One third of Americans suffer from tension headaches. These headaches can be felt on both sides of the head as a dull, steady pain that often becomes intense at the end of the day. Unfortunately, traditional medicine has little to offer chronic headache sufferers. Pain medicine and muscle relaxants will ease the pain. Stress reduction, relaxation and exercise can improve wellness and perhaps prevent the occurrence of the headache.

There are two ways to categorize headaches:

Primary Headache   include tension–type, migraine, cervicogenic, and cluster headaches and are not caused by other underlying medical conditions. More than 90% of headaches are primary.

Secondary Headache   result from other medical conditions, such as infection or increased pressure in the skull due to a tumor. These account for fewer than 10% of all headaches.

Descriptions of the Primary Headache Types:

1.    Tension–type Headaches Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers. As many as 90% of adults have had tension–type headache.

Tension–type headaches usually involve a steady ache, rather than a throbbing one, are described as a feeling of pressure or tightening, may last minutes to days, affect both sides of the head, and and do not worsen with routine physical activity. It may also be accompanied by photophobia or phonophobia (hypersensitivity to light and noise, respectively.). Nausea is usually absent. Some people get tension–type (and migraine) headaches in response to stressful events. Tension–type headaches may also be chronic, occurring frequently or daily. Psychologic factors have been overemphasized as causes of headaches.

Rebound Headache: Rebound headache may occur among people with tension–type headaches, as well as in those with migraines. It appears to be the result of taking prescription or nonprescription pain relievers daily or almost every day, contrary to directions on the package label. If prescription or nonprescription pain relievers are overused, headache may "rebound" as the last dose wears off, leading one to take more and more pills. This is a great reason to call your chiropractor. Break that cycle!

2.    Cervicogenic Headaches Cervicogenic headache originates from disorders of the neck and is recognized as a referred pain in the head. Primary sensory afferents from the cervical nerve roots C1–C3 converge with afferents from the occiput and trigeminal afferents on the same second order neuron in the upper cervical spine. Consequently, the anatomical structures innervated by the cervical roots C1–C3 are potential sources of cervicogenic headache.

Cervical headache is often precipitated by neck movement and/or sustained awkward head positioning (such as painting the ceiling, or washing the floor) and can reproduced with pressure over the upper cervical or occipital region on the symptomatic side. It is often accompained by restricted cervical range of motion, ipsilateral neck, shoulder, or arm pain of a rather vague non-radicular nature or, occasionally, arm pain of a radicular nature.

3.    Migraine HeadachesMigraine headaches are less common than tension–type headaches. Nevertheless, migraines afflict 25 to 30 million people in the United States. As many as 6% of all men, and up to 18% of all women experience a migraine headache at some time.

Among the most distinguishing features is the potential disability accompanying the headache pain of a migraine: migraines may last 4-72 hours, are typically unilateral (60% of reported cases), throbbing, of moderate to severe intensity, and are aggravated by routine physical activity.

Nausea, with or without vomiting, and/or sensitivity to light and sound often accompany migraines.   An "aura" may occur before head pain begins–– involving a disturbance in vision, and/or an experience of brightly colored or blinking lights in a pattern that moves across the field of vision. About one in five migraine sufferers experiences an aura.

Usually, migraine attacks are occasional, or sometimes as often as once or twice a week, but rarely occur daily.

4.    Cluster Headaches Cluster headaches are relatively rare, affecting about 1% of the population. They are distinct from migraine and tension–type headaches. Most cluster headache sufferers are male –– about 85%.
Cluster headaches come in groups or clusters lasting weeks or month. The pain is extremely severe but the attack is brief, lasting no more than a hour or two. The pain centers around one eye, and this eye may be inflamed and watery. There may also be nasal congestion on the affected side of the face.

These "alarm clock" headaches may strike in the middle of the night, and often occur at about the same time each day during the course of a cluster. A history of heavy smoking and drinking is common, and alcohol often triggers attacks.

In the September 2001 issue of the Journal of Manipulative and Physiological Therapeutics was a report on the effectiveness of chiropractic care, specifically labeled "SMT" in the study, for patients with chronic headaches.  The data for this report was gathered from nine trials involving 683 patients with chronic headache.

In this study chiropractic adjustments (termed SMT in the study) were compared to massage and medications for short term relief of up to six weeks after a month of care.  The question of long term health benefits was not addressed.  Results showed that the chiropractic group did better than the massage group.  The group that received medication also showed relief however, the rate of  side effects for the medication group was considerably higher than the chiropractic group.  This difference gave a decidedly large advantage to chiropractic over the medication.  

According to the report, the financial cost of headaches is great, with billions of dollars spent annually for lost productivity and treatment.  The study also noted that people affected with headaches have commonly been treated by medical practitioners. Recently however, they are increasingly turning to non-medical or alternative therapies for relief.  A recent study from Harvard University  by Dr. Eisenberg reported that one of the most common alternative practitioners sought out for the treatment of headaches was the chiropractor.  This study confirms what most chiropractors and their patients have already known, that chiropractic is one of the most effective avenues of health for headache sufferers.

Another recent study has suggested, however, that chiropractic treatments can decrease the frequency and length of headaches as well as the number of painkillers needed for relief. Dr. Niels Nilsson of Odense University in Odense, Denmark, and Dr. Geoffrey Bove of Beth Israel Deaconess Medical Center and Harvard Medical School, have studied the impact of chiropractic treatment on headaches. They have found that chiropractic treatment can work, but accurate diagnosis of the headache is key to efficacy. The diagnosis of tension headaches relies on very general symptoms.

Unfortunately, these symptoms can mask a headache of a different nature: cervicogenic headaches (originating in the cervical / neck region). Dr. Nilsson estimates that 15-20 percent of all recurrent headaches are cervicogenic.

Cervicogenic headaches are characterized by pain on one side of the head with associated neck pain on the same side. A patient with these headaches perceives pain in the head, but the actual source of the pain lies in the cervical spine.

This distinction is important, because cervicogenic headaches improve upon chiropractic spinal manipulation. Dr. Nilsson says, "My 1997 study showed that a group of cervicogenic headache patients who received spinal manipulation and soft tissue therapy did significantly better than a similar group which received only soft tissue therapy. Spinal manipulation in itself has a significant effect on cervicogenic headaches."

The most recent study indicates that, in contrast to cervicogenic headaches that respond specifically to spinal manipulation, tension headaches respond to chiropractic intervention regardless of whether or not spinal manipulation was performed. Dr. Bove says, "This study shows that tension-type headaches do respond to hands-on therapy, but that cervical spinal manipulation is unlikely to be the factor that affects change."

Dr. Norman Harden, director of the Center for Pain Studies at the Rehabilitation Institute of Chicago, believes the study was well designed. "All in all a very good study, considering the impossibility of blinding a chiropractic procedure. This study, a very vast amount of anecdotal and empiric evidence and now some legitimate studies such as this support the use of chiropractic treatment for tension-type headaches," he says. Most chiropractic patients have yet to realize the contribution chiropractic intervention can make to headache improvements. Only about two percent of patients visit a chiropractor for headache relief.

"Mary" is an example of the typical patient who turned to chiropractic treatment for her sore back. She was pleased to discover that the treatment could also eradicate her headaches. "I began to see a chiropractor for my back problems," she says. "During the treatment for back pain, I casually mentioned my almost daily "normal" tension headaches. My chiropractor advised me that a headache is not "normal". He recommended a few simple lifestyle changes and performed spinal manipulations. With the help of my chiropractor, I haven't had any notable headaches now for close to 10 years."

Yet another report released by the Foundation for Chiropractic Education and Research (FCER) show the effectiveness of chiropractic care for sufferers of Tension Headaches.  The story released February of 2001, was the continuation of a release of a study done at Duke University several years earlier.  In the study many different types of physical and  behavioral treatments were used for patients with headaches.  Chiropractic care was specifically compared to amitriptyline, a common medication used for headaches.

In this study the staff at the Duke Center screened articles from the literature, created evidence tables, and analyzed the quality and magnitude of results from these studies. They then drafted an evidence report with peer review from a panel of 25 reviewers, including researchers and clinicians in chiropractic.

The results showed that chiropractic was highly effective for patients with tension headaches. When compared with the drug amitriptyline, chiropractic and the drug had similar short term effects during the episode.  However, the drug carried with it an adverse reaction rate in 82% of the patients. 

The most profound effects were seen after the care was discontinued in the study.  In these instances the patients who were on drug therapy essentially returned to the same state as before.  However, the patients who were under chiropractic care continued to show sustained reduction in headache frequency and severity even after the chiropractic care was discontinued.  The implications are that chiropractic is not actually a therapy or treatment, but rather gets to the cause allowing the body to effect a correction that lasts beyond actual care.

 When you are ready to get started  resolving your headaches with chiropractic you can call Dr. Adrain Sturdevant at 479-435-3917.  We are located in Fayetteville, AR.