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Dr. Patrick J. Shwaluk
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Headaches

Chiropractors have been successfully treating headaches for over 100 years. The treatment of headaches is the third most common reason, next to low back and neck pain, for consults to chiropractors. There are over 100 different types of headache and most of them are rare and difficult to diagnose and treat.  Fortunately the most common headaches are generated from abnormal function of the joints and muscles of the neck and are very treatable.

The term cervicogenic headache was introduced in 1983 to describe headaches which are generated from abnormal function of the joints and muscles of the neck. These are possibly the most common headaches encountered in medical and chiropractic practices. The term cervicogenic headache does not implicate one disease process or tissue of the neck but refers to any condition of the neck that causes headache. Most commonly, disruption of the joints, tendons, ligaments and muscles of the upper part of the neck are responsible for this type of headache. Trauma to the head and neck or whiplash and poor posture are the most common causes of cervicogenic headache. It has been well documented that chiropractic spinal manipulation of the joints can relieve these symptoms.

There are many different types of cervicogenic headaches. The subtle differences depend on the tissue generating the referred pain. A variety of trigger points in the neck muscles can refer dull pain to different parts of the head.  Even though these headaches tend to recur on one side of the head they can shift from side to side or to other parts of the head. It is possible to have more than one joint or muscle causing headaches in different parts of the head at the same or at different times.

Cervicogenic headaches are generally experienced frequently. They can occur daily and persist for months at a time until treated with appropriate chiropractic care. The intensity varies from mild to moderate to severe. They are aggravated by movement and relieved by rest. Cervicogenic headaches are not associated with serious underlying pathology. You do not die from them - you only feel like dying.

Migraine type symptoms can be referred to the head from the neck. These headaches vary in intensity and can be severe and throbbing. They can be associated with nausea, vomiting, phonophobia (sensitivity to noise) and photophobia (sensitivity to light) - all features that are associated with common and classic migraines. This type of migraine is called a cervicogenic migraine.

Classic and common migraines occur less frequently than cervicogenic migraine - less than one episode per month. Classic and common migraines do not vary in intensity - they are typically described as severe, excruciating or debilitating. Common analgesic medication, like Aspro and Panadol, typically do not relieve classic or common migraine but in the early stages they can relieve all types of cervicogenic headaches. Tolerance to medication, however, may happen with continued use and in time may provide no benefit to cervicogenic headache sufferers. Migraines tend to last from 4 - 24 hours while cervicogenic headaches may last from 3 hours to 3 weeks.

45% of adults report suffering severe or disabling headaches. 40% of headache patients experience two or more different types of headaches. For example, they can suffer classic migraine and a variety of cervicogenic migraine / headaches. 

The majority of headaches are not life threatening and are well managed with conservative chiropractic care. The patient’s response to manipulation and soft tissue therapy of the neck frequently helps to distinguish between migraine and cervicogenic headaches. As a rule of thumb, chiropractic care relieves cervicogenic migraines / headaches but has minimal lasting effect on migraine or pathology based headaches. Headache that continue to recur at their normal frequency regardless of the frequency or type of chiropractic care received generally require medical or surgical care. 

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