Headaches: Does Chiropractic Help?

Headaches (HA) can be tremendously disabling, forcing sufferers away from work or play into a dark, quiet room to minimize any noise and light that intensifies the pain. According to the National Headache Foundation, there are over 45 million Americans who suffer from chronic, re-occurring headaches, of which 28 million are of the migraine variety. Also, approximately 20% of children and adolescents deal with headaches that can interfere significantly with their daily routines. There are many different types of headaches and many sub-types within the main categories. Here are a few: Tension HA (also, called cervicogenic HA), migraine, mixed headache syndrome (a mixture of migraine and tension HAs), cluster (less common but the most severe), sinus headaches, acute headaches, hormone headaches, chronic progressive headaches (traction or inflammatory HAs), and MANY more! Just “GOOGLE” “headache classification” for the daunting list! Let’s take a look at how chiropractic manages these headaches!
According to a study completed in 2005, a review of the published literature revealed good evidence that intensity and frequency of HAs are indeed helped by chiropractic intervention. They limited their review to cervicogenic headaches and spinal manipulation and noted the need for larger scale studies. The well-respected Cochrane database reported spinal manipulation (SM) as an effective treatment option with short-term benefits similar to amitriptyline, a commonly prescribed medication for migraine HA patients.
For cervicogenic HA, the combination of neck exercises and SM was found to be effective in both the short- and long-term, and SM was superior to massage or placebo (sham or “fake” manipulation). Regarding the question of treatment frequency of SM plus up to two modalities (heat and soft tissue therapy), a preliminary study found that when comparing patients receiving one, three, or four visits per week for three weeks, those receiving 9-12 treatments during the three weeks had the most benefit. Regarding the questions, “what is affected by SM” and, “why does SM work” for cervicogenic HA patients, a study describes the intimate relationship between the upper cervical nerve roots (C1-3), the trigeminal (cranial nerve V), the spinal accessory (cranial nerve XI), and the vascular system. Inflammation within these structures and their relationship with the trapezius and SCM muscles help us understand the “why” and “how” of SM and referred pain pattern to the face and head in those with cervicogenic HAs. Realizing this is a bit “technical”, feel free to GOOGLE these structures and you’ll appreciate the close proximity they have to each other and how adjustments, or SM, applied to the upper cervical spine can affect this region. It has also been reported that SM and strengthening of the deep neck flexor muscles benefits the cervicogenic HA patient. Many HA sufferers have combinations of symptoms including dizziness, neck pain, concentration “fog”, fatigue, and others, which were found to also respond to SM applied to the upper cervical spine. One study reported a 36% reduction in pain killer medication use in a group of cervicogenic headache patients receiving SM but no reduction in the patient group receiving soft-tissue therapy. The list of research studies goes on and on! So WHAT are you waiting for? TRY CHIROPRACTIC for your headache management!!!
We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for headaches, we would be honored to render our services.

Whiplash Management

Whiplash usually occurs as a result of a car crash when the head moves in a fast, uncontrolled way in many possible directions. The forwards-backwards movement is described in a classic “whiplash” injury but side-to-side, rotational, or a combination of movements often occur, especially if we add in the factor of the head being turned or rotated when the impact occurs, regardless of how the car is hit. This month, let’s talk treatment!

Think of “Whiplash Management” in steps:

STEP 1: IMMEDIATELY seek chiropractic attention following a whiplash injury: This is important as studies show delayed treatment is associated with worse outcomes after the dust settles. To avoid long-term disability, DON’T WAIT! Pain usually scares people into a guarded, protective way of thinking. The longer you wait, the greater the muscle tightness, spasm, weakening, and your increased fear of activity because of the pain!

STEP 2: Reduce Inflammation: The words “pain” and “inflammation” are quite synonymous. If you feel “hurt,” you are “inflamed.” We must begin anti-swelling/inflammation measures ASAP after an injury like whiplash. The BEST/safest approach is an ICE PACK – rotate it on/off/on/off/on every 15 minutes (1.25 hours/session) three times a day OR, CONTRAST ice with heat (10 min. ice/5 min. heat x3, ending with ice = 40 min.). BOTH methods produce a PUMP-like effect to quickly get rid of the inflammation. You also have the option of OTC medications (Aspirin, ibuprofen, and naproxen) but these NSAIDs (non-steroidal anti-inflammatory drugs) carry significant side-effects for some people, the most evident early on being stomach upset/irritation (later, liver and kidney damage) so be careful! You don’t want to have to treat an ulcer on top of your whiplash! Consider anti-inflammatory nutrients, herbs, vitamins, and food – they’re safe and effective (we’ve discussed these previously – SEARCH the web for more information).

STEP 3: AVOID INACTIVITY: This is important since the “natural” thing to do is nothing, “…because it hurts!” WE will guide you in this process as you need to know how much and what type of activity is safe and appropriate. You have to “interpret” the pain as being either safe or harmful and then you react accordingly. You MUST tell us the type of pain (sharp, knife-like is harmful vs. a “good” stretch type of hurt is safe), how much pain there is (7-10 on a 0-10 scale is potentially harmful), how constant it is, and what helps/hurt (what have you tried and learned so far). THEN, we will guide you appropriately (with your help)!

STEP 4: DO NORMAL ACTIVITY: This dovetails our last point. Get on with your normal activities as avoiding work and other ADLs (activities of daily living) leads to “disability thinking” or thinking you’re worse than you are. DON’T LET THAT HAPPEN. Talk to us!!!  

STEP 5: AVOID prolonged faulty postures: Whether it’s a conversation with a person who is NOT directly in front of you, a faulty computer screen position, talking in a car without turning your body (look straight ahead), or talking on the phone, CHANGE IT!  

STEP 6: COMPLY with a home-based exercise program: This is HUGE! We will guide you in this process. We will start with ice and then possibly a home traction device, isometrics followed by Theratube or band (isotonic) exercises, posture training, and much more. You NEED guidance in this area – let us HELP YOU!  

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Whiplash, we would be honored to render our services.

Carpal Tunnel- More Fun Facts!

Did you know that Carpal Tunnel Syndrome (CTS) can affect anyone? None of us are immune to developing CTS as roughly 1 out of 20 of us will develop CTS in our lifetime! This month, let’s look at some of the risk factors for developing CTS.

1)  Race: Caucasians carry the greatest risk of developing CTS.

2)  Gender: Women are three times more likely than men to develop CTS. This may be because female wrists are smaller and shaped a little differently than male wrists, but hormonal differences are probably the most important reason for this variance.

3)  Pregnancy: Up to 62% of pregnant women develop CTS. This is thought to be due to the excess fluid retention that normally occurs during pregnancy and most likely stems from the elevation in hormone levels that NORMALLY occurs during pregnancy. The prevalence in the first, second, and third trimesters is 11%, 26%, and 63%, respectively, thus supporting the fact that the risk increases with the length of the pregnancy. Though CTS usually resolves after giving birth, symptoms can continue for as long as three years following delivery!

4)  Birth Control Pill (BCP): The use of BCPs increases CTS risk due to an increase in hormonal levels similar to the CTS risk increase during pregnancy.

5)  Occupational: Workers in highly repetitive, hand-intensive occupations (such as line work, sewing, finishing, meat processing, poultry or fish packing) have a higher rate of developing CTS.

6)  Injury to the wrist or hand: An obvious example is a wrist fracture from a slip and fall, sports injury, or blunt trauma like a car accident. When there is a direct pinch on the median nerve, nerve damage can occur quite quickly, and as a result, the onset of symptoms can be very fast. Less obvious injuries, which usually have significantly slower onsets, include repetitive motion injuries, often referred to as “cumulative trauma disorders” and include a group of conditions such as tendonitis, sprain/strain, bursitis, and other types of soft tissue injuries.

7)  Certain conditions: Nerve damaging conditions that can cause CTS include diabetes and alcoholism. Other conditions that can contribute and/or cause CTS include menopause, obesity, thyroid disorders, kidney failure, and more.

8)  Inflammatory conditions: These include several types of arthritis such as rheumatoid, lupus, and others. Osteoarthritis is technically NOT an “inflammatory” condition but it can cause CTS by compressing the median nerve via a bone spur formed within the carpal tunnel.

9)  Faulty work stations: A job site has A LOT to do with whether or not a person develops CTS. Though jobs that require fast, repetitive movements pose the greatest risk (see #5 above), other work-related factors that may be controllable can also significantly contribute to the development of CTS. Some of these include the shape of tools such as screwdriver handles shaped like a gun (pistol) which allow for better alignment of the wrist than a “normal” straight screwdriver handle. Another is a power tool that may have too much vibration or torques too hard at the end of a cycle. A handle that is too cold/hard (e.g., metal handle) or that may be too large for the worker’s hand is an additional factor to consider. Positioning the work so that the wrists can stay straight vs. bent can be VERY helpful. In fact, if some of these “ergonomic” factors are not fixed, CTS can be next to impossible to remedy. Also, poor posture in the back, neck, and the rest of the body can result in compensatory faulty postures elsewhere. Look in a mirror and poke your chin out towards the mirror. Now look at your shoulders. See how they roll forward and feel the strain in your upper back and neck? Keep your chin tucked in, NOT out. This can make a BIG difference in your posture!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Carpal Tunnel Syndrome, we would be honored to render our services.

What kind of headache do I have?

Headaches come in MANY different sizes, shapes, and colors. In fact, if you search “headache classification,” you will find the IHS (International Headache Society) 152 page manual (PDF) lists MANY different types of headaches! Last month, we discussed migraine headaches. This month, we’ll talk about the other headache types. So WHY is this important? Very simply, if we know the type of headache you have, we will be able to provide you with the proper treatment. Headaches are classified into two main groups: “primary” and “secondary” headaches. The “Primary” headache list includes: 1) Migraine; 2) Tension-type; 3) Cluster; 4) “Other primary headaches,” of which eight are listed. One might think that with this simple breakdown of the different types of headaches it should be easy to diagnose a type of headache. Unfortunately, that’s NOT true! In fact, a 2004 study published that 80% of people with a recent history of either self or doctor diagnosed sinus headache had NO signs of sinus infection and actually met the criteria for migraine headaches! So, the more we can learn about the different types of headaches, the more likely that we will arrive at an accurate diagnosis.

Tension-Type Headaches: This is the most common type affecting between 30-78% of the general population. It is usually described as a constant ache or pressure either around the head, in the temples, or the back of the head and/or neck. There is typically NO nausea/vomiting, and tension-type headaches rarely stop you from performing normal activities. These headaches usually respond well to chiropractic adjustments and to over-the-counter medications like Advil, aspirin, Aleve, and/or Tylenol, though we’d prefer you first reach for an anti-inflammatory herb like ginger, turmeric, bioflavonoid, and the like as these have less stomach, liver, and/or kidney related side-effects. These headaches are typically caused by contraction of the neck and scalp muscles, which can be result of stress, trauma, lack of sleep, eyestrain, and more.

Cluster Headaches: These are less common, typically affect men more than women, and occur in groups or cycles. These are VERY DISABLING and usually arise suddenly and create severe, debilitating pain usually on only one side of the head. Other characteristics include: a watery eye, sinus congestion, or runny nose on the same side of the face as the headache. An “attack” often includes restlessness and difficulty finding a pain-reducing, comfortable position. There is no known cause of cluster headaches, though a genetic or hereditary link has been proposed. The good news is that chiropractic adjustments can reduce the intensity, frequency, and duration of cluster headaches!

Sinus Headaches: Sinusitis (inflamed sinuses) can be due to allergies or an infection that results in a headache. This may or may not include a fever, but the main distinguishing feature here is pain over the infected sinus. There are four sets of sinuses. Many people know about the frontal (above the eyes on the forehead) and maxillary (under the eyes in our cheeks) but the two sinuses deep in head (ethmoid and sphenoid sinuses) are much less known or talked about. These two deep sinuses refer pain to the back of the head, and when infected, it feels like the back of the head could explode. Lying flat is too painful so sitting up is necessary. Chiropractic adjustments applied to the sinuses, upper neck, and lymphatic drainage techniques work GREAT in these cases!

We will continue next month with the remaining types of headaches!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for headaches, we would be honored to render our services.