• Starts as a tight feeling over the sub-occipital muscles.
• Usually follows stressful situations and/or related to ergonomics coupled with food allergies.
• Acute tension headaches generally clear initially with over the counter analgesics or with rest.
• Chronic tension headaches may persist through the night and may continue beyond any definable stress period.
• Typically insistence of co-workers or family is a good indicator of serious chronic tension headaches.
• Slight dizziness, decreased concentration, tightness throughout the para-spinal musculature and scalp.

Migraine (Classic V.S. Common)

Common accounts for 90% of migraine headaches-Classic 10%. Classic is a neurological migraine with aura. Aura is a disturbance of nervous function, such as: spots, waves, areas of incomplete vision. In addition these headaches are pulsitile and hemicranial or one sided. Common migraine typically is hemicranial without any aura.

Sensitivity to light and noise, headaches have a duration of a day or two.
Have been linked to dietary intake. Such as, chocolate, cheese, fatty foods, oranges, tomatoes, and onions. These foods are high in tyramine the amino acid that has been proven to trigger a migraine (allergy type reaction).
Alcohol, exposure to glare, sudden jarring and rapid change in the barometric pressure will trigger these headaches.

Basilar migraine-uncommon variant of a migraine.
Blindness, visual disturbances through both visual fields, poor articulated speech, equilibrium difficulties, ringing in the ears, confusion, loss of consciousness, throbbing and occipital in nature.

Cluster or Horton’s cephalgia

Most common in men and alcohol always precipitates no matter how much is consumed.
20-40 years of age, individuals are usually awakened by this headache and the duration is approximately an 1.5 hours.
Starts as a rapid onset of tingling in one nostril followed by a sensation of a red-hot poker feeling up the nostril and/or acid being poured into the eye.
Occurs 2-3 times per night, 2-3 times per year, daytime attacks less frequent.

Withdrawal

Headaches that are the result of illegal drugs, prescription medication, alcohol (hangover), and caffeine.

Intracranial Hematoma and/or Sub-arachnoid hemorrhage*

No trauma with insidious onset. Sudden onset of back, neck and head pain.

Intracranial Lesions*

Progression of an acute condition with a change in pattern over several weeks.
Changes in personality, continuous incapacitating headaches. Anyone with night pain/sweats or headaches should rule out an intracranial lesion.

Arnold-Chiari Malformation*

Congenital herniation of the brainstem and lower cerebellum through the foramen magnum.

• Magnesium, 250 to 500 milligrams up to 3 (t.i.d.) times per day.
• 5-hydroxytryptophan (5-HTP)-100mg 3 (t.i.d.) times per day. Tension/Migraine headaches cause an increase in the breakdown of serotonin this results in a decreased pain threshold. The precursor to the production of serotonin is 5-HTP.
• Vitamin B6: 25 mg 3 (t.i.d.) 3 times per day.
• Fever-few-herb plant that has vasoconstrictor properties.
• Fish or Flax seed oils.
• Place a cold pack over ones head and submerge your hands in warm water during an acute headache.

• Consume a diet that focuses on whole, unprocessed foods (whole grains, legumes, vegetables, fruits, nuts, and seeds).
• Eliminate alcohol, caffeine, and sugar.
• Identify and control food allergies.
• Get regular exercise.
• Perform a relaxation exercise (deep breathing, meditation, visualization) 10 to 15 minutes each day.
• Drink at least 48 ounces of water per day.

Evaluation of ergonomics, lifestyle, food allergies, and postural complications with recommendations to resolve these issues.

Treatment utilizing ishcemic compression, strain counter-strain, massage, ultrasound therapy, interferential current therapy, mobilization/adjustments to the cervical and thoracic spine, and exercise tailored to correct ones posture and provide regional stabilization.
Adjustments help relieve paraspinal musculature/zygapophysial joint tension and adhesion’s that occur to allow improved inter-segmental motion and decrease nociception. The muscles and vertebral joints have nociceptive fibers where pain is transmitted through or to each spinal nerve for that respective muscle and/or vertebral level.

Patients that suffer from cervicogenic headaches who have tried conservative chiropractic care should consider manipulation under anesthesia (MUA). The MUA procedure has helped resolve my patient’s headaches 90% of the time on average.

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