Treating Headaches
Headaches present themselves in different ways but they affect everyone. Sometimes a headache is a pain in a specific part of the head, such as behind the eyes. Or maybe it’s a general pounding sensation, perhaps accompanied by nausea. The pain itself may be dull or sharp and may last for anywhere from a few minutes to a few days.
Headache pain can result from low blood sugar, high blood pressure, stress or fatigue, reaction to drugs, temporomandibular joint dysfunction (TMJ) or tightness in the neck muscles. Recurrent headaches are generally of two types: tension headaches (also called cervicogenic headaches) and migraine headaches. There is a third, less common type of headache called a cluster headache which is similar to a migraine.
Types of Headaches
Tension Headaches
The most common type of headache is called a tension headache. Tension headaches affect perhaps 75% of all headache sufferers. Most people describe a tension headache as pain on either one side or both sides of the head, like a tight band or a dull ache behind the eyes.
These headaches usually begin slowly and increase in intensity gradually. They tend to begin toward the end of the day, lasting a few minutes or a few days. Tension headaches are often the result of bad posture, which stresses the spine and the muscles in the upper back and neck. In some cases, chronic tension headaches will persist for months. Other symptoms such as nausea, throbbing or vomiting are not usually associated with tension headaches.
Subluxations are the most common cause of tension headaches. Trigger points are often in the upper back and neck. When the top cervical vertebrae lose their normal motion or position, a small muscle called the rectus capitis posterior minor (RCPM) muscle can spasm. This small muscle has a tendon that slips between the upper neck and the base of the skull and attaches to the thin tissue called the dura mater that covers the brain. Although the brain itself has no feeling, the dura mater is 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 often suffer from this type of headache.
Referred pain from trigger points in the Sternocleidomastoid (SCM) or levator muscle on the side of the neck can be a cause of tension-tupe headaches. These are more common in people who suffer muscle damage due to a whiplash injury.
Migraine Headaches
25 million people in the U.S. experience migraine headaches each year. Among these, about 75% are women. Migraines are often associated with nausea and sensitivity to light or noise. They can last from a few hours to as long as a week and include dissociative visual symptoms such as the sight of auras or flashing lights prior to an attack.
Migraine headaches often run in families and first appear before age 30. This supports the theory that there is a genetic component involved. Some people have attacks several times a month while others may have less than one a year. With age, migraine attacks occur less frequently and become less severe.
Constriction, then dilation, of the blood vessels in the brain cause a migraine headache. The decreased flow of blood during constriction leads to the visual symptoms that many people experience, but even those who do not see auras can usually tell an attack is imminent.
Dilation leads to a rapid increase in blood pressure and the typical, pounding headache. With each heartbeat, pressure pulses into the brain through the carotid arteries in the neck.
There is still debate about why the blood vessels constrict in the first place. Lack of sleep, stress, flickering lights, strong odors, even changing weather patterns can all trigger migraines. Food, too, can be a catalyst, especially those that are high in an amino acid called 'tyramine'. Lifestyle changes can be a factor in reducing the occurrence of migraines.
Cluster Headaches
Cluster headaches are short, excruciating and usually felt behind the eye as, normally on one side of the head. Unlike migraines, cluster headaches are much more common in men. This is the only type of headache that tends to occur at night.
They are called 'cluster' headaches because they tend to occur over a period of several days, one to four times per day. It may be months or even years between the clusters. As with migraines, cluster headaches are likely due to a localized increase in blood pressure and dilation of the blood vessels.
Chiropractic Care for Headaches
Chiropractic adjustments are uniquely 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 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.
Afflicted individuals require a thorough evaluation before a proper course of chiropractic care can be determined. In most cases of tension headaches, significant improvement can be achieved through manipulation of the upper two cervical vertebrae, coupled with adjustments to the junction between the cervical and thoracic spine. If food and lifestyle triggers can be avoided, this treatment is also helpful in most cases of migraine headaches.
Headache Trigger Points
Trigger point therapy for headache targets four muscle groups: 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. These muscles connect the upper back to both the base of the skull (splenius capitis) and the upper cervical vertebrae (splenius cervicis). Trigger points in the Splenius muscles cause pain that travels to the top of the head or to behind the eyes.
The Suboccipitals, a group of four small muscles, are responsible for maintaining 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 as if it is inside the head. The whole head can hurt, 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 the top of the sternum (breastbone). The SCM trigger points can affect balance and vision as well as referred pain that tends toward deep eye pain, headaches over the eye, even earaches, dizziness and nausea.
The trapezius muscle is the 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 to the back of the head. This trigger point is capable of producing satellite triggerpoints in the muscles in the temple or jaw, which can lead to jaw or tooth pain.
Migraine sufferers may experience visual symptoms called an "aura" prior to an attack. This aura is sometimes described as flashing lights.
Avoid Headache Triggers:
- Stress may be a trigger, but certain foods and odors, changes in weather or menstrual cycles are among the other factors that can lead to headaches.
- Emotional factors: depression, anxiety, frustration, letdown, and even pleasant excitement may be associated with developing a headache.
- Keep a diary of your headaches. This will help you determine whether such factors as food, change in weather, or mood have any relationship to your symptoms.
- Repeated exposure to nitrite compounds can result in a dull, pounding headache 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 contain sodium nitrite.
- Eating foods prepared with monosodium glutamate (MSG), a flavor enhancer, can result in headache. Soy sauce, meat tenderizer, and a variety of packaged foods contain MSG.
- Headache can also result from exposure to poisons, even common household varieties like insecticides. Children who ingest flakes of lead paint may develop headaches as could someone who has contact with batteries or lead-glazed pottery.
- Foods that are high in the amino acid tyramine, such as ripened cheeses (cheddar, brie), chocolate, or any food pickled or fermented, should be avoided.