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Everybody gets a headache now and again. Some come on for no particular reason, some are self-inflicted and some are a warning sign of a more serious underlying concern. Twenty five years ago headaches were the third most common reason people sought medical attention, now according to a 2017 Mayo Clinic survey, that number has dropped to number 9 in the top ten. Although headache is clearly a major significant health burden, the public and many health care professionals see it as a somewhat trivial complaint. As a result, the physical, emotional, social and economic burdens of headache are poorly acknowledged compared with those of other, less prevalent, neurological disorders according to Shelagh Ross of the “World Headache Alliance.”
It has been estimated that 2.6 million adult Canadian women and just slightly less than one million adult men suffer from migraine, but only half are likely to have been adequately diagnosed by a doctor. As well, approximately 10% of children and 28% of adolescents complain of migraine headaches. The impact of headache, therefore, is substantial; there are surprisingly few actual causes of headache, with over 93% being related to the structures in the neck followed by sinus, toxicity and a few even rarer causes. Tumors actually represent less than 1% of headache causes. Statistically the most debilitating form of headache is the migraine. A Canadian survey shows that 92% of migraine sufferers have disability ranging from diminished function to requiring bed rest. Sufferers feel isolated, misunderstood, and often desperate. In Canada the cost of migraine in the workplace is approximately $500 million annually and in Ontario, the average overall annual cost due to migraine is estimated to be $3,025/patient, mostly due to indirect costs.
According to the World Health Association, the most common type of headache is called a tension or “cervicogenic” headache. TTH (tension type headache) is the most common primary headache disorder.
Episodic TTH, occurring on fewer than 15 days per month, is reported by more than 70% of some populations.
Nearly 90 per cent of women and about 70 per cent of men will get a tension headache during their lifetime, while 37 per cent of women and 21 per cent of men experience them regularly.
Tension type headache typically refers to a headache which originates from the neck and are often referred to in research as “cervicogenic headaches” While the pain begins from damage to the bony structures, soft tissues, or nerves of the upper neck, pain often spreads to or is referred to the frontal-temporal areas of the head – i.e. behind the eyes, ears, forehead, or jaw.
Tension-type-headache is the most common type of headaches, especially among people aged 20-60. According to the Cervicogenic Headache International Study Group, individuals with cervicogenic headache often present with a limited cervical range of motion, an altered neck posture, or pain which is triggered by certain neck positions or movements. In addition, when manually stimulated, certain muscular trigger points will refer pain to the shoulders or head. Cervicogenic headaches are primarily diagnosed by means of a physical exam and careful history taking. Other diagnostic tools may include: X-ray, magnetic resonance imaging (MRI),
In the ’90s, researchers began to uncover neck headache causes. First they discovered that the upper neck joints could refer pain to the head. Then they noted that certain nerves in the neck could also cause headaches. By the early 2000s, a few neurosurgeons began to notice that when they needed to cut through the upper neck muscles, some patients’ headaches would vanish. They then began studying cadaver dissections more closely, and they discovered what everyone else had missed: the upper neck muscles actually connected into the covering of the brain, called the dura. They called this newest neck headache connection the myodural bridge (myo=muscle and dural=covering of the brain).
To quote Dr. Chris Centeno MD and specialist in regenerative medicine…”I remember when I began my career that the neurologists I met actually disputed that the neck had any role in headaches. This was despite a century of experience of physical therapists, chiropractors, and alternative health practitioners successfully relieving headaches by treating the neck.”
There is substantive research emerging that demonstrates that damage to the muscles of the neck whether it be micro-trauma due to faulty posture, stomach sleeping, damage from injury, chronic stress as well as a host of other physical and environmental factors are responsible for approximately 93% of the headaches we suffer. Professor Jim Elliot from Northwestern University has done some ground breaking study demonstrating the impact of trauma to the small muscles at the base of the skull such as seen in people suffering whiplash as a predictor to further neck pain and associated headache.
Of the 10 most researched benefits of chiropractic care, headache ranks as #2. Research shows that spinal manipulation – one of the primary treatments provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck. A 2014 report in the Journal of Manipulative and Physiological Therapeutics (JMPT) found that interventions commonly used in chiropractic care improved outcomes for the treatment of acute and chronic neck pain and increased benefit was shown in several instances where a multimodal approach to neck pain had been used1. Also, a 2011 JMPT study found that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches.
What Can a Doctor of Chiropractic Do?
Your doctor of chiropractic may do one or more of the following if you suffer from a primary headache:
Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.
Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.
The take away…
Headaches impact more than 3.6 million Canadians adults. Most headaches originate from the structures in the neck. Emerging research is demonstrating chiropractic to be an effective and safe option for the treatment of headaches including migraines. Headaches are the #2 reason that people seek chiropractic care. The average number of visits to a chiropractor per incident is 8-12.
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