Are your headaches a pain in the neck?
Chiropractors are well known for their treatment of back pain and musculoskeletal issues in general. However, they may not be the first people that spring to mind when you are searching for a solution to persistent headaches. So, you may be surprised to hear that a notable proportion of our patients have been treated successfully for pain associated with headaches.
This is not to say that chiropractic can be regarded as a ‘go-to’ treatment for all types of headache; your chiropractor would first establish what is causing your particular type of headache and look to rule out any ‘red flags’ for more serious causes of the pain (more about these later).
So, what kind of headache is it?
A headache is defined as being a pain in any part of the head. It can occur on the either side, radiate across the head or to a more specific point, or even feel like a tight band around the head. There are numerous types of headache, each with specific symptoms, duration of pain, and occurrence. Unsurprisingly, 90 % of the population will experience a headache at some point in their lives. There are 3 common types of headache that respond well to chiropractic treatment…
Tension headache
This type of headache produces a tight band-like pain around the head and accounts for 26% of all headaches.
Tension headaches do not usually cause the sufferer any form of disability, other than the pain itself, as they tend to be mild to moderate in intensity and not aggravated by physical activity. These headaches are usually triggered by factors such as stress or anxiety, lack of sleep, loud noises, dehydration or even depression. They generally last from 30 minutes to a few hours, but may persist for longer.
Recent studies have shown that manual therapy, such as chiropractic treatment and soft tissue work, significantly reduces the frequency and duration of tension headaches.
Cervicogenic headache
These headaches occur when pain is referred up to the head from the neck. 15-20% of all headaches are cervicogenic headaches.
The pain is usually unilateral (one-sided), dull, constant and non-throbbing in nature. The initial pain generally begins at the base of the skull, radiating up and into the head, spreading along the scalp and towards the temple, eye and/or ear area. It is commonly associated with neck stiffness and a diminished range of neck motion and may last anything between 1 hour and 1 week, sometimes persisting even longer. Adults between the ages of 33 and 43 are most commonly affected by these headaches. Chiropractic treatment, massage, dry-needling and other techniques used by the chiropractors at Creative Chiro have been effective in the treatment of cervicogenic headaches. Studies have also shown that these manual therapies, combined with an ongoing exercise regime, often produces the best outcome in patients suffering from these headaches.
Migraine headache
This is the most common disabling headache, with between 28-40 million working days lost in the UK annually due to migraine absenteeism.
1 in 5 women, and 1 in 15 men in the UK suffer from migraines. It can be accompanied by visual disturbance. An aura may occur before the migraine starts and is usually a flicker of light or zigzags across the visual field.
Practitioners speak of the 5 Cs in terms of migraine triggers. These are cheese, chocolate, coffee, cola, and citrus fruit. Other triggers include sleep disruption or not enough sleep, dehydration, skipping meals, hormonal fluctuations, exposure to certain chemical substances, and even vitamin D deficiency in some cases.
Symptoms of a migraine may include throbbing or pulsating pain in one or both sides of the head, nausea, light and/or sound sensitivity, and is aggravated by physical activity. It is a disabling, recurring headache of varied frequency, usually lasting for a period of 24-72hrs.
Chiropractic treatment can assist migraine sufferers in diminishing the intensity and frequency of their migraines, through manual treatment, lifestyle and nutritional advice, and exercise therapy.
And what about those red flags?
There are a few headache symptoms that we need to be aware of, as they may be indicative of something more significant. We call these symptoms RED FLAGS. These types of head pain usually require immediate medical investigation and should be attended to by specialists in a hospital environment.
A new, severe, explosive or violent headache, which starts suddenly and reaches its peak intensity within 5 minutes. Usually called a thunderclap headache.
A stiff neck with an associated fever along with nausea or vomiting, skin rash, and confusion.
Headache accompanied by slurred speech, altered vision, problems in moving limbs, loss of balance, or memory loss.
Worsening of a pre-existing headache with no other predisposing factors.
Headache associated with a history of cancer, HIV, or any other systemic illness.
Is your headache actually a pain in the neck?
Another thing to consider is that many patients confuse true headaches with pain referrals from other areas of the body.
For example, localised areas of spasm -known as trigger points - in muscles such as the sternocleidomastoid (SCM) and scalenes in the neck, the temporalis muscles in the skull, or the pterygoids and masseter muscles of the jaw can all refer pain into the face and head when active.
Issues with the joint that hinges the jaw (the temporomandibular joint or TMJ) and dental problems may also refer pain into the face and temporal area.
Inflamed and blocked sinuses also simulate headaches with pain across the temple, eyebrows and cheekbones.
Practitioners at Creative Chiro are trained to recognise each of these conditions to ensure that you receive the correct diagnosis of your pain, in order to achieve the best outcome.
What can we do to help?
Your chiropractor at Creative Chiro will assess you by taking a comprehensive history, followed by a physical examination, including orthopaedic and neurological assessments. These are all vital, to not only determine the type of headache you are experiencing, but to rule out any red flags.
If appropriate, a treatment plan is discussed with you, including various procedures such as manipulation/mobilisation, soft tissue therapy, dry needling, stretching, nutritional/lifestyle and postural advice, or in certain circumstances, a referral to your GP/A&E for further assessment.
A recent case of mine perfectly illustrates this. The patient had seen our website and decided to call us as he was growing increasingly concerned, having suffered from agonising, recurrent headaches for several weeks. He had consulted with his GP, had been sent for numerous blood tests, scans and other tests, all to no avail. Pain medication was not beneficial at all.
The reception team ensured that all the relevant information was gathered from the patient regarding these tests and scan results before he was booked in for treatment. Although an initial MRI had shown no evidence of mass, haemorrhage or infarction (stroke), he was awaiting a further scan in the coming days to rule out an area of slight concern for an aneurism.
It was agreed that he would attend the Practice for his initial consultation on the understanding that any treatment would be approached with caution until we had the results of the final scan.
After a thorough initial consultation, including neurological tests, he received his first treatment: Light soft tissue therapy on the muscles in his thoracic and cervical spine, gentle stretching of these same muscles and gentle chiropractic manipulation of his mid thoracic spine.
Happily, the patient immediately felt some improvement in his condition. We then tracked the results of his final scan and were subsequently able to ring the patient to assure him that the scan results were clear and I could proceed with a full chiropractic treatment plan.
On his second appointment, I was able to confirm that the headaches were cervicogenic with associated neuralgia (nerve pain). To address this issue, he required chiropractic adjustments to his cervical C-1 and mid-thoracic spine, combined with soft tissue therapy on his scalene, sternocleidomastoid (SCM) and the suboccipital muscles at the base of the skull/top of the spine, which contribute to movement of the head. This was combined with myofascial release techniques, applied over the suboccipital area.
The patient was also given stretches to do at home, along with postural and lifestyle advice. Not only has the treatment successfully alleviated his painful headaches, it has also improved the range of motion in his neck. This has allowed him to get back to doing the things in life that he enjoys, without the debilitating pain and added worry about whether there was something more serious causing his symptoms.