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Tension vs. Migraine: What’s the Difference?

9 May

Most likely, everyone reading this article has had a headache at one time or another. The American Headache Society reports that nearly 40% of the population suffers from episodic headaches each year while 3% have chronic tension-type headaches. The United States Department of Health and Human Services estimates that 29.5 million Americans experience migraines, but tension headaches are more common than migraines at a frequency of 5 to 1.

Knowing the difference between the two is important, as the proper diagnosis can guide treatment in the right direction.

TENSION HEADACHES: These typically result in a steady ache and tightness located in the neck, particularly at the base of the skull, which can irritate the upper cervical nerve roots resulting in radiating pain and/or numbness into the head. At times, the pain can reach the eyes but often stops at the top of the head. Common triggers include stress, muscle strain, or anxiety.

MIGRAINE HEADACHES: Migraines are often much more intense, severe, and sometimes incapacitating. They usually remain on one side of the head and are associated with nausea and/or vomiting. An “aura”, or a preheadache warning, often comes with symptoms such as a bright flashing light, ringing or noise in the ears, a visual floater, and more. For migraine headaches, there is often a strong family history, which indicates genetics may play a role in their origin.

There are many causes for headaches. Commonly, they include lack of sleep and/or stress and they can also result from a recent injury—such as a car accident, and/or a sports injury — especially when accompanied by a concussion.

Certain things can “trigger” a migraine including caffeine, chocolate, citrus fruits, cured meats, dehydration, depression, diet (skipping meals), dried fish, dried fruit, exercise (excessive), eyestrain, fatigue (extreme), food additives (nitrites, nitrates, MSG), lights (bright, flickering, glare), menstruation, some medications, noise, nuts, odors, onions, altered sleep, stress, watching TV, red wine/alcohol, weather, etc.

Posture is also a very important consideration. A forward head carriage is not only related to headaches, but also neck and back pain. We’ve previously pointed out that every inch (2.54 cm) the average 12 pound head (5.44 kg) shifts forwards adds an EXTRA ten pounds (4.5 kg) of load on the neck and upper back muscles to keep the head upright.

So, what can be done for people who suffer from headaches? First, research shows chiropractic care is highly effective for patients with both types of headaches. Spinal manipulation, deep tissue release techniques, and nutritional counseling are common approaches utilized by chiropractors.

Patients are also advised to use some of these self-management strategies at home as part of their treatment plan: the use of ice, selftrigger point therapy, exercise (especially strengthening the deep neck flexors), and nutritional supplements.

Can Chiropractic Help My Headaches?

22 Feb

Everyone, well at least almost everyone, has had headaches from time to time, and we all know how miserable they can make us feel. In fact, at some point in time, 9 out of 10 Americans suffer from headaches that range between mild and dull to throbbing, intense, and debilitating, sometimes to the point of requiring bed rest in a dark, quiet room.

The common reflex is to reach for that bottle of pills and pray the headache subsides so you don’t have to call in sick and lose another day of productivity when you have so much to do. Unfortunately, between the side effects of many medications designed to help headaches and the pain associated with the headache, this approach is frequently NOT the answer. So what is?

The good news is that many studies have identified spinal manipulation therapy (SMT), the main type of care utilized by chiropractors, as being very effective for popular types of headaches—in particular tension-type headaches that arise in the neck. An important 2001 study reported that SMT provided almost immediate relief for headaches that arose in the neck with SIGNIFICANTLY fewer side effects and longer-lasting results compared with commonly prescribed medications.

Another interesting study that found similar results included tracking the prevalence/frequency of headaches after treatment stopped. The authors of the study reported the patients receiving SMT had continued to experience sustained benefits throughout the following weeks, and even months, in contrast to those in a medication treatment group where headaches came back almost immediately after they discontinued treatment.

The most commonly prescribed medication for tension-type headaches are non-steroidal anti-inflammatory drugs (NSAIDs). Common over-the-counter options include ibuprofen (Advil, Nuprin, etc.) and Aleve (Naproxen). For those who can’t take NSAIDs because of blood thinning and/or stomach-liver-kidney problems, doctors commonly prescribe acetaminophen (Tylenol), but it can be hard on the liver and kidneys, especially when taken over time.

So, what can you expect from a visit to a chiropractor for your headaches? The typical approach begins with a thorough history and examination with an emphasis of evaluating the neck and its associated function. Your doctor of chiropractic may also perform tests designed to reduce pain and some that provoke a pain response to identify the “pain generator” or cause!

Because each patient is unique, the type of care provided will be individually determined based on the findings, the patient’s age, comfort, and preference of both the provider and patient.

So, the next time you find yourself reaching for pills because of headaches, remember that there are better options! Give chiropractic a try. You’ll be GLAD you did!!!

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 neck pain or headaches, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR HEADACHES!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888


Can Chiropractic Help My Headaches?

22 Dec

According to the World Health Organization, headaches are among the most common disorders of the nervous system affecting an estimated 47% of adults during the past year. Headaches place a significant burden on both quality of life (personal, social, and occupational) and financial health. They are usually misdiagnosed by healthcare practitioners, and in general, are underestimated, under-recognized, and under-treated around the world. So, what about chiropractic and headaches… Does it help?

Suffice it to say, there are MANY studies showing chiropractic care helps headache sufferers. For instance, in a review of past research studies using an “evidence-based” approach, chiropractic treatment of adults with different types of headaches revealed very positive findings! Researchers note that chiropractic care helps those with episodic or chronic migraine headaches, cervicogenic headache (that is, headaches caused by neck problems), and tension-type headaches (chronic more than episodic). There appears to be additional benefit when chiropractic adjustments are combined with massage, mobilization, and/or adding certain types of exercises, although this was not consistently studied. In the studies that discussed adverse or negative effects of treatment, the researchers noted no serious adverse effects.

In patients suffering from athletic injuries, particularly post-concussion headache (PC-HA), chiropractic care can play a very important role in the patient’s recovery. With an estimated 1.6 to 3.8 million sports-related brain injuries occurring each year, approximately 136,000 involve young high school athletes (although some argue this is “grossly underestimated”).

Several published case studies report significant benefits for post-concussion patients after receiving chiropractic care, some of which included PC-HA from motor vehicle collisions, as well as from slips and falls. For example, one described an improvement in symptoms that included deficits in short-term memory as well as attention problems. In this particular study, a six-year-old boy fell from a slide in the playground, and after 18 months of continuous problems, underwent a course of chiropractic care. After just three weeks of care, his spelling test scores improved from 20% to 80% with even more benefits observed by the eighth week of care!

Another case study looked at a 16-year-old male teenager with a five-week-old football injury who had daily headaches and “a sense of fogginess” (concentration difficulties). He reported significant improvement after the second visit, with near-complete symptom resolution after the fifth visit (within two weeks of care). After seven weeks of care, he successfully returned to normal activities, including playing football.

Dizziness and vertigo are also common residuals from concussion and were present in a 30-year-old woman just three days following a motor vehicle accident. She also complained of headache, neck pain, back pain, and numbness in both arms. The case study noted significant improvement after nine visits within an 18-day time frame.

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 neck pain or headaches, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR NECK PAIN! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

What Can I Do the Stop a Migraine?

28 Oct

Migraines can be life-altering! They can stop us from being able to enjoy a child’s piano recital, participate in family events, go to work, or simply do household chores! Wouldn’t it be nice to have ways to self-manage these miserable, often disabling headaches? Here are some options!

  1. RELAXATION THERAPY: Search for a calm environment, turn off the lights (photophobia, or light sensitivity, is a common migraine complaint), minimize sound/noise (due to “hyperacusis”), and sleep if possible. Monitor the room temperature and/or use hot/cold compresses to the head and/or neck regions to relax tight muscles (heat) and reduce pain and swelling (cold). Similarly, a warm shower or bath can have similar beneficial effects.
  1. SLEEP WELL: Migraines can interfere with falling asleep, they can wake you up during the night, and they are often triggered by NOT getting a good night’s sleep. To improve your sleep quality: a) Establish regular sleeping hours. Wake up and go to bed at consistent times every day, including weekends. b) Keep daytime naps short (20-30 min. max). c) “Unwind” at the end of the day – try soothing music, a warm bath, or reading a favorite book (avoid suspenseful movies). d) Don’t eat/drink too much before bedtime as heavy meals, caffeine, nicotine, and alcohol can interfere with sleep. e) Don’t exercise intensely before bedtime (stretching is fine). f) Eliminate distractions in the bedroom, including TV and bringing work to bed. Close the bedroom door and use a fan to muffle out distracting noises. g) If you take any medications, check for known side effects, as many contain caffeine or other stimulants that can interfere with sleep – including some meds that treat migraines! Talk to your doctor and pharmacist!
  1. EAT WELL: Be consistent about when you eat and don’t skip meals (fasting increases the risk for migraine). Keep a food journal to figure out your migraine triggers and avoid foods that commonly trigger migraines like chocolate, aged cheeses, caffeine, and alcohol. Try eliminating these and see how you feel!
  1. EXERCISE REGULARLY: This is MOST IMPORTANT for migraine management as it facilitates sleep cycles and stimulates the release of endorphins and enkephlins that help block pain. It also helps fight obesity, which is another risk factor for 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 neck pain or headaches, we would be honored to render our services. 

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR HEADACHES! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Neck Pain – Drugs or Chiropractic?

8 Oct

When you have neck pain, do you instinctively reach for that bottle of ibuprofen or Tylenol? If so, is that the best option? Who can we trust for the answer? Since between 10-20% of the population suffer from chronic or persistent neck pain, this is a VERY IMPORTANT question!

If we look at the literature published in peer reviewed journals by authors who have no financial incentives in the outcome of the study, we can find accurate, non-biased information to answer this question. So, let’s start with a landmark study published in SPINE, a leading medical journal that reviewed ALL the publications printed between 2000 and 2010 on neck pain – a total of 32,000 articles with over 25,000 hours of review. (Haldeman S, Carroll L, Cassidy JD, et. al. The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: Executive Summary. Spine 2008,33(4S):S5-S7). This resulted in a 220 page comprehensive report from a multidisciplinary International Task Force involving seven years of work from 50+ researchers from 19 different clinical scientific disciplines worldwide looking at the MOST EFFECTIVE approaches available (both surgical and non-surgical) for patients suffering from neck pain.

Highlights from the study include the following: 1) Manipulation/mobilization are safe, effective, and appropriate treatment approaches for most patients with disabling neck pain (both traumatic and non-traumatic); 2) Neck pain patients should be informed of ALL effective treatment options so they can choose effectively; 3) The very rare risk of vertebrobasilar artery (VBI) stroke is NO DIFFERENT when comparing patients consulting a doctor of chiropractic verses a primary care medical physician as the stroke event, in most cases, has occurred prior to the visit; 4) The treatment option(s) available should consider the potential side effects and personal preferences of the patient; 5) For most neck pain patients, treatments that were found to be safe and effective include manipulation, mobilization, exercise, education, acupuncture, analgesics, massage, and low-level laser therapy; 6) For non-neurological neck pain, ineffective treatments (poor choices) include surgery, collars, TENS (transcutaneous electrical nerve stimulation), most injection therapies (including corticosteroid injections and rhizotomy); 7) For neck pain WITH nerve compression, there is very little research published on non-surgical care. Here, in the absence of serious pathology or progressive neurological loss, start with the most conservative (like chiropractic!) followed by more invasive treatments like epidural steroid injections (ESI’s) and surgery; 8) Whiplash patients should follow similar guidelines as described above; 9) Some benefit from the chosen treatment should be seen within the first two to four weeks of care; and, 10) Be realistic about treatment goals – neck pain is often recurrent (comes and goes) as most people (50-80%) will NOT experience complete resolution of symptoms and will have neck pain again one to five years later.

Another study published in The Annals of Internal Medicine (“Spinal Manipulation, Medication, or Home Exercise with Advice for Acute and Subacute Neck Pain: A Randomized Trial. 3 January 2012, Vol.156, No. 1, Part 1) reports similar information favoring spinal manipulation and exercise, as these were found to be SUPERIOR to medication use. Another study reported excellent results for 27 patients utilizing chiropractic care who had herniated cervical disks WITH spinal cord compression verified on MRI (70% improved after an average of 12 visits)! TRY CHIROPRACTIC FIRST!!!

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 neck pain, we would be honored to render our services.

Tension-Type Headaches – Management Strategies.

1 Sep

Headaches (HA) can significantly alter a person’s quality of life. Moreover, they can interfere and sometimes even prevent an individual from performing important activities such as going to work, attending school, or participating in group activities such as sports, music programs, holiday gatherings, and more. The focus of this month’s Health Update is on Tension-Type Headaches (TTH), a common “primary headache” with tremendous socioeconomic impact.

Compared with migraine headaches, tension-type headaches are actually more common and can be equally as disabling. A recent study reviewing popular treatment approaches for TTH reported that establishing an accurate diagnosis is important prior to beginning treatment and finding “…non-drug management is crucial.” Recommendations regarding treatment also include becoming educated about TTH, obtaining reassurance, and identifying trigger factors that can precipitate a TTH. Psychological treatments with scientifically-proven benefit include relaxation training, EMG biofeedback, and “cognitive-behavioral therapy” (CBT). Physical therapy, chiropractic, and acupuncture are widely used, but further research supporting these approaches is needed. The researchers state “simple analgesics” are the primary drug choice for TTH, but they strongly oppose the use of combination analgesics, triptans, muscle relaxants, and opioids, “….and it is crucial to avoid frequent and excessive use of simple analgesics to prevent the development of medication-overuse headache.” They state that the tricyclic antidepressant amitriptyline is “drug of first choice” when treating chronic TTH, but they point out side effects can be significant, thus hampering their use. The researchers conclude that the treatment of frequent TTH is often difficult, and multidisciplinary approaches can be helpful. THIS IS WHERE CHIROPRACTIC FITS IN! These researchers state that non-drug approaches as well as medications “…with higher efficacy and fewer side effects [are] urgently needed.” They advise that future studies need to focus on optimizing treatment programs to best suit the individual patient utilizing psychological, physical, and pharmacological-treatment approaches.

So, what can chiropractic bring to the table in this “team” treatment approach? First of all, it is non-drug oriented, the need of which clearly was emphasized in this study. Second, the presence of muscle tension at the base of the skull/top of the neck can be addressed VERY SPECIFICALLY with spinal manipulation of the cervical spine, active release, myofascial release, trigger point therapy, manual cervical traction, and more! Third, the use of NON-PRESCRIPTION nutrients such as ginger, tumeric, boswellia, Bromelain, white willow bark, fish oil/omega-3 fatty acids are all non-drug (with fewer potential side effects) options that facilitate in controlling inflammation. Using a home cervical traction device can also be VERY HELPFUL! Specific exercise training aimed at muscle relaxation, stretching, and strengthening (especially the deep neck flexors) can ALL BE MANAGED by a doctor of chiropractic!!!