Headaches Are a Real Pain (in the neck)?

When we experience a headache, the focus tends to be on alleviating symptoms directly within the head but many times the source of the pain may actually originate in the neck.

There are 7 vertebrae that make up the neck (cervical spine) and 8 sets of nerves that exit this part of the spine. These nerves innervate various parts of the head, neck, shoulders, arms and hands. The uppermost spinal segments, C1-C2-C3, share nerve tracts with the cranium. The brain lacks the ability to define the precise location of pain when coming from the neck. This is why the brain usually mistakes upper cervical spine pain as a headache.

Muscle tension can come from emotional or physical stress. Physical stress such as spinal misalignment of the neck or sitting for long periods at a computer, gripping a telephone between the shoulder and ear or driving in heavy traffic are all activities that can lead to muscle tension, resulting in headaches.

The most common type of headache is the tension headache. Approximately 80-90 % of the U.S. population suffers from tension headaches at some point in their lives. The International Headache Society recognizes and classifies two types of tension headaches: Episodic, which occur less than 15 days per month and Chronic which occur more than 15 days per month for 6 months or more. Both types are pressing “band-like” (non-pulsating) in nature. The pain location is bilateral at the base of the head or forehead. The pain may cause modification of activity but is usually not incapacitating. Causative factors include abnormal posture, muscular tightness, joint stiffness, general stress, and lack of sleep.

Head pain originating from the cervical spine is known as a cervicogenic headache. The pain may radiate to the forehead, temple, eyes or ears and it is aggravated by neck movements of sustained postures. A person will typically exhibit reduced neck range of motion, one-sided neck, shoulder or arm pain and tightness/contracture of neck and shoulder muscles.

Approximately 15% of the population suffers from migraines. These can be far more debilitating than the tension-type headaches. Many times, migraine sufferers report some sort of trigger that initiates their headache (food, drink, smell). There may be a hormonal component as more women than men are affected by migraines. Stress, lack of sleep, missing meals or rapid changes in blood sugar can also be triggering factors. Consuming vasoactive foods such as coffee, alcohol, preservatives, monosodium glutamate (MSG) dialates the blood vessels within the skull resulting in headache pain.

The nature of pain is usually moderate to severe throbbing or pulsatile, one-sided and localized in the frontal, temporal and/or eye area. 80% of migraine sufferers experience nausea while 20% report visual disturbances such as hazy or shimmering light patterns in their field of vision. Paresthesias (numbness) in the arm, hand, or face occurs in 40% of cases. Duration is usually several hours to a day or more.

Cluster type headaches are defined by recurrent, brief (5 minutes to 3 hrs.) attacks of sudden, severe, one-sided, overall head pain, described as “excruciating, piercing and deep”. The frequency of attacks can occur every other day up to 8 times per day. A typical cluster lasts 2 weeks to 3 months. Triggers include stress, relaxation, extreme temperatures, glare, allergic congestion. Some speculated causes are hormonal influences disrupting circadian rhythm, serotonin metabolism, and histamine receptors.

Dysfunctional patterns of movement and posture affect how much tension and stress the body holds. Chiropractic care helps to restore proper spinal alignment, joint range of motion and reduce abnormal stressors by normalizing muscle tension.

Proper breathing is essential to relaxation, blood flow and oxygen supply to the brain and body. Headache sufferers tend to breathe more from their chest and shoulders as opposed to their diaphragm. This leads to increased tension in the head and neck due to repeated elevation of the shoulders and upper back muscles. Chiropractic spinal adjustments increase proper function of the spine, ribs, and hips to maximize breathing and postural control.

At our practice, we incorporate specific myofascial release and trigger point therapy which aims at reducing contracted musculature in the neck, shoulders and back, decreasing the tension on the cervical spine. Chiropractic adjustments applied to the joints of the neck, especially in the upper cervical spine, work well for headaches of all types. Often, the most effective treatment for headaches is the combination of both spinal manipulation and myofascial release to the involved musculature.

If you are suffering from headaches, let us help determine the cause of your pain. Call our office today! 802-655-0354

References:

Biondi, David M. DO, The Journal of the Osteopathic Association, Cervicogenic Headache: A Review of Diagnostic and Treatment Strategies. http://www.jaoa.org/content/105/4_suppl/16S.full

Chapman-Smith LL.B. (Hons.), David. September 2010 Vol. 24 No. 5:
http://www.chiro.org/LINKS/ABSTRACTS/Cervicogenic_Headache_Revisited.shtml

Cornell University http://www.biog1105-1106.org/demos/105/unit10/muscles.html, accessed 6/27/2012.

Kamhi, Lawrence M., MD, FIPP. Neck Pain and Headaches. Treating Cervicogenic Headaches. http://www.spineuniverse.com/blogs/kamhi/neck-pain-headaches, submitted on March 17th, 2010.

McCrory DC , Penzien DB et al. Evidence report: Behavioral and Physical Treatments for Tension-Type and Cervicogenic Headache Des Moines, Iowa, Foundation for Chiropractic Education and Research. 2001.

Nickelston, Perry, DC, FMS, SFMA. A Drug-Free Way to Treat Headaches: Chiropractic Care. To Your Health, April 2012 (Vol. 06, Issue 04)

Vizniak, Nikita A.,DC, Carnes, Michael A., DC Conditions Manual, 2004, page 8-17.