Chronic Headache Syndrome?
Chronic Headache Syndrome is a fairly new “syndrome” as classified by modern medicine (or should I say, as classified by pharmaceutical companies!)
As a chiropractor, I have had too many patients complaining about neck and/or low back pain, and when I ask them if they experience headaches, I am always shocked to hear this response, “…well, sure I have headaches…but that’s normal for me.”
Sadly, people often visit a chiropractor to seek relief from their headaches, only after exhausting the route of pharmaceuticals drugs, and have become concerned with the negative side effects of long-term use.
Often the cause of headaches is very simply; spinal ‘misalignments’ along with muscle spasms in the neck usually due to stress. Chiropractic care remedies headaches by removing the interference of the nerve roots, which is the principal reason for the pain, along with recommendations of lifestyle changes.
I honestly don’t know of a chiropractor who doesn’t report improvement of these so-called “normal” headaches with their patients who received chiropractic care, thus, allowing them to discontinue the use of pain medicines.
However, there are many skeptics of chiropractic care who claim there is little to no research regarding cervical adjustments, and its effectiveness to eliminate pain.
This couldn’t be farther from the truth.
There has, in fact, been much research regarding chiropractic cervical (neck) adjustments, and the reduction of many types of headaches. The increasing body of evidence strongly supports, that headaches can be safely diminished without the dangerous side effects of NSAIDS (Non-Steroidal Anti-Inflammatory Drugs), and/or other pain-relieving medications which are too often prescribed by medical doctors.
Basically, there are two types of “common” headaches: tension and migraine. And both types are blamed for the development of the “Chronic Headache Syndrome”.
Sadly, most medical doctors prescribe headache medications without even knowing the actual cause of the headaches regardless of what type it is!
Tension headaches (cervicogenic headaches) are the most common resulting from contraction of head, neck, and upper back muscles. Though they can occur in isolated incidents, the probable causes of the chronic muscle contraction associated with tension headaches is prolong stress and fatigue.
Although migraine headaches are not as common as tension headaches, they can be extremely debilitating to those who suffer from them. This type of headache occurs when blood vessels of the head and neck constrict, resulting in a decrease in blood flow to those vessels. The consequential throbbing pain, most often on one side of the head, is frequently accompanied with nausea, and sensitivity to light and sound.
The cause of migraines is more a mystery than tension headaches (so the medical profession claim) but, nonetheless, is considered to be a result of prolonged muscle tension, triggered by allergic reactions, and/or hormonal changes, but more commonly, due to stress and fatigue.
It should be noted that, too often, tension headaches are misdiagnosed as migraines.
Does the Chiropractic Adjustment Work?
One of the principal tools used by a chiropractor to establish the vertebral level that requires the cervical adjustment is established via manual palpation. Simply, the doctor moves the patients neck slowly to determine the ROM (range of motion), pain, muscle tenderness and inflammation.
The question here would be the effectiveness of the manual palpation.
A study done by Dr. Hanten et al. found that palpation is a more than a “reliable tool in identifying the area of misalignment of the spine, but also proves to be a good indicator of establishing a diagnosis of a tension/cervicogenic headache” in symptomatic patients. After the diagnosis of the subluxated (misaligned) vertebra(s), the chiropractic adjustment will be performed. This can be executed by many different styles of techniques.
The most widely used technique, as well as most popular, is the diversified approach. This adjustment is done by a high-speed, low-amplitude thrust (HSLAT) to the segment identified as subluxated. Most patients recognize this technique by the “crack or popping” sound they hear, which is often associated with the adjustment.
But does the adjustment actually have an effect at reducing the headaches?
To help answer this question, let’s refer to the study done by Dr. Nilsson et al. (1997). The conclusion indicates that the adjustment done as HSLAT had “significant reduction in the intensity of pain, as well as, a reduction of the duration of the headache”. This study substantiates another study done earlier by Dr. Nilsson (1995), when he wanted to establish whether HSLAT adjustments are an effective treatment on cervicogenic headaches. He determined that the adjustments had possible positive effects, but the methodology was skewed resulting in this later 1997 study.
How about comparing the effectiveness chiropractic adjustments to pain medications?
Another study was done by Dr. Boline et al. did just that! It compared the effectiveness of chiropractic treatments with Amitriptyline — pharmaceutical treatment prescribed mainly for depression, but is also used for chronic pain syndromes.
They found Amitriptyline slightly more effective in reducing the pain, but was also associated with adverse side- effects at the end of the treatment, which lasted for a six-week period.
Some common side-effects can range from: dizziness; drowsiness, dryness of mouth, headache, and increased appetite (may include craving for sweets), nausea, tiredness or weakness, unpleasant taste, and weight gain. YIKES!
[Notice that a “headache” is part of the side-effects! This is not an uncommon side-effect of most “pain” medications!]
Those who received the spinal manipulative therapy experienced sustained therapeutic benefit without the negative side effects - especially, no side-effect of headache! Thank goodness since headaches are what you want to get rid of and avoid!
So just how many visits to the chiropractor does it take for headaches to go away?
Dr. Haas et al. asked the same question and found there was relief from headache pain in nine to twelve visits, although more than twelve visits may be required for maximum relief. It has also been reported that for some patients, pain was resolved after a single visit! (Of course all patients are unique, and results vary. These are examples of the averages)
There is also the question of the nutritional component. And this is a subject that is actually very controversial in the chiropractic world today.
Nonetheless, if this component is overlooked, it is technically no different than the medical doctor overlooking the effectiveness of chiropractic care in lieu of a drug.
One such nutritional component is Vitamin B2 (Riboflavin).
Vitamin B2 (Riboflavin) has proven to extremely effective in migraine headache relief with no side-effects!
A 2004 study published in the European Journal of Neurology also explored the usage of “high dose” riboflavin on the frequency, duration, and intensity of migraine sufferers aging twenty to sixty-five. And they found that, “…riboflavin is a safe and well-tolerated alternative in migraine prophylaxis.”
This really should come as no big surprise since nearly all types of headaches can be traced back to stress—and stress depletes vital nutrients; especially B vitamins and Vitamin C.
To read more about Vitamin B2 and its effectiveness against Migraines, I invite you to read Migraine Solution.
Chiropractic care has come a long way since its entrance in 1895 by founder D. D. Palmer. For many years what chiropractic lacked, was the research to prove the efficacy of this new system of healthcare, as well as, the benefits of its use. However this has been steadily changing!
The research done regarding chiropractic care and its effectiveness on headaches, has proved positive and certainly warrants more research including more long-term studies!
As time has passed, more and more research has been done to validate the effectiveness of chiropractic care, and although the tip of the iceberg has barely been scraped, progress is starting to be made – exponentially!
- Rasmussen B. “The epidemiology of headache.” Cephalgia, 1995. 15. 45-68.
- Hanten W., Olson S., Ludwig G.M. “Reliability of Manual Mobility Testing of the Upper Cervical Spine in subjects with Cervicogenic Headache.” The Journal of Manual & Manipulative Therapy, 2002. 10(2). 76-82.
- Nilsson N., Christensen H.W., Hartvigsen J. “The effect of Spinal Manipulation in the Treatment of Cervicogenic Headache.” JMPT, 1997. 20(5). 326-330.
- Nilsson N. “A Randomized Controlled Trial of the Effect of the Spinal Manipulation in the Treatment of Cervicogenic Headache.” JMPT, 1995. 18(7). 435-440.
- Sinnott R.; Chiropractic Books: “The Green Books”, 1997. Chapter 7. 117-118.
- Phongphua C., Hawk C., Long C., Young C., Gran D.F. “Feasibility Study for a Clinical Trail of Chiropractic Care for Patients with Migraine
- Headaches Using Different Chiropractic Techniques.” The Journal of Chiropractic Education, 1999. 13(1). 75. http://bipolar.about.com/cs/sfx/a/sfx_elavil.htm
- Boline P.D., Kassak K., Bromfort G., Nelson C., Anderson A.V. “Spinal Manipulation vs. Amitriptyline for the Treatment of Chronic Tension-type Headaches: A Randomized Clinical Trail” JMPT, 1995. 18(3). 148-154.
- Vernon H., Jansz G., Goldsmith C., McDermaid C.”A Randomized, Placebo-controlled Clinical Trail of Chiropractic and Medical Prophylactic Treatment of Adult Tension-type Headache.” Focus on Alternative and Complementary Therapies, 2003. 8(4). 548.
- Haas M., Groupp E., Aickin M., Fairweather A., Ganger B., Attwood M., Cummins C., Baffes L. “Dose Response for Chiropractic Care of Chronic Cervicogenic Headache and Associated Neck Pain: A Randomized Pilot Study.” JMPT, 2004. Nov/Dec. 547-552.