Have you ever performed an internet search on headaches while actively experiencing a headache? This can be a very harrowing experience which could possible cause you to rush immediately to the emergency room demanding extensive testing and invasive treatment. Therefore, I thought I could shed some light on the subject and offer a conservative treatment options for the most common type of headache.
As ridiculous as this internet searching story sounds, many people while searching for such information, see such causes of headache as stroke, brain tumor and aneurysm. Granted, these are serious disorders that require immediate attention and prompt evaluation from your doctor, however, considering the number of patients that report to the emergency room with a headache only a small fraction actually have these more serious disorders.
I am going to discuss the most common cause of headache which is the muscle tension headache, and explain an effective and conservative treatment option to relieve them. Many of you will be familiar with this type of headache especially if you have ever had head pain that felt like it was originating from the neck which radiated into the hairline of you scalp and at times radiated to your temple region.
Muscle tension headaches fall into the category of cervicogenic headaches, and account for greater than ninety percent of all headaches. Cervicogenic means, originating from the neck, commonly from muscle tissue, cervical (neck) joints, and smaller cervical nerves that surround the area. It has been extensively researched that many muscles in the posterior/back section of your neck specifically the trapezius, levator scapula and the suboccipital (base of cranium) muscles, to name a few, can have areas of tension and hyperactivity that we commonly call trigger points. Briefly stating, these focal areas in the muscle trigger pain not only in that area, but can refer pain to the head. An analogy to further explain this is thinking of someone who has a heart attack. They may have left arm pain, but they do not have an arm problem, but referred pain coming from the heart. These involved muscles, in a similar neurological pattern, can refer pain to other regions of the body, in this case the head.
How do these muscles get this way, you ask? The most common reasons are either from acute trauma such as a car accident (whiplash), sports injury, or from repetitive overuse. We are a society that performs many tasks in a flexed position whether it's leaning over a counter washing your face, or sitting at your desk at work on your computer typing. These tasks as well as others puts our head in a flexed position over our shoulders requiring most of our neck muscles to remain in a contracted state for a majority of the day. This overuse causes micro-tears in the muscle. Think of a piece of cheese cloth tearing as you gently pull on it in both directions. These micotears lead to mild swelling and the accumulation of normal blood chemicals to heal the area. However, these blood chemicals also may make the nerve tissue more sensitive, therefore causing pain and potentially a headache.
Research studies have shown that patients who have this kind of a headache can improve with a conservative treatment approach. Specifically, treatment should focus on decreasing pain, decreasing the pain and spasm in the trigger points, decreasing inflammation and promoting tissue healing. A thorough treatment plan should begin with passive modalities such as electric muscle stimulation and heat to decrease pain, inflammation and spasm. Secondarily, localized, intensive manual therapy such as trigger point therapy, myofascial release and ischemic compression should be administered to the involved muscles. As crude as it may sound, but what do we do with a tough steak which is essentially muscle tissue of an animal? We poke our fork to tenderize it.
With manual therapy, we use our hands and at times devices to "tenderize" the muscle and break up the trigger point and restrictions in the muscle. Thirdly, chiropractic manipulation whether it is a gentle (non-cracking) or a tradition method should be performed. Duke University performed an extensive research study and concluded that "chiropractic treatment is both safe and effective in the treatment of cervicogenic and tension based headaches."
Lastly, Cold Laser (Low Level Laser Therapy) can be administered to the involved trigger points to decrease spasm, inflammation and promote tissue healing. You can find more information on cold laser therapy on my website listed below. As with most treatment plans, a home exercise plan and ergonomic instructions should be given to you from your treating provider. In my office, my patients are given instructions on proper stretching and strengthening exercises to stabilize the cervical spine; we also discuss awareness of the postures we use in daily life, at work and at home, to minimize the stress to the cervical spine. Beyond the focus of this article, there are other dietary and supplemental foods, vitamins, minerals and herbal supplements that may help.
Dr. Scott Leslie is a licensed Chiropractor and Certified Athletic Trainer. He is one of less than one-hundred nationally having this dual credential. He practices at South Lake Chiropractic P.C. and specializes in the treatment of sports injuries. For more info, www.southlakechiro.com or call 631.422.4234