HEADACHE

According to the World Health Organization, 50 to 75% of people have had a headache in the last year. Not only are headaches common, an inconvenience, and uncomfortable, but they can be debilitating. Negatively impacting a normal lifestyle, headaches can diminish production, performance, and mood; and escalate irritability, stress, and absence of daily activity.

WHAT IT IS

Headaches can happen for many reasons which makes it difficult to know what type of a headache you have and the cause.  Each type of headache is treated differently, which is why an accurate diagnosis is critical. 

Headaches are a painful and disabling feature of a small number of primary headache disorders.

Primary headache disorders are namely migraine, tension headaches, cervicogenic headaches, and cluster headaches. Because we treat musculoskeletal disorders, the information below is most pertinent to headaches that are related to the spine, namely cervicogenic headaches (CH) and tension headaches.

CHs associate with neck problems.  Cervicogenic (generated from cervical spine) headaches are head pain from poor neck mechanics and joint movements.  Tension headaches are closely related but are defined as headaches originating from muscular tension of the neck and shoulder girdle.  Dr. Annas at Nexus Spine & Sport will take you through necessary tests to determine the origins and create a treatment plan from there.

Posture plays a critical role regarding neck pain, which can cause pain in the head region, triggering a headache. American culture in the 21st century puts excessive stress on our joints. Technology, desk jobs, and sleeping habits — to name a few — influence headaches. The muscles, tendons, and ligaments of our neck are pain sensitive and can send symptoms to other areas of the body.  The postures and stresses we hold our neck and shoulder girdle into for hours a day are micro traumas, leading to injuries and headaches over time.  Headaches can decrease quality of life and work productivity.  Over time, the structures will begin to adapt to this poor posture, perpetuating the problem and poor movement patterns.

WHAT IT ISN’T

Cervicogenic headaches are rarely a sign of something scary or dangerous. However, it’s important to distinguish the difference from other types of headache as they can share similar symptoms.

Migraine sufferers know a migraine from a “bad” headache. Migraine headaches are typically more severe than CH and have a known trigger, e.g., food, light, smells. Pain is usually on one side of the head with symptoms behind the eye and at the back of the head. Sensitivity to light and noise, and nausea and vomiting are common. Some experience “auras” or visual disturbances preceding a migraine. Migraines can last a few hours to as long as a few days and can occur seldom or several times a year.

Cluster headaches are the least common type, and their underlying cause is unknown. Cluster headaches are very intense — described as one of the worst pains you can experience. Cluster headaches occur regularly over a period in “clusters.” They can last anywhere from 30 minutes to a few hours, occurring multiple times in a day over several weeks.  They are more common in males.

A thorough history and evaluation is critical to coming to an accurate diagnosis, so the proper treatment can be provided.

If a headache occurs suddenly and accompanied by pain, dizziness, nausea, vomiting, or unconsciousness — especially when associated with trauma — seek emergency medical care immediately.

COMMON CAUSES OF A HEADACHE

The most common treatments are rest, medication, physical therapy, chiropractic adjustment, cupping, exercise, acupuncture, massage, and other various conservative therapies.

While most acute bouts of cervicogenic and tension will resolve on their own within a few weeks, the risk of recurrence is very high. The greatest risk of injury is the previous injury — if you’ve done it once, it’s very likely to happen again.  We are here to speed that recovery process, decrease the pain as you recover, and create strategies to prevent them from happening in the future.

Few individuals need surgery for Cervicogenic headaches. However, if the pain is debilitating and unrelenting after conservative options are exhausted, a “nerve block” or surgery may be necessary.

Commonly, we find cervicogenic and tension headaches are the result of a problem of the neck joints and muscles just below the base of the skull.

COMMON TREATMENTS OF A HEADACHE

The most common treatments are rest, medication, physical therapy, chiropractic, acupuncture, massage, and other various conservative therapies.

While most acute bouts of CH will resolve on their own within a few weeks, the risk of recurrence is very high. The greatest risk of injury is the previous injury — if you’ve done it once, it’s very likely to happen again.

Few individuals need surgery for CH. However, if the pain is debilitating and unrelenting after conservative options are exhausted, a “nerve block” or surgery may be necessary.

At Nexus Spine & Sport, we successfully treat CH and tension headaches, similarly to a neck problem. Commonly, we find CH is the result of a problem of the neck joints and muscles just below the base of the skull. 

WHAT YOU CAN DO ABOUT A HEADACHE

With all mechanical pain, there’s a ‘what’ and a ‘why’ — what the problem is and why it’s occurring in the first place. To achieve resolution, it’s crucial to not only identify and correct the problem at hand but address the behaviors which lead to the issue’s occurrence. Here are some self-help tips:

• Keep moving
• Avoid sitting for longer than 30-minutes at a time
• Sit with upright posture with lumbar support
• Take micro-breaks: stretch, take a stroll, grab a snack, move around
• Sleep with one pillow supporting a neutral, aligned spine.
• Learn proper shoulder & lifting mechanics with Dr. Annas
• Take mental notes of what you are doing when your pain feels better or worse to identify any behavioral patterns

STILL STRUGGLING WITH A HEADACHE? WE CAN HELP!

Our approach isn’t to just “fix” the problem, rather understand what it is and what it isn’t, so the correct treatment is applied to the right problem — only then can we achieve a solution. The guessing game must be eliminated in order for the proper treatment to be prescribed.

Nexus Spine & Sport initiates treatment for neck pain by utilizing evidence-informed treatment protocols, such as FMS, FAKTR, or the Mckenzie Method (MDT) for example. MDT is a proven system of examination, treatment, and classification of spinal, joint, and other musculoskeletal pain, backed by years of research, evidence, and practice. The MDT system is designed to identify the mechanical problem and improve the mechanics, thus decrease or eliminate the pain and functional problems.  These systems have been shown to be low cost, fast, and effective even for chronic pain.  Only after a thorough history and necessary orthopedic and neurological are performed can an accurate diagnosis be attained.  It is then that the specific treatment plan can be created.

Treatment can vary from massage, to cupping, to adjustments, to laser, to rest and more.  If a mechanical force caused the problem, then it is logical that a mechanical force may be part of the solution (i.e. adjustment, MDT end range loading, etc.)

The goal is for you to be able to understand and control your pain yourself, not needing your doctor/chiropractor on a repetitive basis. If your problem is something we are unable to treat, we will know this within the first few visits, and then we recommend the next best course of action to find you a solution.

If you are experiencing loss of vision, loss of speech, nausea, or sudden onset of unrelenting horrible pain, seek medical attention immediately.