Archive for headache
How a Headache Works
Posted by: | CommentsHere’s some things I hear every week from new patients:
“I woke up this morning with an excruciating headache. I thought the top of my head was going to blow off!” “I notice as the day goes on, tightness in my neck worsens and I get a headache usually by 2-3pm.” “I don’t know if I can do my work with my headaches.”
And the next thing that usually comes is…
“Why does it hurt so much?”
Well, to answer that question you need to know a bit more about how headaches work. Headaches are one of the most common complaints prompting patients to visit a health care provider. The National Institutes of Health (NIH) describe four types of headache: vascular, muscular contraction or tension, traction and inflammatory.
Vascular Headaches
The most common form of a vascular headache is migraine. Migraine sufferers usually complain of severe pain on one or both sides of the head, nausea or vomiting and sometimes visual changes. There is often a heightened sensitivity to light or noise prompting migraine sufferers to lay in a dark, quiet room until the migraine passes. Women are more likely to suffer from migraines than men and the severity of symptoms can be so extreme that all activity must be stopped until it passes.
The next most common type of vascular headache is the toxic headache produced by a fever. Other vascular headache types include “cluster” headaches, which are characterized by repeated episodes of intense pain that start in one spot and spread out from that spot. These may only last a few minutes to an hour but carry a very high level of pain and activity intolerance. Another common type of vascular headache is that resulting from high blood pressure.
Tension Headaches
Muscle contraction or tension headaches involve tightening of the facial and neck muscles. These often start in the neck and radiate over the top or to the sides of the head. The muscles in the neck are usually extremely tight and tender and often, moderate pressure applied with the finger or thumb to these muscles will prompt radiating pain into and/or over the top of the head. This can also result in significant activity intolerance but usually not as severe as migraine or cluster headaches.
Traction and Inflammatory Headaches
Traction and inflammatory headaches result because of other conditions that range from a sinus infection to a stroke. These types of headaches can serve as a warning sign of a more significant or serious condition. Another example is meningitis as well as other conditions affecting the sinuses, spine, neck, ear, and teeth.
I know it seems complicated and for most people they don’t really care what kind of headache they have, they just want it gone. So…
How do I get rid of them pesky headaches?
The NIH suggests, when headaches occur ≥3 times a month, that “… preventive treatment is usually recommended.” Certainly, in some cases, medication may be indicated but only after ruling out a more serious condition and after exhausting less invasive treatments that carry fewer side effects.
The American Chiropractic Association recommends: 1) avoid long time periods of staying in one position (computer, sewing machine, reading, etc.) and take stretching/neck range of motion exercise breaks every ½ to 1 hour; 2) Exercise – walking, low impact aerobics; 3) Avoid teeth clenching (due to straining the temporomandibular – TMJ, or jaw joint); 4) Drink lots of water – stay hydrated.
Chiropractic care may include spinal adjustments, nutritional advice (dietary suggestions, vitamin/mineral options such as a B complex), exercise, posture retraining, and relaxation techniques. But What if chiropractic doesn’t work?
Sometimes, the problem is more serious. Visit your MD if you’re getting more than 3 a week. But there may be another cause-
Your headaches may be caused by a bulging or herniated disc in your neck. The good news is that treatment options exist that don’t require surgery.
The DRX9000C true spinal decompression machine is used for the treatment of bulging/herniated discs in the neck and low back. For more information just give our office a call and we can what kind of treatment relief is necessary to get you back to a normal healthy life ASAP!
This information is solely advisory, and should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.
Whiplash Revealed
Posted by: | CommentsThe term “whiplash” refers to an injury to the neck muscles, the muscle attachments (tendons), ligaments, and sometimes the disks that lie between the vertebral bodies of the spine. In a rear-end collision, the cause of whiplash occurs from a sudden, rapid acceleration of the body and neck as the car is pushed forwards. In these first 50-75 milliseconds following impact, the head remains in the same place while the body is propelled forward. This is followed by a “crack-the-whip” movement of the head and neck when the muscles in the front of the neck stretch like rubber bands and suddenly spring the head forwards, all occurring in less than 300 msec. The force on the head and neck is further intensified if the seat back is too springy, or angled back too far. Also, if the headrest is too low, the head may ride over the top and more injury can result.
Here’s a break-down of what occurs in the first 200 msec of a 5 mph rear-end collision:
0 msec: At the moment of impact, the car seat just begins to move and the occupant has not yet been accelerated forward.
50 msec: As the back of the car seat pushes the torso forward, the spine moves forward, resulting in a straightening of the thoracic and cervical spine. This rapid bending in just a few joints can result in ligament damage in the lower spine.
75 msec: This difference in motion between the neck and torso results in an S-shaped curve, where nearly all of the bending in the cervical spine takes place in the lower cervical spine. Such rapid bending in just a few joints can result in ligament damage in the lower spine.
150 msec: At this point, the torso has been pulled so far forward on the lower neck that the head is forced backwards, often over the headrestraint. Depending on the position of the headrest, the angle of the seat back, and the “spring” effect of the seatback, the ligaments in the front portion of the spine are often injured during this phase of the collision. About 3-4 G’s are exerted on the shoulders.
200 msec: Finally, the force of the car seat throws the head and torso forward. Here, 5 G’s are exerted on the head and neck as it whips forward.
Symptoms occurring from such a seemingly mild accident can have catastrophic consequences. The primary symptom is neck or upper back pain that may develop immediately or be delayed days, weeks, and sometimes months. A partial list of possible symptoms (each injured person’s symptoms are different and differ in intensity) include: muscles spasms, loss of movement, headache, dizziness, concentration &/or memory loss, difficulty swallowing, chewing &/or hoarseness, burning or tingling, shoulder/arm/hand radiating pain, and more. After an accident, no matter how mild, you should be seen by a qualified health professional to determine the extent of injury.
The treatment of whiplash varies from “watchful waiting” to a multidisciplinary team approach that includes neurology, physical therapy, chiropractic, non-surgical spinal decompression, psychology, and possibly surgery (rare). In a recent article published in the American Journal of Physical Medicine and Rehabilitation (2009, March Vol. 88, No. 3, pp 231-8), the relationship between clinical, psychological and functional health status factors was investigated in a group of patients with chronic whiplash-associated disorder (WAD). A total of 86 patients with chronic WAD participated in the study and outcomes were tracked using questionnaires that measure pain, disability and psychological issues including depression, anxiety and catastrophizing. Physical examination factors included measuring the cervical range of motion. An analysis of the degree of neck disability and the relative contribution of physical vs. psychological factors revealed catastrophizing and depression played greater roles than did cervical range of motion. This suggests psychological factors play an important role in the outcome of whiplash.
More than just the physical factors like range of motion should be focused on when treating chronic whiplash patients. Answering the patient’s questions, explaining the mechanism of injury and how that relates to their specific condition, and addressing depression, anxiety, coping, and other psychological issues is very important. Discussing treatment goals with patients is also very important. For example, making light of the injury by stating something like, “…you’ll be fine after the treatments,” may harm the patient as anything short of “fine” may be interpreted as failed treatment by the patient. It is also important not to paint too dismal of a picture as that can have negative psychological effects as well, as this may suggest that they will never improve.
Explaining the difference between “hurt” and “harm” is of great value to the chronic whiplash patient as she is often told, “if it hurts, don’t do it.” This sends an unfortunate message to the patient that any activity where an increase in pain occurs is “bad” when in fact, that activity may help the patient get better in the long run. This can make or break an acceptable outcome as many may feel like they shouldn’t do anything and this can lead to unemployment, boredom, and the many psychological issues previously described.
The best advice is to remain active and try to ignore discomfort by staying within “reasonable activity boundaries.” Reasonable activity tolerance is learned as time passes and trying different activities for different lengths of time. This type of coaching should be at the center of chronic whiplash management rather than over focusing on physical factors such as range of motion.
If you, a loved one, or a friend is struggling with whiplash residuals from a motor vehicle collision, you can depend on receiving a multi-dimensional chiropractic assessment and therapeutic approach at this office. We sincerely appreciate your confidence in choosing our office for your health care needs. Call 519-988-0220 right now to book an appointment and end your suffering!