Help for headaches

(June 2005) — One of the most common ailments encountered by doctors is headache. More than 40 million people in this country suffer from severe headaches, according to the Center for Disease Control, and the number is increasing steadily. The majority of these people are women between the ages of 18 and 45 years, but many men also are affected. Unfortunately, many headaches are misdiagnosed and people continue to suffer, often becoming reliant on various medications to function in everyday life.

One of the most common of these headaches is called the cervicogenic headache. The term cervicogenic simply means that the headache is caused by the cervical spine (the seven bones that make up the neck). These headaches are typically more severe on one side of the head than the other and can cause pain at the base of the head, the temples and behind the eyes.

They can last from hours to weeks and often are accompanied by pain and stiffness of the neck or shoulders. The pain can be throbbing or pounding and is often severe to the point where people miss work or avoid activity. Nausea and sensitivity to light or sound may also be present. And because of the intense pain and the striking similarity in symptoms, these headaches are often diagnosed as migraines and treated with medication. People can suffer for years, never knowing that the source of their headaches is actually their neck.

In order to understand how cervicogenic headaches develop, it’s important to understand how the spine and nerves work. The neck is made up of the first seven bones of the spine (there are 24 bones or vertebrae in the spine), starting at the base of the skull and ending at the top of the back. The spinal cord runs down through the center of the spine and the nerves travel out to the body through holes between the bones.

The nerves are like wires that carry information (including pain) between the brain and the rest of the body. Common daily activities such as driving, reading, gardening, sports, watching television, sleeping and even everyday stress can all contribute to the wear and tear on the joints of the neck.

When these joints stop working properly they can become a source of constant irritation to the nerves and lead to pain. And because of the way the neck is “wired,” the pain commonly occurs in the head and face producing a headache. Unless normal movement is restored to these joints, headaches can continue for years.

Research into cervicogenic headaches has been gaining a lot of steam in recent years, which is good news for sufferers. Only 10 years ago, the idea that headaches could be caused by the neck was a foreign concept. The cervical spine (neck) is now thought to be one of the most common causes of headache.

The real transition in thinking occurred in 1995 when a group of medical doctors and researchers at Syracuse University established the neck as the cause of a significant number of headaches. According to Peter Rothbart, M.D. and president of the World Cervicogenic Headache Society:

“We couldn’t believe it at first. We’ve been able to put together a scientific explanation for how neck structure causes headaches — not all headaches, but a significant number of them. It’s true that chiropractors have been saying this for years.”

Ultimately, the key to determining whether someone is suffering from cervicogenic headaches is a proper assessment of the joints of the neck. One of the tools that has proven invaluable in my office for this assessment is something called video fluoroscopy. This is a type of X-ray machine that allows the doctor to see the spine and joints in motion. The procedure is painless and generally takes less than a minute.

The best part is that the patient can watch the moving X-ray with the doctor and see where the joints aren’t working properly. The doctor can then direct treatment to those areas of the spine. Often when normal motion is restored to these joints, headaches improve dramatically.

It’s interesting that many of the patients I see who suffer from these headaches come to my office for other reasons. Neck pain, back pain, numbness or tingling in the arms or fingers, and pain in the shoulders or between the shoulder blades are among the most common. Only through questioning the patient does it come to light that they’re also suffering from chronic headaches; headaches they believe are migraines and thus totally unrelated to their other symptoms.

These headaches can show up years after an auto accident or fall, or may be the result of years of activity such as sports, physical labor, or daily wear and tear. As their headaches continue, people begin to sleep poorly, feel tired and moody, and lack energy. Overuse of headache medications can further complicate the problem by producing more severe headaches called “rebound headaches.”

Chiropractors have been helping patients successfully with headaches for decades now. Not all headaches are cervicogenic headaches, but many are. In most cases, with reduction of headache comes better sleep, increased energy, a better sense of health and well being, and a return to normal activity.

Perhaps most important, people become less reliant on medications and are less likely to be subject to the serious side effects that come with them. A healthy diet, exercise, and good posture can go a long way in preventing their return.

Dr. McGahey practices in Bellevue utilizing video fluoroscopy for treating headaches, whiplash injuries and back pain. He has been featured on King 5 News HealthLink and was nominated as Top Alternative Provider in 2004 by Seattle magazine. Contact him at the Eastside Chiropractic Group at 425-455-3300 or visit www.eastsidechiro.net.