Headaches – the hidden cause

Neck exercise to relieve headacheAnyone who has suffered from regular headaches knows how unpleasant and disrupting they can be. Many headache sufferers find it difficult to concentrate, to work or even carry out simple activities without feeling grumpy.

Jamie’s story

Jamie came to me here at Sundial because of six years of headaches that were affecting his work and his life with his partner. And things were getting worse. A recent increase of the frequency of the episodes made him realise he had to do something.

Headaches can be bad enough but Jamie’s symptoms started a journey all of their own. His pain was travelling from his neck to the top of his head on one side and travelling down to the shoulders and to between his  shoulder blades. He would always have the headaches during the week and only found respite at the weekends. A stressful day at work or being on a computer for long period of time was increasing the pain to unbearable levels so even painkillers were ineffective

Jamie has a job with a lot of responsibilities in a big company and needs to manage a team. He spends a lot of time sitting in meetings and even more staring at  a computer screen. Stress is a constant feature in his work.

When Jamie came to see he was keen to end this agony. After an examination I found that some of the joints in his neck were stiff and not moving correctly. The surrounding muscles were in spasm and were very sore to the touch. It was clear that Jamie was suffering from headaches caused by referred pain from the neck – so called cervicogenic headaches.

In Jamie’s case the dysfunction has been triggered by his repetitive poor posture, especially sitting at the computer for long periods of time.

Successful treatment begins

I started to treat Jamie for cervicogenic headaches, by addressing the cause. As a chiropractor I worked on the muscles of Jamie’s neck and shoulders applying gentle pressure to relax the muscle tension. I also used my hands to increase the mobility of his neck joints using gentle pressure.

But Jamie had to bring some change in his life as well. Here are the tips I gave him and it could help you too to deal with your cervicogenic headaches.

Jamie has now far fewer  episodes of pain and during a really stressful day at work, if the pain starts, he can decrease the intensity and the duration of the episode by himself using these tips

If you would like a free check up to see if chiropractic can help you then call to make an appointment or use our online booking above.

Headaches – a pain in the neck

Headaches sketchHeadaches can sometimes be caused by neck problems in disguise. This type of headache is called a cervicogenic headache. Evidence for the best way to treat this type of headache has been lacking – until now.

Cervicogenic headaches may respond well to manipulation, mobilisation and specific exercises a new study shows. This is good news because this type of headache accounts for one in five of all chronic or long-term headache symptoms.

The new headaches study is a review of lots of other studies. Pooling all the results in a so called meta-analysis is a great way to improve the power of individual studies and get some meaningful results. Although the results were not all clear cut in favour of manual therapy the trend seems to indicate that the sort of treatment used by chiropractors is likely to be effective of cervicogenic headaches.

Cervicogenic headaches are caused by muscle spasms or spinal joint problems in the neck. They affect women four times more than men for some reason. They are made worse by poor posture as well as activities that cause your chin to poke forward such using a laptop or a computer screen that is set too low.

Chiropractic treatment for cervicogenic headaches uses gentle adjustments to unlock the stiff spinal joints as well as deep muscle release techniques to improve the underlying causes of the pain. Our physio’s here at Sundial can also prescribe specific exercises after identifying the weak muscles in your neck and shoulders. Laser therapy or acupuncture needles may be used.

If you would like to know if we may be able to help you, give us a call and make an appointment to see us. If you a not sure whether this approach is for you then make an appointment for a check up at no charge. We will tell you whether your headaches are likely to be caused by neck problems and may respond to chiropractic and physio care.

Reference: 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.

Headaches in children part 2 – treatment

Headaches in children are common. What can be done to help? Here at Sundial our first line of treatment is chiropractic care. We often find joints at the top of the neck have become stiff or locked. The nerves around the joints get irritated and can lead to muscle spasm which can cause childhood headaches.

Chiropractic treatment for headaches in children

Headaches in children need a different approach to the treatment in adults. The joint in the neck neck are delicate and this is obviously doubly true in kids too. We usually start with gentle massage or trigger point therapy. Trigger points are localised areas of muscle spasm which refer pain to another area, in this case, to the head. These are sometimes called cervicogenic headaches.

Treating trigger points often reproduces the headache and confirms the diagnosis. This tells us that we have found the true cause of the headaches. The muscle relaxation techniques are combined with gentle mobilisation of the neck joints. We often use a specialist adjusting instrument which is very specific and comfortable and above all – safe.

Headaches in children can often be present for years before effective treatment is carried out so it can take a few visits to correct the underlying problems. A typical treatment program consists of four to six sessions over about six weeks.

Most children with these type of headaches are pain free after that. A periodic check may be needed to make sure it does not come back but usually it is as simple as that.

Advice for children with headaches

  • Watch your posture
  • Limit screen time
  • Get regular exercise
  • Watch the artificial additives

An important part of the treatment program is specific advice to prevent recurrence. Poor posture especially on a computer or games console is a key cause of headaches. Slumped, rounded shoulders and the chin poking forwards compresses the joint in the neck and, after a while, strains the muscles which eventually can go into spasm. Hour after hour of this may lead to permanent tissue changes later in life.

Other common causes of poor posture are television watching, doing homework on the bed or the floor or at inadequate tables and reading without proper support. School desks and chairs are often inadequate as Matthew Bennett’s interview with BBC Newsround shows.

Carrying heavy school bags can also strain the shoulder muscles which attach to the neck and aggravate the problem still further.

If kids are exercising and running around then at least they are not at the computer or watching television. Physical activity strengthens the postural support muscles of the back, shoulders and neck and will help with these types of headaches.

Staying active is an important of the Sundial headache program. We can advise on specific exercises to do too. These will relax tight muscles and strengthen other neck support muscles that often have become weak with poor posture.

As ever, advice to limit artificial additives is true here too. There is some evidence that additives excite nerves that could increase pain. Aspartame, especially when combined with other additives has been shown to act as a neurotoxin (more here). So best avoid it just in case. Aspartame is an artificial sweetener found in many fizzy drinks, sweets, pre-prepared food and desserts as well innocent looking stuff like baked beans.

Often we hear people say that dehydration can lead to headaches and whilst it is true in severe dehydration there is not much evidence that being a bit thirsty causes a headache. However it can’t hurt to keep kids drinking plenty of water for a whole host of health reasons. It may even prevent a headache.

Headches in Children part 1

Reference

Bronfort report

Headaches in children

Headaches in children are a bigger problem than we thought. Up to half of children may experience a headache in any particular month. That figure alone is astonishing. Here at Sundial we regularly see children with headaches but obviously we are scratching the surface of this distressing condition.

Parents of children with headaches are also affected. Trying to comfort a child with a headache is distressing especially if conventional treatment options are limited. A new study on paediatric headaches sheds some light on the ineffectiveness of many treatments for headaches in children.

Giving children strong drugs for headaches may be of limited benefit. Drugs such as anticonvulsants, antidepressants, and beta-blockers are commonly used with little or no evidence that they actually help. Often any improvement has been put down to a placebo effect. Some doctors recommend avoiding drugs all together and going to lie down in a dark room instead.

But short of doing nothing what other options are there. Unfortunately the research in this area is poor in all areas of healthcare. Some options are chiropractic, acupuncture or massage. In adults all of these treatments have shown promising results, with the usual small print – “more research is still needed”.

What causes childhood headaches?

It is likely that the same things that cause head pain in adults are causing head pain in children. Spasm of the upper neck and shoulder muscles can refer pain to the head and face so anything that increases tension in these muscles can potentially cause a headache. In addition a trauma to the delicate neck joints can also trigger a headache. Children are forever falling off bikes or climbing frames or simply tripping over. They fall asleep in cars and on sofas with out any neck support and this can cause the neck joints to seize up and the neck muscles to go into spasm. Without adequate treatment the headaches, often with neck pain, will persist.

There are other causes of childhood headache such a migraines, fever and other health issues but these are much rarer.

Headaches – Which type of headache is it?

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:-

  1. Cervicogenic or spinal headache caused by neck problems
  2. Tension headache caused by tight muscles and/or stress
  3. Migraines

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.

Spinal Headache

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.

Tension Headaches

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.

Migraine Headaches

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 (2.). 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.

More..

References

1. Stress and tension-type headache mechanisms. Cathcart et al. Cephalalgia 2010; 30(10): 1250-1267.

2. Manual therapies for migraine: A systematic review. Chaibi A, Tuchin PJ & Russell MB. Journal of Headache & Pain 2011; 12: 127-133.

3. Effectiveness of manual therapies: the UK evidence report. Gert Bronfort et al Chiropractic & Osteopathy 2010, 18:3

Migraine Awareness Week

Headaches - Causes and TreatmentsAs Migraine Awareness Week comes to an end we look at some of the ways chiropractic can help treat migraines and headaches.

Migraines affect about 1 in 6 people in the UK and, as you know if you are one of them, can completely wipe you out. There are two main types of migraine:-

Classical migraine

These migraines have early warning signs like flashing lights in the eyes or loss of a vision; tiredness or a stiff neck. This is known as the aura.

Common migraine

Here there are no warning signs.

Sometimes migraines get confused with an ordinary headache. Ordinary headaches will often ease on lying down but a migraine is less likely to. Migraines can often throb on one side only where as a cervicogenic headache doesn’t throb and is often on both sides of the head. Migraine sufferers often report a sensitivity to light or sound, nausea and vomitting too.

Migraine treatment

Medication is the first line of defence that GP’s use. Sometimes if taken early enough the drugs can prevent or lessen the severity of an attack. Many people find the drugs have side effects which can put them off taking them. Fortunately there are other treatment options.

Chiropractors BrightonChiropractic may help with migraines. A recent study reviewed the best research and found that manipulation can improve migraines and help prevent them coming on so frequently. At Sundial we regularly see people with migraines and often get positive feedback from sufferers.

If you come in to see us for migraines we will check your spine, particularly in the neck, to see if there are any problems here that may contribute to your problem. Some of the blood vessels that supply the brain come up through the spine itself. Although the mechanism for causing migraines is unclear  sorting out these neck problems seems to help.

If you would like a chiropractic check up for migraines then give us a call.