There are many types of headaches cited in medical literature. I would like to focus on the most common that can be helped in chiropractic practice. Tension, Jaw (TMJ) and cervicogenic headaches (originating in the neck, shoulders and spine) would be the most common; followed by migraine headaches. Serious life threatening causes of headache that include aneurism, vertebral/carotid artery dissection, brain tumors and head injuries can present to the chiropractor’s office and it is our role if suspected to refer out for medical opinion immediately. Thankfully they are relatively rare.
Chiropractic for Headaches & Migraines
What Type of Headache do I have?
Usually present as a generalized headache characterized as a dull tightness around the scalp. Tension headaches can affect concentration, mood and can cause nausea. The Jaw (TMJ) can also be involved which can be caused by clenching or grinding because of stress, jaw injury or misalignment.
Cervicogenic Headache (originating in the neck, shoulders and spine):
Typically one-sided intense non-throbbing headache that can cause nausea and vomiting if severe enough. It can feel like the pain is behind one eye ball. No visual disturbance or neurological signs. Usually involves pain and discomfort in the upper neck.
Usually an intense headache on one side that can involve nausea, vomiting and visual disturbance. Some migraines begin with visual disturbance like partial blind spots or squiggly lines in the visual field with the headache beginning after about 20 minutes. It has a throbbing pulsating nature. Due to its severity and the other symptoms the migraine patient cannot function and is usually bedridden.
Diagnosis of your Headache Type & Treatment
Depending on the type of headache your chiropractor will determine the course and method of treatment. Providing that the headache has not arisen due to a serious medical reason treatment usually begins. Usually the chiropractor will be able to reproduce the headache in the patient by pressure especially in the neck, head and sometimes the shoulder region. If the headache is not of spinal origin appropriate referral to another specialist will be organized. All spinal related headaches will involve treatment via spinal adjustments and acupressure techniques. The region usually involved is the upper cervical region. In tension related headaches the TMJ (Jaw Joint) is often involved due to stress. Stress management techniques will also be discussed. With migraines there can also be dietary factors as well as hormone factors that will be addressed sometimes involving co-management with other health professionals.
What Research Shows
“Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.”
McCrory, Penzlen, Hasselblad, Gray (2001), Duke Evidence Report
“The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. . . Four weeks after cessation of treatment . . . the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values.” ‘
Boline et al. (1995), Journal of Manipulative and Physiological Therapeutics
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