Management of headache disorders

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Headache disorders are some of the most common disorders of the nervous system. The World Health Organization has estimated that prevalence among adults of current headache disorders (at least one within the last year) is about 50%. It can range from a light headache to a 10/10 pain. Headaches can have a major impact our daily living. They are classified by the International Classification of Headache Disorders (ICHD) and include 2 broad categories: Primary, when they are not the result of any other underlying disease or condition and Secondary, when there is a further underlying cause. 


Primary headaches:

Common primary headaches are migraine and tension-type headaches. Patients with migraines can feel different type of symptoms pattern. Most of the time, the presentation of the migraine has one side distribution. It can be pulsatile and accompanied by nausea and/or vomiting. The person may also have warning signs as aura or light and sound sensitivity. On the other hand, tension type headaches are typically related to muscle tension and are present with both side head pain characterized by a pressing or tightening sensation (e.g. band-like).



Secondary Headaches:

They are attributed to underlying clinical problems in the head or neck that may also be episodic or chronic. Cervicogenic headaches are common type of secondary headache encountered by chiropractors and can be attributed to a source of pain that originates in the neck. Reduced cervical range of motion, neck tenderness and trigger points that refer pain from the neck to the head can also be noticed. Secondary headaches could also be related to dehydration, medication side effect, sinus infection, concussion or other health conditions. 


From so many type of headache existing, it is important for the chiropractor to conduct a thorough assessment and to do a proper examination and diagnosis of the patient’s condition. Some person can present more than one type of headache and multiple associated symptoms. If so, each headache should be diagnosed separately and managed appropriately. 


The research literature shows that chiropractic care may be concurrent with pharmacological treatment or may provide an alternative to it. Spinal manipulation (defined as high velocity low amplitude thrusts delivered to the spine) is recommended for the management of patients with migraine or cervicogenic headaches. The selection, frequency, dosage and duration of treatment(s) will depend on the nature of the headaches. Treatment frequency may vary from 1-2x per week and following appointments can go up to 8 weeks. In addition, multimodal multidisciplinary interventions including massage, physiotherapy may benefit patients with migraine as joint mobilization or deep neck flexor exercises may improve symptoms of cervicogenic headaches.


In conclusion, chiropractors are expert of the spine, muscles and nervous system and use specific techniques to treat a specific person. It is not all patients that benefit from the same therapy in exactly the same manner. Most people will find relief from a combination of exercises, manual therapy and education of the origin of their problem. Also, a good way to keep track of headaches is by maintaining a diary. It helps to track the frequency, duration, intensity and evolution of the headaches. 



Other benefits of chiropractic care: 

- Improve movement in your neck, shoulders, back and torso

- Better posture

- Relief from headaches, neck and back pain

- Prevention of work-related muscle and joint injuries

- Enhanced athletic performance and manage sport injuries

- Improve flexibility

- Relief of pregnancy-related backache

- Correction of gait and foot problems