Headaches

The three most common types of headaches are cervicogenic, tension, and migraine. These are explained below followed by information on how chiropractic treatment may help.


Cervicogenic headache

Cervicogenic headache is pain referred from a source in the neck and perceived in one or more regions of the head, face, or both. Signs that implicate a source of pain in the neck are mechanical exacerbation of pain, reduced cervical range of motion, focal neck tenderness, and trigger points that refer to the head.

When myofascial tender spots are the only cause, the headache should be diagnosed as tension-type headache, not cervicogenic headache.

Tension headaches

Tension headaches present as bilateral head pain with a pressing, tightening (band-like) quality and are mild to moderate in intensity. They are not likely caused by underlying problems in the neck or head.

Various precipitating factors may cause tension headaches:

  • Stress: usually occurs in the afternoon after long stressful work hours or after an exam
  • Sleep deprivation
  • Uncomfortable stressful position and/or bad posture
  • Irregular meal time
  • Eyestrain
  • Caffeine withdrawal
  • Dehydration

Tension headaches have frequent episodes that last for minutes to days. There is no associated nausea or vomiting but there may be photophobia (sensitivity to light) or phonophobia (sensivity to noise). The pain is not aggravated by routine activities. There may be tenderness to touch around the head.

Migraine headaches

Migraine headaches usually present as unilateral, pulsating pain of moderate or severe intensity. Migraines may present with or without an aura. Some forms of migraine may stem from nerve stress in the vertebrae of the neck or may be triggered by muscle tension.

The headaches are recurrent and can last 4-72 hours. During migraine headaches, one or more of the following are present: nausea, vomiting, photophobia, and phonophobia. The pain is aggravated by routine activities.

Chiropractic treatment for headaches

Your chiropractor is trained to diagnose the cause of your headache, and treat you accordingly, or refer you elsewhere if appropriate. Chiropractic treatment including specific chiropractic spinal manipulation and mobilization, soft tissue therapy, and exercise has been found to be effective in the treatment of cervicogenic, tension, and migraine headaches. You may also be given an appropriate postural and lifestyle advice as well as rehabilitation and maintenance plan to prevent a recurrence of the problem.

Some important facts on headaches

There are several established “red flag” symptoms that would reflect a significant problem within the head or neck and should alert you to a more serious cause of headache. If these occur, seek medical assistance without delay.

  • Systemic signs or symptoms: fever, weight loss, history of malignancy or human immunodeficiency virus (HIV), or meningitis.
  • Neurologic signs or symptoms: hemiparesis (weakness of the entire side of the body), hemisensory loss (loss of sensation on one side of the body), diplopia (double vision), or dysarthria (slurred, slow, and difficult to understand speech).
  • Unusual onset: “Worst headache of my life,” headache that reaches peak intensity within seconds to minutes (thunderclap headache).
  • Older age: new onset headache over 40 years of age.
  • Progression of existing an headache disorder: change in the quality, location, or frequency of existing headaches.
  • Neck or occipital pain with a sharp quality and severe and persistent headache.
  • Seizures.

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