If you are suffering from regular headaches the chances are that you regularly use painkillers to help alleviate the pain. You may also be taking anti-inflammatory medication or if you’re getting migraine headaches other exotic combinations of drugs. This headache treatment may help with the symptoms but does not address the underlying cause of the headaches. Fortunately there is another approach that research has shown to be effective for certain types of headache relief. Chiropractic can offer significant help to certain types of headache.
The key to getting the right treatment is understanding which type of headache you have. It is not always that easy to know as you may have more than one type of headache going on at different times. There are 3 main types of headaches that may respond to gentle conservative care. They are:-
The other serious types of headache are caused by things like internal bleeds, infections and space occupying lesions which need urgent medical care.
The first step in successful treatment for headaches is to identify which sort you have then a programme of treatment can be suggested which may help.
Often called cervicogenic headache, in this type the pain is associated with neck pain and pain at the back of the head. Sometimes the muscles in the neck are tender to press. It may cause pain to the forehead, over the eyes or temples too. People often describe a vice like feeling around their head. The pain is often aggravated by certain posture or neck movements. Interestingly it often eases when lying down as the weight of the head does not have to be supported. People with this type of headache often have a history of many years of suffering with it.
There has been a lack of evidence with the best way to treat this type of headache until recently. Cervicogenice headaches may respond well to manipulation, mobilisation and specific exercises a new study shows (1). This is great news because this one in five of all chronic or long-term headache symptoms are Cervicogenic.
Tension headaches are the most commonly diagnosed type of headache with four out of five people being told that this is the cause of their pain. Tension type headaches are characterised by a frequent, steady, dull ache on both sides of the head which can last for long time. People are able to get on with normal life in spite of mild light and sound sensitivity.
Most doctors think that tension headaches are due to tight muscles in the shoulder, neck or scalp. This has not been shown in the research however. It has been tricky to identify tightness in these muscles in spite of looking quite hard. It is more likely that stress plays a bigger role that first thought. Stress, from work, daily-life and relationships has been found to be the most common headache trigger.
When we get stressed our adrenal glands release adrenalin which sensitises the pain receptor nerve endings in the body. In addition our central nervous system can become sensitised to on-going pain messages so that the pain persists even after the injury has gone. This is a plausible potential cause of tension headaches. It may also explain why manual therapy has been less successful at treating it. Traditionally tension headaches have been treated with massage, exercises and manipulation but results have been mixed. It might be that a simple switch to de-stressing type exercises and desensitising manipulation and mobilisation might be more effective.
People often mistake a tension headache for a migraine and there are a lot of similarities in including the mechanisms that are thought to cause them. A good way to determine which type you have is to compare the symptoms.
Migraines are characterised by severe, one-sided, throbbing pain, often around one eye. They are often preceded by visual disturbances. They are relatively short lived but disabling often with extreme light and sound sensitivity as well nausea. Exercise tends to make them worse and lying down doesn’t help much.
Chiropractic care has been shown to help migraines (3.). Massage and acupuncture have also been shown to help.
If you would like a free check up to see which type of headache you have then give us a call to make an appointment.
1. Conservative physical therapy management for the treatment of cervicogenic headache: A systematic review. Racicki S, Gerwin S, DiClaudio S et al. Journal of Manual & Manipulative Therapy 2013; 21(2): 113-24.
2. Stress and tension-type headache mechanisms. Cathcart et al. Cephalalgia 2010; 30(10): 1250-1267.
3. Manual therapies for migraine: A systematic review. Chaibi A, Tuchin PJ & Russell MB. Journal of Headache & Pain 2011; 12: 127-133.
4. Effectiveness of manual therapies: the UK evidence report. Gert Bronfort et al Chiropractic & Osteopathy 2010, 18:3
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