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Headache
Headache is one of the most common reasons a
person consults any doctor. It is also, according
to a recent survey by a leading consumer magazine,
the single most common condition for which people
are dissatisfied with the treatment they have
received.
There are many different types of headaches,
and the most common are tension (muscle
contraction) headaches and migraines. Regardless
of the type of headache, effective treatment
starts with the identification of factors that
are unique to each patient and a clear
diagnosis.
At the Rhode Island Spine Center, the approach
we take to the treatment of headache sufferers
involves attempting to detect those specific
factors that are involved in the development of
each individual’s problem. We then employ a
strategy that is personalized to each patient
and is designed to correct these factors to
the fullest extent possible. This may involve
treatment at the Rhode Island Spine Center
alone, or may involve treatment in conjunction
with another health professional such as a
neurologist or pain specialist.
What are the Most Common Headache Types?
Most commonly, a person suffering from
headaches will have either the tension
headache or migraine headache types.
However, the distinction between these
headache types is not as simple as it
would seem. In fact, some experts believe
that there is no real distinction between
these headache types but, rather, they
all share a common underlying cause that
has several different contributing
factors.
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Tension Headache
Tension headaches are sometimes referred to
as muscle contraction headaches. They are the most
common type of headaches and can be felt anywhere in
the head, but the temples and forehead are the most
frequent areas. They are also associated with tightness
in the head or scalp. They are not typically
associated with other symptoms such as nausea, numbness
or visual sensations but can be worsened by
emotional stress.
Migraine Headache
Migraine headaches are usually more severe than
tension headaches and generally occur in attacks that
can last from a few hours to a few days. They are
often accompanied by other symptoms such as nausea,
vomiting, increased sensitivity to light and sound,
numbness or coldness in the hands or tremor.
In some cases, the patient experiences an aura - a
period of 10-30 minutes preceding the headache during
which the person experiences symptoms such as jagged
lines or flashing lights before the eyes, strange
odors, difficulty speaking or numbness.
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There are other, less common, types of headache that
must be considered for a proper diagnosis of the headache
disorder to be made. Some of the more important
ones are:
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Cluster headaches occur in "clusters"
which can occur for days, weeks or months at a time,
then disappear for up to a year or more.
Temporal arteritis headaches are caused by
inflammation of an artery and occcur on the
side of the head.
Sinus headaches are caused by sinus
infection.
In addition, more potentially serious causes of
pain in the head must be taken into consideration.
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How Can Headaches Relate to the Neck?
As was stated above, there are several different contributing
factors that lead to the development of tension headache,
migraine, or the mixed types of headaches that fall somewhere
in between these types. One of these is cervical spine
dysfunction. This can consist of joint dysfunction, in which
the joints of the neck lose their proper mobility, muscle
dysfunction, in which the muscles of the neck become either
excessively tense or excessively limp or instability, in which
the ability of the nervous system to properly regulate these
joints and muscles becomes disturbed. Most commonly, a
combination of these occurs, and the result is pain. This
pain can be perceived in the neck or referred pain can
develop, causing the pain to be perceived in the head.
How Can Referred Pain From the Neck Cause Headache?
The area in the brain to which the nerves that sense pain
in the head send their signals is the same area to which the
nerves that sense pain in the neck send their signals.
Because of this, the brain is not always able to localize
exactly from where the pain is arising. This, coupled with
the other factors that contribute to tension and migraine
headache, causes the pain to primarily be perceived
in the head.
What Are the Other Factors that Contribute to Headache?
In addition to dysfunction in the neck, most headache
conditions involve a disturbance in the control of the
chemicals and blood vessels of the brain. The delicate
balance that exists in the brain can be altered, leading
to conditions that are favorable for the development of
headache. If these conditions are combined with the
presence of dysfunction in the neck, the likelihood of
developing headache becomes greatly increased.
Are There Any Other Components That Are Significant in the Development of Headache?
There are certain secondary factors that can contribute
to the headache, or can be triggers for a headache
episode. These include stress, emotional upset or
certain foods like chocolate or red wine. Also,
hormones, such as those related to the menstrual
cycle, can play a role.
How is Headache Treated?
At the Rhode Island Spine Center, the staff
Chiropractic Physicians are trained in the
differential diagnosis and treatment of
headache. Working as a team with the staff
Physical Therapists, the treatment at the
Center is primarily aimed at the neck component,
as well as the secondary factors mentioned
above. This treatment may include any or
all of the following:
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Spinal Manipulation
Spinal Manipulation consists of gently moving
the involved joint into the direction in which
it is restricted and may involve the application
of a short, quick movement in that direction.
In many cases, a fast movement is not used,
but rather, a slow mobilizing movement is used.
"Cracking" type manipulation is often
useful but, in most cases, non-"cracking"
techniques are just as effective. If you are
nervous about "cracking" techniques,
please speak to your treating chiropractic
physician.
Muscle Relaxation / Stimulation
Muscle Relaxation or Stimulation Procedures consist
of gentle stretches to the involved muscle that has
excessive tension, or repeated contractions of the
muscle that is limp. Gentle finger pressure
techniques may be applied to the pain of trigger
points.
Stabilization / Sensorimotor Exercises
Stabilization or Sensorimotor Exercises are designed
to train your central nervous system to improve
stability so your neck is maximally protected
during routine activities.
Workplace and Lifestyle Advice
Workplace and Lifestyle Advice is designed to
address factors in your diet and work, home or
recreational activities that perpetuate the
dysfunctions that lead to headaches.
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The treatment plan developed for your specific problem
may include one or more of these approaches, and may
involve others as well. This may include referral to
another health professional, such as a neurologist,
if it is deemed appropriate.
© 2004 The Rhode Island Spine Center
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