances. Referred pain patterns tend to be deep eye pain, headaches
over the eye and can even cause earaches. Another unusual characteristic of SCM
trigger points is that they can cause dizziness, nausea and unbalance.
The trapezius muscle is the very large, flat muscle in the upper and mid
back. A common trigger point located in the very top of the Trapezius muscle
refers pain to the temple and back of the head and is sometimes responsible for
headache pain. This trigger point is capable of producing satellite trigger
points in the muscles in the temple or jaw, which can lead to jaw or tooth pain.
Avoid Headache Triggers
Stress may be a trigger, but certain foods, odors, menstrual periods, and
changes in weather are among many factors that may also trigger headache.
Emotional factors such as depression, anxiety, frustration, letdown, and
even pleasant excitement may be associated with developing a headache.
Keeping a headache diary will help you determine whether factors such as
food, change in weather, and/or mood have any relationship to your headache
pattern.
Repeated exposure to nitrite compounds can result in a dull, pounding
headache that may be accompanied by a flushed face. Nitrite, which dilates blood
vessels, is found in such products as heart medicine and dynamite, but is also
used as a chemical to preserve meat. Hot dogs and other processed meats
containing sodium nitrite can cause headaches.
Eating foods prepared with monosodium glutamate (MSG) can result in
headache. Soy sauce, meat tenderizer, and a variety of packaged foods contain
this chemical which is touted as a flavor enhancer.
Headache can also result from exposure to poisons, even common household
varieties like insecticides, carbon tetrachloride, and lead. Children who ingest
flakes of lead paint may develop headaches. So may anyone who has contact with
lead batteries or lead-glazed pottery.
Foods that are high in the amino acid tyramine should also be avoided, such
as ripened cheeses (cheddar, brie), chocolate, as well as any food pickled or
fermented foods.
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