Back Clinic Headaches & Treatment Team. The most common cause of headaches can relate to neck complications. From spending excessive time looking down at a laptop, desktop, iPad, and even from constant texting, an incorrect posture for extended periods of time can begin to place pressure on the neck and upper back, leading to problems that could cause headaches. The majority of these types of headaches occur due to tightness between the shoulder blades, which in turn causes the muscles on the top of the shoulders to tighten and radiating pain into the head.
If the source of the headaches is related to a complication of the cervical spine or other regions of the spine and muscles, chiropractic care, such as chiropractic adjustments, manual manipulation, and physical therapy, can be a good treatment option. Also, a chiropractor may often follow up chiropractic treatment with a series of exercises to improve posture and offer advice for future lifestyle improvements to avoid further complications.
Holistic: Migraine headaches are typically debilitating, and require a comprehensive approach for successful treatment. It is helpful to consider migraine headache as a symptom of an underlying imbalance, rather than simply a diagnosis. A holistic approach is a satisfying way to think about and treat migraine headache. Physicians trained in this approach will consider a broad array of features that may contribute to the experience of migraine headache, including disturbances within the following key areas:
Nutrition
Digestion
Detoxification
Energy production
Endocrine function
Immune system function/inflammation
Structural function
Mind-body health
Migraine headache is an excellent example of biologic uniqueness; the underlying factors participating in each individual�s outcome may differ quite a bit from person to person. The journey of identifying and addressing these factors often results in an impressive improvement in frequency and intensity of the expression of migraine. Committed individuals will find the added benefit of better general health along the way.
Nutritional Considerations: Holisitic
Food Allergy/Intolerance
Numerous well-designed studies have demonstrated that detection and removal of foods not tolerated will greatly reduce or eliminate migraine manifestations. True allergy may not be associated with migraine in most individuals, but food intolerance is more common. Migraine frequency and intensity have been demonstrated to respond well to elimination diets, in which commonly offending foods are removed for several weeks. Elimination diets are easy to perform (although they do require a high degree of commitment and education), and can help in identifying foods that are mismatched to an individual. The majority of patients who undergo an elimination diet learn that their diets were contributing to chronic symptoms, and they typically feel much better during the elimination phase. Common foods that act as migraine triggers include: chocolate, cow�s milk, wheat/gluten grains, eggs, nuts, and corn. In children specifically, common migraine triggers include cheese, chocolate, citrus fruits, hot dogs, monosodium glutamate, aspartame, fatty foods, ice cream, caffeine withdrawal, and alcoholic drinks, especially red wine and beer.
There are several methods which may be used to detect food allergies. Laboratory testing can be convenient, but is not always a reliable means of detecting food intolerance. (See Summary of Recommendations for information on how to implement the elimination diet).
Foods such as chocolate, cheese, beer, and red wine are believed to cause migraine through the effect of �vasoactive amines� such as tyramine and beta-phenylethylamine. These foods also contain histamine. Individuals who are sensitive to dietary histamine seem to have lower levels of diamine oxidase, the vitamin B6-dependent enzyme that metabolizes histamine in the small bowel. The use of vitamin B6 improves histamine tolerance in some individuals, presumably by enhancing the activity of this enzyme.
Other diet-related triggers associated with migraine headache include: glucose/insulin imbalances, excessive salt intake, and lactose intolerance. Aspartame, commonly used as a sweetener, may also trigger migraines. Each of these factors may be readily avoided by adopting more conscious eating habits, and by carefully reading labels.
Magnesium
An estimated 75% of people consuming the standard American diet (SAD) are not getting adequate magnesium, and it is felt to represent one of the most common micronutrient deficiencies, manifested by a diverse range of problems. Though many elements can contribute to magnesium depletion, stress is among them, and both acute and chronic stress are associated with increased episodes of migraine. Daily doses of magnesium should be first line considerations for migraine sufferers (caution if kidney function is impaired), and intravenous magnesium can be very helpful in an emergency room setting, but probably only works to terminate an acute migraine if the individual is truly magnesium deficient.
Essential Fatty Acids
It is important to remember that the brain is largely composed of fat. Although essential fatty acids have not received much research attention relative to migraine, there may be a significant role of fatty acids and their metabolites in the pathogenesis of migraine headache. Two small placebo-controlled studies demonstrated that omega-3 fatty acids significantly outperformed placebo in reducing headache frequency and intensity. High quality fish oil should always be used. A good frame of reference is that each capsule should contain at least 300 mg of EPA and 200 mg of DHA. A reasonable starting dose would be two to four capsules twice daily with meals.
Digestive Function: Holistic
Holistic practitioners are generally sensitive to the centrality of the gastrointestinal tract in producing overall health. Though we utilize a reductionistic approach to understanding human anatomy and physiology, we might consider that no system functions as an independent entity (GI, endocrine, cardiovascular, immune, etc.), and that a complex symphony of interrelated functions cuts across organ systems. For example, much of the immune system is found in the Peyer�s patches of the GI tract; in this light, we can see how food, chemicals, and unhealthy microbes might produce immune system activation from gastrointestinal exposure. We also recognize the importance of a balanced ecosystem of intestinal microbes; intestinal dysbiosis, or disordering of the gastrointestinal ecology, may readily produce symptoms, both within and distant from the GI tract. Some colonic bacteria act upon dietary tyrosine to produce tyramine, a recognized migraine trigger for some individuals. H. pylori infection is a probable independent environmental risk factor for migraine without aura, especially in patients not genetically or�hormonally susceptible. A high percentage of migraine patients experienced relief from migraines when H. Pylori infection was eradicated.
Detoxification: Holistic
Patients with migraine headache sometimes report that strong chemical odors such as tobacco smoke, gasoline, and perfumes may act as triggers. It is not uncommon for migraineurs to report that they are triggered by walking down the laundry soap aisle in the grocery store. Support for phase 1 and especially phase 2 detoxification may be beneficial for these individuals, as toxic overload or impaired enzymes of detoxification could theoretically be a significant mediator of headaches. Susceptibility to toxicity may be potentiated by a combination of excessive toxic exposures, genetic polymorphisms leading to inadequate detoxification enzyme production, or depletion of nutrient cofactors that drive phase two detoxification conjugation reactions Support for detoxification function is particularly important in modern life, given our exposure to unprecedented high levels of toxic chemicals. Some nutrients that supply support for detoxification function include: n-acetyl cysteine (NAC), alpha lipoic acid, silymarin (milk thistle), and many others.
Energy Production: Holistic
Riboflavin (Vitamin B2)
Energy production within the parts of the cell called mitochondria can be impaired in some migraine sufferers. Riboflavin is a key nutrient that is involved in energy production at this level. Riboflavin at 400 mg/day is an excellent therapeutic choice for migraine headache because it is well tolerated, inexpensive, and provides a protective effect from oxidative toxicity. Its use in children has been investigated, leading to similar conclusions,suggesting that, for pediatric and adolescent migraine prophylaxis, 200 mg per day was an adequate dose, but four months were necessary for optimal results.
Coenzyme Q10
CoenzymeQ10 (CoQ10) is also a critical component of energy function, and is an important antioxidant. Evidence supports the administration of CoQ10 in reducing the frequency of migraines by 61%. After three months of receiving 150 mg of CoQ10 at breakfast, the average number of headache days decreased from seven to three per month. Another study, using 100 mg of water soluble CoQ10 3x/day, revealed similar results. CoQ10 deficiency appears to be common in the pediatric and adolescent population, and can be an important therapeutic consideration in these age groups. Like riboflavin, CoQ10 is well tolerated (though expensive), with little risk of toxicity. It must be used with extreme caution in patients who also take warfarin, as CoQ10 may counteract the anticoagulation effects of warfarin. It is also noteworthy that many medications can interfere with CoQ10 activity, including statins, beta-blockers, and certain antidepressants and antipsychotics.
Endocrine (Hormone) Function
Female Hormones
It does not appear coincidental that migraine onset correlates with the onset of menstruation and that episodes are linked to menstruation in roughly 60% of female migraineurs. Although there is no universal agreement over the precise relationship between female hormones and migraine headache, it is apparent that the simultaneous fall of estrogen and progesterone levels before the period correlates with menstrual migraine. Estrogen gel used on the skin can reduce headaches when used premenstrually. Some researchers have found that continuous use of estrogen may be necessary to control menstrual migraines, which tend to be more severe, frequent, longer lasting, and debilitating than general migraines. Although published studies are lacking, many practitioners have used transdermal or other bioidentical forms of progesterone premenstrually with success. Of course, the risks of using hormones must be weighed against the benefits. Interestingly, administration of magnesium (360 mg/day) during second half of the menstrual cycle in 20 women with menstrually related migraines resulted in a significant decrease of headache days.
Melatonin
Melatonin, the next downstream metabolite of serotonin, is important in the pathogenesis of migraines. Decreased levels of plasma and urinary melatonin have been observed in migraine patients, and melatonin deficiency appears to increase risk for migraine. Melatonin has been used with some success, presumably via a restorative effect on circadian rhythms. A small study in children demonstrated significant improvement in their migraine or tension headache frequency with a 3 mg nightly dose of melatonin Melatonin appears to modulate inflammation, oxidation, and neurovascular regulation in the brain, and in one study, a dose of 3 mg/day was shown to be effective in reducing migraine headache frequency by at least 50% in 25 of 32 individuals. Ironically, some patients anecdotally report an increase of headaches (generally not migraine) when administered melatonin. The brains of migraineurs do not seem adaptable to extremes; a regular schedule of sleep and meals and avoidance of excessive stimulation are advisable to reduce excessive neural activation.
Immune Function/Inflammation: Holistic
Medications that produce an anti-inflammatory effect, such as aspirin and nonsteroidal agents, frequently produce an improvement in migraine symptoms during an acute attack. The herbs described below also play a role in reducing inflammation. Inflammation and oxidative stress can be identified in many conditions and disease states. It is important to acknowledge that the standard �modern� lifestyle is pro-inflammatory; our bodies are constantly reacting to one trigger after another (foods mismatched to our physiology, toxic burden, emotional stressors, excessive light and other stimulation) that activate our inflammatory cytokines (messengers of alarm). Providing broad-based support through lifestyle change and targeted nutrients may improve outcomes substantially, and this may be achieved foundationally by simplifying our�ingestions/exposures and supporting metabolic terrain. Herbal therapies are included in this section because of their relevant effects upon inflammation.
Feverfew (Tanacetum parthenium)
The precise mechanism of action of feverfew as a migraine preventive is unknown Though at least three studies found no benefit with feverfew, several controlled studies have revealed favorable results in improving headache frequency, severity, and vomiting when feverfew was compared to placebo. There are several caveats that should accompany the use of this herb:
Because of its anti-platelet effects, feverfew must be used with caution in patients on blood thinning products; avoid in patients on warfarin/Coumadin.
Feverfew does not have a role in managing acute migraine headache.
When withdrawing feverfew, do so with a slow taper, since rebound headache may occur.
Feverfew is not known to be safe during pregnancy and lactation.
Proceed with caution if an individual has an allergy to other members of the Asteraceae family (yarrow, chamomile, ragweed).
Most commonly reported adverse effects are oral ulceration (particularly for those chewing the leaves raw), and GI symptoms, reversible with discontinuation.
Feverfew is otherwise well tolerated. The typical dosage range is 25-100 mg 2x/day of encapsulated dried leaves with meals.
Butterbur (Petasites hybridus)
Butterbur is another effective herbal therapy for migraine headache. Butterbur is well tolerated, with no known interactions. Some individuals have reported diarrhea when using butterbur. In one study, its efficacy was demonstrated in children and adolescents between the ages of 6 and 17 years. Its safety is unknown during pregnancy and lactation. The plant�s pyrrolizidine alkaloids can toxic to the liver and carcinogenic, so only extracts that have specifically removed these compounds should be utilized. Many of the studies on Butterbur utilized the product Petadolex� because it is a standardized extract that has removed these alkaloids of concern. The usual dosage is 50 mg, standardized to 7.5 mg petasin and isopetasin, 2-3x/day with meals (although recent studies show that higher doses appear to be more effective1,2 ). Interestingly, butterbur�s diverse qualities make it useful for other conditions, including seasonal allergic rhinitis, and possibly painful menstrual cramps.
Ginger (Zingiber officinalis)
Ginger root is a commonly used botanical, known to suppress inflammation and platelet aggregation. Little clinical investigation has been performed relative to ginger use in migraine headache, but anecdotal reports and speculation based on its known properties make it a safe and appealing choice for migraine treatment. Some practitioners advise patients with acute migraine to sip a cup of warm ginger tea. Though evidence for this practice is lacking, it is a low-risk, pleasant, and relaxing intervention, and ginger is known to have anti-nausea effects. The most anti-inflammatory support is found in fresh preparations of ginger and in the oil.
Structural Considerations: Holistic
Practitioners of manual medicine seem to achieve success in reducing headache through various techniques such as spinal manipulation, massage, myofascial release, and craniosacral therapy Manual medicine practitioners frequently identify loss of mobility in the cervical and thoracic spine in migraineurs. While many forms of physical medicine seem helpful in shortening the duration and intensity of an episode of migraine, literature support is sparse with regard to manipulation as a modality to prevent recurrent migraine episodes. However, a randomized controlled trial of chiropractic spinal manipulation performed in 2000 revealed a significant improvement in migraine frequency, duration, disability, and medication use in 83 treatment group participants. Tension headache may also respond favorably to these techniques because of the structural component involved in muscular tension. The incidence of migraine in patients with TMJ dysfunction is similar to that in the general population, whereas the incidence of tension headache in patients with TMJ dysfunction is much higher than in the general population. Craniosacral therapy is a very gentle manipulative technique that may also be safely attempted with migraine.
Mind-Body Health: Holistic
There are few things more insulting than to be told by a medical professional to �Just reduce your stress.� Though the total load of stress experienced by an individual can be reduced through paring down unnecessary obligations, many everyday life stressors are unavoidable and cannot be simply eradicated. Thus, the answer to reducing stress for unavoidable contributors lies in two important areas: enhancing physical and mental resilience to stress, and modifying the emotional response to stress.
A multitude of programs to reduce the impact of stress on our physical and emotional well-being are rapidly becoming mainstream. For example, mindfulness meditation programs by Jon KabatZinn, PhD and many others are being offered to communities by hospitals around the country. This technique is simple to perform and has demonstrated positive outcomes in heart disease, chronic pain, psoriasis, hypertension, anxiety, and headaches. Breathwork and guided imagery techniques are likewise effective in producing a relaxation response and helping patients to feel more empowered about their health.
Biofeedback and relaxation training have been used with mixed success for migraine headache. Thermal biofeedback uses the temperature of the hands to help the individual learn that inducing the relaxation response will raise hand temperature and facilitate other positive physiologic changes in the body. Learning how to take more active control over the body may reduce headache frequency and severity. The effectiveness of biofeedback and relaxation training in reducing the frequency and severity of migraine headaches has been the subject of dozens of clinical studies, revealing that these techniques can be as effective as medication for headache prevention, without the adverse effects. Other relevant modalities to consider in this light include cognitive behavioral therapy, neurolinguistic programming, hypnosis, transcutaneous electrical nerve stimulation, and laser therapy.
Exercise should not be overlooked as a modality helpful in migraine headache. Thirty-six patients with migraine who exercised 3x/week for 30 minutes over six weeks experienced significant improvement in headache outcomes. Pre-exercise beta-endorphin levels in these individuals were inversely proportional to the degree of improvement in their post-exercise headache parameters. All patients should understand the critical importance of exercise on general health.
Acupuncture: Holistic
A discussion about a holistic integrative approach to migraine headache would be incomplete without acupuncture, which is an effective treatment modality for acute and recurrent migraine. A qualified/licensed practitioner of Traditional Chinese Medicine or a physician trained in medical acupuncture should be consulted.
Holistic: Summary Of Recommendations
Since initiators of migraine headache may be cumulative, identify and avoid them when possible. Consider the basic areas of dysfunction bulleted on the first page of this syllabus.
The incidence of food intolerance is high in patients with migraine headache; consider a comprehensive elimination diet for four to six weeks, during which time the following foods are eliminated: dairy products, gluten-containing grains, eggs, peanuts, coffee/black tea, soft drinks, alcohol, chocolate, corn, soy, citrus fruits, shellfish, and all processed foods. Careful reintroduction of one food at a time, no more often than every 48 hours, may help identify a food culprit. Meticulous recording of foods reintroduced is necessary. Most patients feel improved vitality during the elimination phase. Foods that clearly produce migraine (or other) symptoms should be avoided or used on a rotation schedule of not more than once every four days. If multiple foods introduced back into the diet seem to produce migraine headache, consider the possibility of altered intestinal permeability (leaky gut syndrome).
Consider the following supplements (Consult a qualified practitioner for advice):
Magnesium glycinate: 200-800 mg/day in divided doses (decrease to tolerance if diarrhea occurs)
Vitamin B6 (pyridoxine): 50-75 mg/day, balanced with B complex o 5-HTP: 100-300 mg 2x/day, with or without food, if clinically appropriate
Vitamin B2 (riboflavin): 400 mg/day, balanced with B complex
Coenzyme Q10: 150 mg/day
Consider hormonal therapies
Trial of melatonin: 0.3-3 mg at bedtime
Trial of progesterone or estradiol, carefully individualized, under medical supervision.
Botanical medicines
Feverfew: 25-100 mg 2x/day with meals
Butterbur: 50 mg 2-3x/day with meals
Ginger root
Fresh ginger, approximately 10 gm/day (6 mm slice)
Dried ginger, 500 mg 4x/day
Extract standardized to contain 20% gingerol and shogaol; 100-200 mg 3x/day for prevention, and 200 mg every 2 hours (up to 6 x/day) for acute migraine
Manual medicine may be helpful for some individuals.
Acupuncture
Mind-body support
Thermal biofeedback
Read The Relaxation Response by Herbert Benson, MD
Mindfulness meditation programs
Centering prayer
Breathwork
Guided imagery
Yoga, tai chi, qi gong, etc.
Many other modalities to consider!
Conclusion: Holistic Medicine
Patients will often request a more natural and self directed approach to health care. The recommendations above are typically very safe to implement, and are often welcomed by migraine sufferers. A practitioner with an integrative holistic focus will investigate an extensive array of predisposing factors to determine the underlying features most likely involved in a given individual�s condition. In this way, we treat the individual, rather than his or her diagnosis, and we will generate a favorable impact upon his/her overall health in the process.
Chiropractic Care & Headaches
�American Board of Integrative Holistic Medicine. All rights reserved.
If you are among the 45 million Americans who suffer headaches regularly, you are undoubtedly familiar with the traditional methods that people use to treat them, including taking some type of over the counter medication that is supposed to eliminate the pain and reduce any associated swelling. There are many other types of treatment that you may have attempted as well, including taking pharmaceutical concoctions designed to treat pain. However, none of these solutions provide permanent relief that addresses the problem at the core.
In the past few decades, there have been an increasing number of patients throughout the country that have begun to seek alternative forms of therapy for all types of conditions, including headaches. One form of treatment that is very promising for physical as well as other types of pain is chiropractic.
This form of alternative care has been used successfully for over a hundred years and has become a regular part of the American healthcare delivery system. In fact, there are an increasing number of insurance providers that are willing to pay for chiropractic because of its effectiveness.
When a person goes to school to learn about chiropractic, they begin by studying the human anatomy in great detail, just like other medical professionals. However, in addition to looking at how all of the parts work together physically, their training primarily revolves around the diagnosis and treatment of misalignments in the spine known as subluxations.
Theses subluxations compress nerve tissue that affects organ function, soft tissue like muscle, ligaments and tendons and can eventually manifest as other health problems if not treated.
Once the nerves are disrupted pain will result. While it usually manifests itself as physical pain, this is not always the case. In some instances, the person may experience difficulties with sleep or other routine habits.
On the first visit with a chiropractor, a review of previous health issues will be completed, including x-rays (if needed) to determine what types of nerve blockage may be occurring. They will listen to the patient attentively and make an assessment, including determining what types of treatment will best suit the patient.
In the case of headaches, the patient usually has misalignment (subluxations) in the cervical spine. This may be accompanied by muscles that are unduly tight in the neck, shoulders and nearby areas. Pressure on the nerves may cause sharp stabbing pains or there may be a continual dull throb in the region.
The chiropractor will assess the area and then move forward with treatment known as a chiropractic adjustment in order to relieve the pressure and pain. The relief is usually instantaneous, with an increase in positive symptoms for the following few hours.
However, chiropractors don�t just focus on relieving symptoms but rather correcting the problem; therefore, additional treatments will follow to help correct the cause. In addition, the chiropractor will take the time to educate you on the importance of chiropractic, especially if you�ve never been to one before.
If you need further help with your headaches or are ready to see how beneficial chiropractic care can be to your overall health, please give us a call so that you can schedule an appointment with our Doctor of Chiropractic.
This article is copyrighted by Blogging Chiros LLC for its Doctor of Chiropractic members and may not be copied or duplicated in any manner including printed or electronic media, regardless of whether for a fee or gratis without the prior written permission of Blogging Chiros, LLC.
Migraine headaches, a clinical study involving 11 migraine patients and NUCCA care was recently conducted. Let’s take a look at the results and reveal the benefits of NUCCA care and how the study was conducted.
Method Of Study: Migraine Headaches
The 11 patients in the study had never experienced upper cervical chiropractic care before. All were subject to having migraine headaches and were required to have at least 10-26 days with a headache for the previous four months. Additionally, at least eight of those headache days per month required a 4 out of 10 or higher for pain. While many candidates had either a concussion, auto accident or both, candidates who experienced trauma in the past year were excluded.
NUCCA professionals used various kinds of testing to evaluate the patients. Supine Leg Check Screening tested patients� for visible signs of one leg being shorter, which may indicate atlas misalignment. Gravity stress analyzers were used, as well as, calipers for detecting asymmetry in the pelvis were used. A typical NUCCA radiograph series also includes three x-rays a lateral cervical film (side view), a nasium film (back view), and a vertex film (top view) to identify specific misalignments.
According to these diagnostic methods, the practitioner then prepares an alignment specifically designed for the patient involving the patient’s position, the stance of the practitioner, and the suitable force vector for atlas correction. Patients were given between one and five corrections.
Outcome: Migraine Patients
Headache days per month decreased for patients on average. 14.5 headache days per month was the norm. After one month of NUCCA treatment, patients experienced 11.4 headache days per month. At the conclusion of the two-month study, patients were down to 8.7 headache days per month.
Quality of life measurements in three categories also improved radically within the course of two months:
Restrictive enhanced from 38.4 to 73.5
Emotional improved from 53.3 to 81.2
Physical improved from 54.1 to 86.8
MIDAS score (which measures migraine headaches in the form of level of disability caused) improved from a mean of 46.7 to only 14.6.
While further studies are necessary to offer a quantifiable method of documenting the physiological changes which take place because of the corrections, the results speak for themselves as to the advantages of NUCCA for migraine headaches, especially those with a history of neck or head trauma.
Chiropractic & Headaches
Eliminate Headaches And Migraines Juice Recipe
Headaches and migraines. The only thing you want is for it to vanish. Here is a juice that immediately eliminates headaches and migraines! Try this juice recipe out, in addition to getting an adjustment!
Headaches and migraines are often the result of stress, poor diet, poor posture, emotional tension or exposure to environmental toxins. People reach for over-the-counter medications to help ease the pain, but there are much safer and natural ways of getting rid of headaches.
This juice is loaded with minerals such as magnesium and calcium, two crucial components in helping prevent and alleviate headaches. A juice as opposed to these foods in solid form will help nutrients reach the bloodstream faster, alleviating headaches and migraines in a jiffy!
5 stalks celery
1 cucumber
1 cup parsley
2 granny smith apples
3-4 cups leafy greens (ex. spinach, arugula)
Two inches ginger root
1 lime
METHOD:
Blend all ingredients in a juicer, blender, food processor and enjoy immediately to preserve freshness and antioxidants!
Title: The Efficacy of Chiropractic Adjustments in the care of Migraine Headache with patients presenting with cervical disc bulge.
Abstract: Objective: To explore the efficacy of chiropractic adjustments, and non-surgical spinal decompression in the treatment of cervical spine disc conditions presenting as neck pain, migraine headache, dizziness and visual disturbances. Diagnostic studies included physical examination, computer aided range of motion, orthopedic and neurological examinations, plain film x-ray studies, brain MRI, cervical spine MRI examinations.� Treatments included specific spinal adjustments, low level laser therapy and spinal decompression.� The patient�s outcome proved excellent in reduction of neck pain, headache severity and frequency as well as elimination of dizziness and visual disturbances.
Introduction: On 11/19/13 a 37-year-old female presented for examination and treatment of neck pain, migraine headaches with associated dizziness and visual disturbances.� The patient denies and recent injuries.
Presenting Concerns of Research Study
The patient reports neck pain in the cervical occipital region as a 4 on the Verbal Analog Scale of 0 meaning the complete absence of pain and 10 being unbearable pain.� The duration of the current symptom picture is 2 years and 1 month.� The patient further reports episodic migraine headaches starting at the upper cervical region and progressing into her occipital area.� These episodes are accompanied by dizziness and visual disturbances described as kaleidoscope vision.� At the time of the initial consultation these episodes were occurring 2-3 times per week.� The patient reports being afraid to drive her car due to concerns about headache onset.� The patient reports past consultations with her medical doctor who diagnosed her with vertigo and previous chiropractic care without results.� The records from both consultations were reviewed personally.
Clinical Findings:��The patient presents with complaints of neck pain, headaches, dizziness and visual disturbances of 2 years duration.� The patient is a 37-year-old female who is a mother of 2.� The ages are 16 and 3.
Her vital signs are:
Height – 5 ft. 0 inches
Weight – 130 lbs.
Handedness – R
Blood Pressure – L – 107 systolic and 78 diastolic
Radial Pulse – 75 BPM
The patient�s Review of Systems and Family History were unremarkable.
Palpation/Spasm/Tissue changes:� The patient was evaluated by palpation and observation with the following findings: Bilateral cervical spine spasms rated at +2 in the cervical-occipital region.� Orthopedic testing was unremarkable.� Range of motion examination revealed mildly decreased left lateral flexion, moderately decreased flexion, right lateral flexion and extension. No pain was produced during range of motion examination.
Neurological Examination: Biceps, Triceps and Brachioradialis reflexes were rated at a +2 bilaterally.� Sensory examination revealed normal sensation bilaterally for dermatomes C-5 through T1.� Motor/Muscle testing revealed 5 out of 5 bilaterally for Deltoids, Biceps, and Triceps, Forearm and Intrinsic Hand muscles.
Radiographic findings: reversal of the cervical curve with altered C5/C6 disc space is noted. (Fig. 1, (A) (B) A small osteophyte is observed on the posterior inferior body of C5.� Flexion malposition of C5 is also noted.� (Fig. 1, (B).
Fig. 1,� (A), (B) show loss of the cervical lordosis, flexion malposition of C5, partial collapse of C5/6 anterior disc space.
Fig. 1. (B) shows upon magnification a small posterior-inferior osteophyte.
Fig. 2,� (A), (B) shows in T2 MRI images (A) is Sagittal and (B) is Axial a
C5/6 central disc herniation contacting the ventral cord.
Diagnostic Focus and Assessment:�Diagnoses considered are: Brain Tumor, Cervical Disc Displacement, and Cervical-cranial syndrome.� A brain MRI was ordered and produced normal findings.� Diagnostic reasoning included the C5/C6 disc/osteophyte complex and the encroachment into the ventral aspect of the central canal and contact with the cervical spinal cord. (1)�Peter�J. Tuchin, GradDipChiro, DipOHS, Henry Pollard, GradDipChiro, GradDipAppSc, Rod Bonillo, DC, DO.� Received 29 June 1999.��Another consideration was the treatment schedule because the patient lives 60 miles west of the clinic and 2 treatments was the ordered therapeutic schedule.
Therapeutic Focus and Assessment:��Assessment of the cervical spine MRI both sagittal and axial views of the C5/C6 and C6/C7 segmental levels revealed adequate space between the cervical cord and posterior vertebral elements.� It was determined that conservative management of this patient was appropriate.� Therapeutic focus was reducing the pressure of the C5/C6 disc/osteophyte complex on the ventral cord.� Promoting healing of damaged nerve tissue and restoring more favorable position and motion of vertebral segments C5/C6.� The modalities used to treat this patient were:
1.�����Specific Spinal Adjustments: utilizing a Sigma Precision Adjusting Instrument to introduce a percussive force of 20 lbs. with a maximum of impact number of 50.
2.�����Spinal Decompression: A Hill Spinal Decompression table was utilized with 8 lbs. of pull maximum and a cycle of 5 minute at maximum and 5 minutes at reduction to 50% over a 25 minutes treatment session.� The patient completed 18 sessions in total.
3.�����Low Level Laser Therapy was used to promote healing on a cellular level using a Dynatron Solaris system.� Treatments consisted of 30 seconds of exposure to an 860-nanometer beam at C5/C6 and C6/C7 levels.
Follow-up and Outcomes
The patient�s compliance to the treatment schedule as rated at 9 of 10.� Completion of the recommended 18 treatments required 1 week longer than anticipated.� For personal reasons the patient missed 2 treatment sessions but made them up by adding a week to the estimated completion date. Upon discharge examination the patient reports her neck pain on the Verbal Analog Scale a 2 of 10 with 0 being the complete absence of pain and 10 being the worst pain imaginable. She further reported her headaches as a 1 on the Verbal Analog Scale.� Both symptoms were constant since 10/01/11.� This is duration of 25 months prior to her first visit. Her symptoms of dizziness and visual disturbances have been absent since 12/13/13.
Discussion:�Headaches and Migraine Headaches are a big health problem. It has been estimated that 47% of the adult population have headache at least once within last year in general.��More than 90% of sufferers are unable to work or function normally during their migraine. American employers lose more than $13 billion each year as a result of 113 million lost workdays due to migraine. (2)�Schwartz BS1, Stewart WF, Lipton RB. J Occup Environ Med. 1997 Apr; 39(4): 320-7.
This case report is very limited because it represents the experience and clinical findings for just 1 patient. However a study of the references included with this report as well as reports by care providers as well as testimonials from patients indicates that more study should be invested in the relationship of the cervical spine, its structures and biomechanics during the diagnostic workup on headache and migraine patients.
Informed Consent:�The patient provided a signed informed consent.
Competing Interests:�There are no competing interests writing of this case report.
De-Identification:�All the patient�s related data has been removed from this case report.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
References:
1. Schwartz BS1, Stewart WF, Lipton RB.
J Occup Environ Med. 1997 Apr; 39(4): 320-7.
Lost workdays and decreased work effectiveness associated with headache in the workplace.
2. Vernon, H., Humphreys, K., & Hagino, C. (2007). Chronic mechanical neck�pain in adults treated by manual therapy: A systematic review of change scores in randomized clinical trials,�Journal of Manipulative and Physiological Therapeutics, 30(3), 215-227.
3.�Peter J. Tuchin, GradDipChiro, DipOHS, Henry Pollard, GradDipChiro, GradDipAppSc, Rod Bonillo, DC, DO.� Received 29 June 1999
A randomized controlled trial of chiropractic spinal manipulative therapy for migraine?
4.Mark Studin DC, FASBE (C), DAAPM, DAAMLP, William J. Owens DC, DAAMLP Chronic Neck Pain and Chiropractic. A Comparative Study with Massage Therapy.
5.�D�Antoni AV, Croft AC. Prevalence of Herniated Intervertebral Discs of the Cervical Spine in Asymptomatic Subjects Using MRI Scans: A Qualitative Systemic Review. Journal of Whiplash & Related Disorders 2006; 5(1):5-13.
6.��Murphy, D. R., Hurwitz, E. L., & McGovern, E. E. (2009).�A nonsurgical approach to the management of patients with lumbar radiculopathy secondary to herniated disk: A prospective observational cohort study with follow-up.�Journal of Manipulative and Physiological Therapeutics, 32(9), 723-733.
Additional Topics: Chiropractic Helps Patients Avoid Back Surgery
Back pain is a common symptom which affects or will affect a majority of the population at least once throughout their lifetime. While most back pain cases may resolve on their own, some instances of the pain and discomfort can be attributed to more serious spinal conditions. Fortunately, a variety of treatment options are available for patients before considering spinal surgical interventions. Chiropractic care is a safe and effective, alternative treatment option which helps carefully restore the original health of the spine, reducing or eliminating spinal misalignment which may be causing back pain.
A cervicogenic headache begins in the cervical spine, or the neck. Sometimes these headaches mimic migraine headache symptoms. Initially, discomfort may start intermittently, spread to one side (unilateral) of the individual head, and become nearly continuous. Furthermore, pain can be exacerbated by neck movements or a particular neck place (eg, eyes centered on a pc monitor).
Possible Causes of Cervicogenic Headaches
The trigger of a headache is often associated to extreme tension to the neck. The headache may be a consequence of cervical osteoarthritis, a broken disc, or whiplash-type movements that irritates or compresses a cervical nerve. The neck’s bony structures (eg, aspect joints) and its delicate tissues (eg, muscles) can give rise to the improvement of a cervicogenic headache.
Nervous System Function
Certain nerves structures are involved in several cervicogenic headaches. Spinal nerves are signal transmitters that allow the body via the spinal cord and communication between the brain. At each level of the cervical spine is one on the right of the spine and a set of nerves; one on the left side. C1, C2 or C3 may be involved in development of cervicogenic headaches because these nerves permit function (motion) and feeling of the head and neck. Compression can cause pain and inflammation.
Cervicogenic Headache Symptoms
A cervicogenic headache provides in base and the back of the skull as a steady, non-throbbing pain, sometimes extending downward into the neck and between the shoulder-blades. Pain could be felt behind forehead and the brow, although the problem originates in the cervical spine.
Pain usually starts after a sudden neck movements, such as a sneeze. Along with head and neck discomfort, signs may include:
Stiff neck
Nausea and/or vomiting
Dizziness
Vision
Sensitivity to light or sound
Pain in both arms or one
Risk facets that will be engaged in headache on set or irritate cervicogenic headaches include:
Fatigue
Sleep difficulties
Disc problems
Current or neck injuries that are preceding
Poor posture
Muscular stress
Diagnosis of Cervicogenic Headaches
The analysis of a headache commences using a thorough medical background using a physical and neurological evaluation. Diagnostic testing may include:
X-rays
Magnetic resonance imaging (MRI)
CT Scans (rarely)
Nerve block injections to validate the diagnosis, cause
Treatment for Cervicogenic Headaches
Initially, your doctor may advise an over-the counter nonsteroidal anti inflammatory drug (eg, aspirin, Aleve). If this is ineffective, then a prescription anti-irritation and pain reliever might be prescribed. Other treatment options, outlined in purchase of from non-invasive to invasive, include:
Spinal manipulation or alternative manual therapies
Behavioral methods (eg, bio feedback)
Acupuncture
Trigger level injections
Prolotherapy
Facet joint blocks (a type of spinal joint injection)
Nerve blocks (this is generally of the medial branches of the nerves that provide you with the the facet joints)
Radiofrequency pulse ganglionotomy of the nerve root (eg, C 2, C-3)
Spine surgery to reduce nerve or vascular compression (this is rarely necessary)
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Cervicogenic Headache and Chiropractic
Neck pain associated with whiplash-associated disorders resulting from an automobile accident are reportedly the most prevalent cause for discomfort along the cervical spine. The sheer force of an impact from a rear-end car crash or other traffic incident can cause injuries or aggravate a previously existing condition. While neck pain is commonly the result of damage to the complex structures of the neck, cervicogenic headaches may also result due to neck issues. Chiropractic care can help carefully restore the alignment of the cervical spine to relieve headaches and neck pain.
Manual manipulations and spinal adjustments have been demonstrated to be successful treatment alternatives for patient’s with headaches.
Chiropractic’s capability to correct bio-mechanical dysfunctions can help eliminate common factors which may lead to head and neck pain. A majority of headaches are associated with neck pain and other cervical spine issues, best known as cervicogenic headaches. These headaches are musculo-skeletal in nature and are related to tension headaches, which may also relate to migraines.
According to some research studies, there’s less risk of further injury or aggravation of a previous condition through chiropractic adjustments than with popular medical remedies. Additionally, newest research indicates that nine percent of men and 12 percent of women in the United States experience at least one to two headaches per month, with four percent of the population experiencing more regular headaches.
Prevalence of Head Pain & Neck Pain
Two-thirds of all adult males and greater than 80 percent of females in developed countries suffer from persistent headaches, according to the World Wellness Organization (WHO). Headaches are just as harmful in developing nations as well, primarily because such are not considered to be a symptom of disease. WHO estimates that about half of the individuals who experience headaches never receive any treatment for them.
People who suffer from chronic, everyday headaches amount to about four or five percent of the world’s population, surpassing the percentage of several other common illnesses. Experts genuinely believe the connection of headache victims to those with disabilities is approximately the same.
Headaches are so frequent that Americans pay more than one billion annually to get alleviation from them. Medical expenses plus lost-work time and productivity accounts for an estimated $50 billion in losses for American companies. Just as troubling: The discomfort associated with headaches and migraines might be so extreme, it’s often reported that mental illness follows soon after.
Approximately 95 percent of headaches are categorized as stress, migraine, or cervicogenic, originating in the neck. Symptoms include head pain on either side of the head or a stiff feeling in the neck, along with tightness and soreness. A small percentage of headaches is on the array that is more hazardous and it’s possible for these to need further referral to appropriate healthcare professionals to treat them as necessary.
Treatment for Headaches Associated with Neck Pain
By utilizing risk-free and beneficial treatment protocols, many doctors of chiropractic, or DCs, effortlessly help many individuals reduce the symptoms of headaches. A spinal adjustment can certainly help lessen the strain being placed on the spine and its surrounding structures, such as muscles, tendons, ligaments and blood vessels, diminishing the signs of a headache and allowing for better function.
Particularly as it relates to neck modifying, many people have worries about chiropractic manipulation. Atlas Orthogonal chiropractic is a different kind of chiropractic treatment which is performed without manipulation of the head or neck. The �snap,� �crack,� or �pop� sound usually associated with chiropractic or osteopathic manipulation is not necessary to move a vertebra, especially the atlas or upper cervical joint complex.
Chiropractors in general are perhaps not taught aggressive, forceful techniques; the type that’ll injure vessels or tissues. Chiropractors are taught to use speed and finesse as an alternative to pressure. When the physician performing the procedure compensates for slow-pace by increasing pressure in the manipulation, problems can occur.�Chiropractors provide by far the greatest number of manipulations to the spine than any other profession, but other healthcare professionals can also perform manipulation and mobilization techniques.
Chiropractic health practitioners have had the same simple coaching as any other primary care physician. The variation between DCs and MDs lies in their treatment protocols for certain types of injuries and/or conditions.
Conclusive Findings
The need to seek assistance in emergencies is essential, if all other choices happen to be explored. When seeking specific treatment for cervicogenic headaches as well as neck pain, it’s suggested to seek medical attention with Atlas Orthogonal chiropractic, followed closely by other actions that are less-invasive. Surgery is often suggested and recommended to be used as a last option unless otherwise necessary.
Most people that have had an Atlas Orthogonal chiropractic adjustment report feeling as either a puff of force or nothing at all. They hear a tiny tap and they describe feeling the neck’s tightness and soreness decrease. Some explain the experience as initially underwhelming.� Others report a wave like feeling rushing through the body, especially after various treatments. The healthcare professional�may determine substantial changes between his objective findings from before the adjustment and those he finds afterwards in the patients.
About the Atlas Orthogonal Chiropractic Technique
Atlas Orthogonal chiropractic therapy could be an excellent instrument in the prevention of headaches, accidents and several other problems and includes a calming outcome for many individuals.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Cervicogenic Headache and Chiropractic
Neck pain associated with whiplash-associated disorders resulting from an automobile accident are reportedly the most prevalent cause for discomfort along the cervical spine. The sheer force of an impact from a rear-end car crash or other traffic incident can cause injuries or aggravate a previously existing condition. While neck pain is commonly the result of damage to the complex structures of the neck, cervicogenic headaches may also result due to neck issues. Chiropractic care can help carefully restore the alignment of the cervical spine to relieve headaches and neck pain.
The most useful rule-of-thumb for headache and migraine treatment is: Have a program. See your doctor and produce a treatment strategy together. Your program will help you identify and handle migraines or your headaches early, sparing you some discomfort.
Tension Headache Treatments
When you get a pressure-type headache, it’s usually because of a change in neck, your mind, or encounter. Other tissues, nerves, blood vessels, and the muscles are experiencing distress. Treat the change, and you will reduce your headache.
It may build up unwanted stress, in case you have already been hunched over a laptop at work. Or perhaps a new medicine was started by you, or had minor neck injuries.
Take a minute curl up to stretch, or massage head your face, and neck. Consider a nap, a shower, or utilizing pack or ice pack on your own head or neck.
Tension Headache Medications
For tension headaches, you’ve numerous over-the-counter medicine alternatives. Naproxen ibuprofen, acetaminophen, and aspirin are successful. If you suspect your headache is vascular (associated to your own blood vessels), consider a pain-reliever that includes some caffeine.
Get in touch with your doctor for more tips if your headache does not react to to your own behavioral techniques and medications. In the event the headache becomes severe or lasts for more than 10 days, see your doctor. Your headache might be a signal of another condition.
Cluster Headache Treatments
Inhaling 100% oxygen right when a cluster headache starts can help lessen the pain considerably. Your doctor can help you get a portable oxygen unit to carry in a bag or briefcase.
A mainstay migraine medication, sumatriptan, is effective for cluster headaches. Learn to inject yourself right when you sense the first signs of your cluster headache. Other cluster headache medicines that are useful are dihydroergotamine, administered via an I-V, and octreotide sent as an injection.
Migraine Headache Prevention
Over the past 2 decades, health practitioners have realized effective treatments for decreasing the frequency of migraines. Avoid migraine triggers, take preventive medicine, alter your nourishment, and improve your rest.
One of numerous migraine triggers, several are foods, by avoiding so you can reduce your migraine risk:
Beans, legumes, and nuts
Fermented and pickled foods like pickles and olives
Dairy and cheese that is aged
Avocados
Onions
Cured or ag ed meats
Items containing brewer’s yeast
Chocolate, cocoa, and carob
Aspartame
Beverages
Caffeine
Other frequent migraine triggers include:
Stress
Weather changes
Poor diet
Hormonal changes
Nicotine
Physical activities that are intense
As you pay focus on what triggers your migraines, you are able to learn better what to avoid�??this is just a starting listing.
Your doctor will consider other medicines that prevent migraines. He/she might prescribe:
The blood-pressure drugs propranolol or timolol
Anti-depressants such as amitriptyline or fluoxetine
The seizure medication valproate
While these drugs came to market to handle other conditions, they are also efficient for migraine prevention.
Migraine Treatment
Migraine remedy is a race from the clock. You can take steps to reduce the intensity of the assault when you sense the warning signs of a migraine. That is the time to lie down, relax, and simply take your drugs.
Non-steroidal anti-inflammatories (NSAIDs), aspirin, and acetaminophen relieve some migraines. However, many migraine sufferers need stronger medicines for example sumatriptan or a different medication from your triptan family. In a few extreme circumstances, you may be treated by your physician with an opioid.
Treatments such as ice packs or cold compresses on your forehead rush instant reduction. Massaging your scalp and rubbing your temples may also help reduce the intensity of the migraine.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Cervicogenic Headache and Chiropractic
Neck pain associated with whiplash-associated disorders resulting from an automobile accident are reportedly the most prevalent cause for discomfort along the cervical spine. The sheer force of an impact from a rear-end car crash or other traffic incident can cause injuries or aggravate a previously existing condition. While neck pain is commonly the result of damage to the complex structures of the neck, cervicogenic headaches may also result due to neck issues. Chiropractic care can help carefully restore the alignment of the cervical spine to relieve headaches and neck pain.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
The 11 patients in the study had never experienced upper cervical chiropractic care before. All were subject to having migraine headaches and were required to have at least 10-26 days with a headache for the previous four months. Additionally, at least eight of those headache days per month required a 4 out of 10 or higher for pain. While many candidates had either a concussion, auto accident or both, candidates who experienced trauma in the past year were excluded.
Headaches and migraines. The only thing you want is for it to vanish. Here is a juice that immediately eliminates headaches and migraines! Try this juice recipe out, in addition to getting an adjustment!
