Headaches and Chiropractic

If you have a headache, you’re not alone. Nine out of ten Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea.

What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? There is a better alternative.

Research shows that spinal manipulation – the primary form of care provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches 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 spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.

Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.

Headache Triggers

Headaches have many causes, or “triggers.” These may include foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.). About 5 percent of all headaches are warning signals caused by physical problems.

Ninety-five percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease. The headache itself is the primary concern.

“The greatest majority of primary headaches are associated with muscle tension in the neck,” says Dr. George B. McClelland, a doctor of chiropractic from Christiansburg, VA. “Today, Americans engage in more sedentary activities than they used to, and more hours are spent in one fixed position or posture. This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache.”

What Can You Do?

The ACA suggests the following:

• If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.
• Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.
• Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull – leading to TMJ irritation and a form of tension headaches.
• Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.

What Can a Doctor of Chiropractic Do?

Dr. McClelland says your doctor of chiropractic may do one or more of the following if you suffer from a primary headache:

• Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.
• Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.
• Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

“Doctors of chiropractic undergo extensive training to help their patients in many ways – not just back pain,” says Dr. McClelland. “They know how tension in the spine relates to problems in other parts of the body, and they can take steps to relieve those problems.”

What's Wrong With My Back?

Not all back problems are created equal. One person may have been working on a home improvement project and injured her back while simultaneously bending and twisting. Another person may have developed back pain as a result of a vehicular collision. Another person may be experiencing back pain as a result of osteoporosis. Yet another person may have a serious illness which causes back pain as a related problem.

Back pain is a problem common to many types of injuries and illnesses. How can you tell the difference - in other words, how can you tell when back pain requires you to take action, such as seeing your chiropractor? A reasonable approach is to use a 48-hour guideline. Your body usually has a powerful ability to heal itself. If your back pain hasn't gone away on its own within 48 hours, then seeking professional assistance is a very good plan.

However, some situations require immediate attention. For example, if you've had an accident, seeing your chiropractor right away is probably the right thing to do. In another scenario, if you begin to experience severe pain without an obvious cause, then seeing your chiropractor right away makes a great deal of sense. Like many things in life, having physical pain requires us to use good judgment. The 48-hour rule-of-thumb applies to most situations, but if you've had an accident or are having an unusual problem, see your chiropractor as soon as possible, today if necessary.

When a person has back pain, it's very important to make sure there are no related problems. Most of the time there aren't, but no one wants to be the exception and it's always better to be safe than sorry. Making your own diagnosis is never a good idea. "Oh, that's been bothering me for months," some people will say. "It's just back pain." Of course, such an approach to one's health violates the 48-hour rule. If the problem really wasn't anything much, it would have gone away within a few days. Something else is going on, and usually the longer a physical problem is left untreated the more difficult it is to deal with. The old expression, "an ounce of prevention is worth a pound of cure" is as true today as it was 100 years ago.

Your chiropractor is an expert in back pain. They know that physical pain happens for a reason.^1,2 Their job is to discover that reason, using the tools of history taking, physical examination, biomechanical analysis, and special tests, if necessary, such as x-rays and other imaging methods. Most of the time, the underlying problem is mechanical in nature, involving the spinal joints and associated soft tissues, including the ligaments, muscles, and tendons. Such mechanical problems cause the vast majority of cases of back pain, and are directly addressed by chiropractic care.³ In unusual circumstances, your chiropractor will refer you to another specialist. The important approach in all situations is to seek appropriate care. Your chiropractor's office is the right place to start.

 
Most people now know the importance of exercise in daily life. The benefits of exercise range from improved strength, balance, and agility to deeper, more restful sleep, improved outlook on life, and heightened levels of creativity. Of course, there's also an additional direct benefit for persons with back pain.
Most cases of back pain are biomechanical in nature. In these circumstances, spinal joints have lost some mobility and spinal muscles have become tight. The long-term result is back pain, which may be mild, moderate, or severe, depending on the extent of the biomechanical dysfunction. Chiropractic care is the specific treatment for problems involving the spinal joints and muscles. Exercise is an important addition to chiropractic care. When you perform challenging activities throughout a full range of motion, as you do when you exercise, you're retraining the joints and muscles of your back. By engaging in such activities on a regular basis, you're helping to restore spinal strength and mobility, enhancing the benefits you're receiving from chiropractic care.

Your chiropractor is an expert in rehabilitative exercise and will be glad to design an exercise program that will work for you.

¹Bakker EW, et al: Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine 34(8):E281-E293, 2009

²Shambrook J, et al: Clinical presentation of low back pain and association with risk factors according to findings on magnetic resonance imaging. Pain 157(7):1659-1665, 2011

³Wilder DG, et al: Effect of spinal manipulation on sensorimotor functions in back pain patients: study protocol for a randomised controlled trial. Trials 12:161, 2011

Low Back Pain - Don't Just Wait And See

A common mistake made by those suffering from low back pain (LBP) is to play the "wait and see" game. And while it is true that bouts of LBP can disappear on their own without care, what chiropractors know and what research indicates is that waiting too long prior to seeking care for LBP ultimately increases the odds that back pain will reoccur and that more aggressive future care will be required. A recent study comparing those who received physical therapy care early during their acute LBP (less than 4 weeks after the start of their LBP) with those who received care later (more than 3 months after the start of their LBP) found benefits to obtaining care early on. Specifically, those obtaining care within the first 4 weeks of the onset of LBP had a significantly lower incidence of seeking future care for the initial pain. Future care included lumbar surgery, lumbosacral injections, and frequent physician office visits during the following year. The lesson - if you're suffering from back pain, contact your local chiropractor and get yourself checked out. Chiropractic care is safe, natural, effective and scheduling a no-obligation consultation is absolutely painless!  Source: Spine: April 20, 2012 - Volume 37 - Issue 9.