Headaches – How Does Chiropractic Work?

By Dr. Michael Bennese

Headaches are a common complaint at chiropractic clinics. Some causes are unknown but others are more readily categorized. Vascular headaches, such as migraine and cluster headaches, arise from causes related to blood vessels. Vascular headaches often include nausea and/or vomiting, and can be quite disabling and require rest in a dark, quiet place sometimes for a half or a whole day. Another type, tension headaches, usually result from tightness in the muscles in the neck and upper back. Tenison headaches can be caused by stress, work, lack of sleep, sinusitis, and trauma such as whiplash.

Chiropractic is a tremendous resource for headache patients. It is critical to obtain a thorough history, asking the patient how and when the headaches started. This may glean the actual cause of headaches, such as a car accident or injury.

After the history, we will ask about activities that increase or create the headache, which helps us understand how to best manage the headache patient. For example, when certain activities precipitate the onset of a headache, we will modify the work station or give specific, scheduled exercises to keep neck tension under control. We will also gather information about what decreases the neck pain and headaches, then recommend treatments that can often be done at home. For example, if a patient says that pulling on the neck feels great, we might recommend a home traction unit. The quality of pain (throbbing = vascular, ache and tightness = neck), intensity of pain (0-10 pain scale), and timing (worse in the morning vs. evening) help us track change after treatment is rendered, usually gathered once a month.

The physical examination includes checking a patient’s blood pressure, which can create headaches when high; viewing the blood vessels in the back of the eye to ensure there is no evidence of increased pressure against the brain; and checking the ears for infection or wax blockage, which can cause dizziness and/or balance loss. We will sometimes listen to the throat as well as the heart to see if there may be a blockage, a valve problem, or other issues.

We will evaluate neck muscle tightness (spasm) and range of motion, paying particular attention to the positions/directions that increase and decrease pain. We will assess nerve function by checking reflexes, sensation, and muscle strength, as well as correlating information like positions that decrease arm or leg pain since any position that reduces pain in the arm or leg must be incorporated into an exercise plan. We may take X-rays that include bending “stress” views to evaluate ligaments for possible tears or instability.

Thorough evaluation is necessary for successful treatment and management. Treatment approaches include: adjustments; soft tissue therapy such as trigger point stimulation or myofascial release; posture correction exercises and other exercises; education about job modifications; and co-management with other health care providers, if medication or injection therapy is needed.