Headaches affect just about everyone at some point and can present in many different ways. Some people only experience pain in a specific part of their head or behind their eyes; some people complain of a pounding sensation inside their whole head, and some people become nauseated. Headache pain may be dull or sharp and may last anywhere from a few minutes to a few days. Fortunately, very few headaches have serious underlying causes, but those that do require immediate medical attention.
Headaches stem from a wide variety of causes such as drug reactions, temporomandibular joint dysfunction (TMJ), tightness in the neck muscles, low blood sugar, high blood pressure, stress, and fatigue. However, the majority of recurrent headaches fall into two types: tension headaches (also called cervicogenic headaches) and migraine headaches. There is a third, less common kind of headache called a cluster headache, a cousin to the migraine. Let's look at each of these three types of headaches.
Affecting upwards of 75% of all headache sufferers, tension headaches are the most common. Most people describe a tension headache as a constant, dull, achy feeling either on one or both sides of the head or the feeling of a tight band or dull ache around the head or behind the eyes. These headaches usually begin gradually in the middle or toward the end of the day and are often the result of stress or bad posture, which stresses the spine and muscles in the upper back and neck.
As stated, tension or stress headaches can last from 30 minutes to several days, but in some cases, chronic tension headaches may persist for many months. While the pain of tension headaches can be severe, other symptoms, like throbbing, nausea, or vomiting do not usually accompany them.
Subluxations in the upper back and neck, especially the upper neck, in combination with active trigger points are the most common cause of tension headaches. When the top cervical vertebrae lose their normal motion or position, a small muscle called the rectus capitis posterior minor (RCPM) muscle spasms. The problem is that this small muscle has a tendon which slips between the upper neck and the base of the skull and attaches to a thin pain-sensitive tissue called the dura mater that covers the brain. Although the brain itself has no feeling, the dura mater is very pain-sensitive. Consequently, when the RCPM muscle spasms and its tendon tugs at the dura mater, a headache develops. This is the most common cause of stress headaches for people who have desk jobs.
Another cause of tension headaches comes from referred pain from trigger points in the Sternocleidomastoid (SCM) or levator muscle on the side of the neck. This type of tension headache is much more common in people who suffer a whiplash injury because of the muscle damage to the neck region.
Many people who suffer migraine headaches also experience a visual symptom called an "aura" just prior to an attack. An aura is often described as seeing flashing lights.
Each year, approximately 25 million people in the U.S. experience migraine headaches and of those about 75% are women. Migraines are described as intense, throbbing headaches often associated with nausea as well as sensitivity to light or noise. Migraines can last from as little as a few hours to as long as a few days. Many people who suffer | migraine headaches also experience a visual symptom called an "aura" just prior to an attack. An aura is often described as seeing flashing lights. Some people also feel that everything takes on a dream-like appearance.
Migraines tend to run in families with people typically suffering their first attack before age 30. And while some people experience attacks several times a month, others have less than one a year. As they get older, most people find that the frequency and severity of their migraine attacks lessen.
When a constriction of blood vessels in the brain is followed by a dilation of blood vessels, a migraine headache occurs. While the blood vessels are constricted, blood flow decreases and leads to the visual symptoms many people experience. Even in people who don't experience the classic migraine aura, most can recognize that an attack is imminent. The dilation of blood vessels causes a rapid increase in blood pressure, which is responsible for the pounding headache. This means that each time the heart beats, it sends a shock wave through the carotid arteries in the neck and up into the brain.
While there are many theories as to what causes the blood vessels to constrict in the first place, no one knows for sure. What we do know is that a number of things can trigger migraines such as a lack of sleep, stress, flickering lights, strong odors, and changing weather patterns. Several foods also trigger migraines, especially foods high in an amino acid called “tyramine.” Making some lifestyle changes can reduce the likelihood of migraine headaches.
Cluster headaches are typically very short in duration and are usually felt on one side of the head behind the eye.
Cluster headaches are typically excruciating headaches, very short in duration, and usually felt on one side of the head behind the eye. Cluster headaches affect about 1 million people in the United States, but unlike migraines are much more common in men. Cluster headaches are the only type of headache that tend to occur at night. The name “cluster” comes from their tendency to occur one to four times per day over a period of several days. After one cluster of headaches is over, it may be months or even years before they occur again. Like migraines, cluster headaches are likely related to the blood vessels of the brain dilating, causing a localized increase in pressure.
Chiropractic Care for Headaches
Numerous research studies mention the effectiveness of chiropractic adjustments for treating tension headaches, especially those that originate in the neck.
A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that "for those headaches originating in the neck, spinal manipulation results in almost immediate improvement, significantly fewer side effects, and reports of longer-lasting relief from tension-type headache than commonly prescribed medications." These findings support an earlier study published in the Journal of Manipulative and Physiological Therapeutics that found spinal manipulative therapy to be very effective for treating tension headaches. This study also found that patients who stopped chiropractic treatment after four weeks continued to experience a prolonged benefit in contrast to patients who received pain medication.
Each individual case differs and requires a thorough evaluation before a proper course of chiropractic care can be determined. However, in most tension headache cases, patients experience significant improvement through chiropractic manipulation of the upper two cervical vertebrae, coupled with adjustments to the junction between the cervical and thoracic spine. This chiropractic manipulation is also helpful in most migraine headache cases, as long as patients avoid food and lifestyle triggers as well.
Headache Trigger Points
Trigger point therapy for headaches involves four muscles: the Splenius muscles, the Suboccipitals, the Sternocleidomastoid (SCM), and the Trapezius. The Splenius muscles are comprised of two individual muscles, the Splenius Capitis and the Splenius Cervicis, which run from the upper back to either the base of the skull (splenius capitis) or the upper cervical vertebrae (splenius cervicis). Trigger points in the Splenius muscles are a common cause of headache pain that travels through the head to the back of the eye as well as to the top of the head.
The Suboccipitals are actually a group of four small muscles responsible for maintaining proper movement and positioning between the first cervical vertebra and the base of the skull. Trigger points |in these muscles cause pain that feels like it's inside the head, extending from the back of the head to the eye and forehead. Often, the whole side of the head hurts, a pain pattern similar to a migraine headache.
The Sternocleidomastoid (SCM) muscle runs from the base of the skull, just behind the ear, down the side of the neck, and attaches to the top of the sternum (breastbone). Although most people are unaware of the SCM trigger points, their widespread effects include referred pain, balance problems, and visual disturbances. Referred pain patterns tend to be deep eye pain or headaches over the eye. SCM trigger points can also cause earaches, resulting in dizziness, nausea and unbalance.
The Trapezius muscle is the very large, flat muscle in the upper and mid back. A common trigger point located at the very top of the Trapezius muscle refers pain to the temple and back of the head and is sometimes responsible for headaches. This trigger point is capable of producing satellite trigger points in the muscles of the temple or jaw, leading to jaw or tooth pain.
Avoiding Headache Triggers
Stress may be a trigger, but weather changes, menstrual periods, and certain foods and odors are among the many factors that may also trigger headaches.
Emotional factors such as depression, anxiety, frustration, letdown, and even pleasant excitement may be associated with the likelihood of developing a headache.
Keeping a headache diary will help determine whether factors such as food, change in weather, and/or mood have any relationship to your headache pattern.
Repeated exposure to nitrite compounds can result in a dull, pounding headache that may be accompanied by a flushed face. Nitrite, which dilates blood vessels, is found in heart medicine and dynamite, but is also used as a meat preservative; therefore, hot dogs and other processed meats containing sodium nitrite can cause headaches.
Eating foods prepared with monosodium glutamate (MSG) can also result in headache. Soy sauce, meat tenderizer, and a variety of packaged foods contain this chemical, which is touted as a flavor enhancer.
Headache can also result from exposure to poisons, even common household varieties, like insecticides, carbon tetrachloride, and lead. Children who ingest flakes of lead paint may develop headaches as well as anyone who has contact with lead batteries or lead-glazed pottery.
You should also avoid foods high in the amino acid tyramine such as ripened cheeses (cheddar, brie), chocolate, and any pickled or fermented foods.