What a headache!

If you are one of the many people who suffer from headaches, have you ever wondered what might be the cause?  Most headache patients would like to put the blame on their troublesome spouses, misbehaving teenagers or over bearing bosses but as much as these individuals can certainly exacerbate our problems they are not the primary cause of headaches.

Actually there are several varieties of headaches though most people in Singapore like to use the word migraine to label all headaches. However a lot of these so called migraine headaches might be an entirely different entity.   A very common, but sometimes just as severe headache can originate from the bony and soft tissues of the neck and shoulders and is called a “cervicogenic” (originating in the neck) headache.   There are also other distinct types of headaches including muscle tension and cluster headaches as well as rarer though more insidious causes like brain tumors.  Of course we must not forget those ever-so awful ones associated with having a fun night out and a bit too much to drink.   Headaches can even be associated with caffeine, MSG, fumes and occasionally from medication.

As mentioned above, headaches are frequently associated with disorders of the cervical spine.  The underlying causes of this type of headache result from things such as, repetitive strain from too much computer work, whiplash injury, intervertebral disc disease, and progressive neck joint arthritis (wear and tear).

The joints connecting the top two or three levels of the cervical spine to the base of the skull handle almost 50% of the total motion of the entire neck and head region especially with turning.  This area is subject to a continuous amount of repetitive stress and strain, in addition to bearing the primary load of the weight of the head. There are several nerves that course from the spinal cord out through the spaces between the vertebrae then  go between the small muscles at the base of the skull and upwards in to the head.  In fact sensation in much of the scalp and head is from branches of these nerves.  It is no wonder why problems in the neck can lead to a whopping headache.

In many cases the tight knots in the muscles of the neck and shoulders called trigger points, which are associated with neck problems, can also refer pain in to the head.  .  However it is very important that a health care practitioner carefully examines the neck and surrounding area to understand the problem.  It has been found that any alteration in alignment and movement in the neck, especially the upper part, and can cause irritation to the nerves thus triggering headaches.  This is a fact well known to the chiropractic profession as well as patients who have had relief from their headaches by getting a chiropractic adjustment.

The prevalence of cervicogenic headache in the general population is estimated to be between 0.4% and 2.5%, but as high as 20% of patients with chronic headache. The mean age of patients with this condition is 42.9 years, and cervicogenic headache is four times more prevalent in women. Typically the pain from cervicogenic headaches is on one side of the head but can be on both as well and can vary in location. The intensity can vary from a subtle uncomfortable dull ache to an incapacitating pain. Usually the person also has associated neck, upper back and shoulder pain and or tightness in addition to the headache.  This feature is also associated with migraines in the many cases.  However the source of migraines is thought to be in the vascular system particularly the temporal artery located in the side of the head rather than primarily from the tissues of the neck. Migraine headache is caused by a combination of vasodilatation (enlargement of blood vessels) and the release of chemicals from nerve fibers that coil around the blood vessels.

Both cervicogenic and migraine headaches have been shown to respond well to chiropractic adjustments of the cervical spine.  Other conservative management methods include therapy to the muscles of the neck and shoulder such as ultrasound, acupuncture, muscles stretching, postural reeducation, dietary management and supplements. Medication is often important especially in the management of migraines.  Headache sufferers must also learn what their headache triggers might be in order to properly manage their conditions.  Some common triggers include, too much stress, prolonged sitting at a computer, improper or too much exercises, not enough sleep, foods, and other factors as well.

In conclusion it is essential for headache sufferers to first know what kind of headache they truly have in order to get control of this often debilitating condition.