Genesis Chiropractic Spine & Sports Center
7940 South University Blvd Suite 100, 
Centennial Co 80109
Phone (303) 927-6181 or (720) 515-8002
Email: GenesisSpineCenter@gmail.com
Genesis Chiropractic Spine & Sports Center      













Headaches

Headaches


Many forms of headaches are linked to cervical spine disorders. When a vertebra becomes misaligned, sensitive nerves become irritated and produce symptoms include head pain.

Types:
  • Acute headache - if associated with neurologic symptoms or signs, then must be evaluated quickly
  • Acute recurrent headaches - if associated with nausea, vomiting or sleepiness and separated by pain-free intervals, then most likely migraine
  • Chronic progressive headaches - severity and frequency increase over time, structural disorder of CNS may be suspected
  • Chronic nonprogressive headaches - most typical type, usually related to stress
  • Medication overuse headache

Of course there are other factors that can cause migraines and headaches, such as stress and alcohol. But a chiropractor takes a comprehensive approach to your treatment examining any potential trauma to the spine. Chiropractic adjustments are one solution in the treatment of headaches.

If you suffer from headaches, please contact our office to schedule an appointment with us today. We will gladly answer any of your questions and provide you with the best treatment options available to you. If you live in or around Southern Denver area and suffer from headaches, call us today!    

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Causes and Risk Factors

Causes:

  • little evidence exists regarding relative frequency of different headache types among patients in primary care practice (Fam Med 1999 Jul-Aug;31(7):503)
  • most patients presenting to physician's office for evaluation of headache have either tension headache or migraine
    • Tension headache (formerly called muscle contraction headache)
    • Migraine 
    • Neurologists debate the practical difference between tension and migraine headaches as the syndromes overlap, co-exist and may respond to similar medications
  • drugs or toxins
    • many medications have headache listed as a side effect, but causation not clear
    • medications that commonly cause headache include short- and long-acting nitrates, dihydropyridine calcium channel blockers, vasodilators (hydralazine, minoxidil), indomethacin (Indocin), nalidixic acid (NegGram), trimethoprim-sulfamethoxazole (Bactrim, Septra)
    • toxins that can cause headache include carbon monoxide, cocaine, lead, manganese, arsenic, cyanide, inhalant abuse, thallium
    • other substances that can cause headache include alcohol, nitrites, monosodium glutamate
    • high daily caffeine intake reported to cause near-daily headache in children; case series of 36 children ages 6-18 years seen at tertiary headache clinic for daily or near-daily headache related to excessive caffeine intake from cola drinks (at least 1.5 L/day), 33 had complete resolution of headache after gradual withdrawal from cola drinks (Cephalalgia 2003 Jun;23(5):332 in JAMA 2003 Sep 24;290(12):1556)
    • hormonal headache - estrogens, oral contraceptives
    • medication overuse headache has been suggested as a common etiology
      • medication overuse headache defined as headache which resolves or reverts to its previous pattern within 2 months after discontinuation of the overused drug
      • medication overuse headache confirmed in half of suspected cases in which patients remain medication-free
        • Reference - Neurology 2006 Jun 27;66(12):1894
    • association of aspartame and headache controversial
      • ingestion of aspartame by migraineurs associated with significant increase in headache for some subjects in 13-week randomized placebo-controlled crossover trial of 25 patients, results based on 11 patients (44%) who completed trial, mean number of headaches 1.55 with placebo and 3.55 with aspartame 300 mg orally 4 times daily (Headache 1988 Feb;28:10)
      • no association of headache and aspartame in randomized trial of 40 patients with history of headache within 24 hours of consuming products containing aspartame identified through prior complaints to manufacturer of NutraSweet, patients were studied during 6-day hospitalization with aspartame vs. placebo given on day 3 or day 5 in crossover fashion, 14 (35%) vs. 18 (45%) reported headache with aspartame vs. placebo (N Engl J Med 1987 Nov 5;317(19):1181); results not generalizable to migraine patients as study group was self-selected through complaints to aspartame manufacturer (DynaMed commentary)
      • excessive aspartame might trigger migraine in some patients, but overall evidence limited, 3 randomized trials reviewed (Bandolier 2005 May;135:5)
  • small percentage of patients have intracranial organic pathology
    • infection
      • meningitis, brain abscess, herpes simplex or other encephalitis, neurotuberculosis, toxoplasmosis, African sleeping sickness, subdural empyema
      • Lyme disease reported in 2 patients with persistent headache and increased intracranial pressure (Pediatrics 2003 Dec;112(6):e477
    • intracranial mass lesion - tumor, sarcoidosis
    • hemorrhage - subarachnoid hemorrhage, hypertensive parenchymal hemorrhage, subdural hematoma
    • ischemic conditions - stroke, transient ischemic attack (TIA), vascular malformations
    • traumatic brain injury
    • other causes of increased intracranial pressure (intracranial hypertension) - cerebral edema, idiopathic intracranial hypertensio (pseudotumor cerebri) (presumably caused by stretching of dura), Chiari malformations, hydrocephalus, hypertensive encephalopathy, venous sinus thrombosis, superior vena cava syndrome
    • acute exertional headache (orgasm, cough, sneeze) - 90% have benign headache presumably caused by transient intracranial-spinal pressure dissociations; 10% patients found to have significant organic disease
    • low pressure headache
      • post lumbar puncture headache
      • posttraumatic cerebrospinal fluid leak
      • spontaneous intracranial hypotension due to spinal cerebrospinal fluid leaks 
        • Reference - JAMA 2006 May 17;295(19):2286
    • multiple sclerosis
  • small percentage of patients have other organic syndromes
    • cluster headache
    • cranial bone pain - osteomyelitis, multiple myeloma, Paget disease of bone
    • scalp pain - tinea capitis, tension from hair-pulling (for example, tight ponytail or braids), external compression headache (for example, swim-goggle headache), occipital neuralgia (posterior head pain)
    • vascular involvement - temporal arteritis, carotid or vertebral artery dissection, carotidynia, post-endarterectomy headache
      • review of MRI, MR angiography, and CT angiography in the diagnosis of carotid and vertebral artery dissection can be found in AJR Am J Roentgenol 2009 Oct;193(4):1167
    • eye pain - acute glaucoma, optic neuritis, squinting
    • ear pain - disorder of middle ear, nervus intermedius neuralgia (felt deeply in auditory canal)
    • acute sinusitis
    • dental pain - dental abscess, impacted tooth, TMJ syndrome, periodontitis
    • facial nerve pain - trigeminal neuralgia, atypical facial neuralgia
    • neck pain - cervical spine disease (greater occipital neuralgia), acute cervical sprain or strain (whiplash), retropharyngeal tendinitis
    • any acute febrile illness
    • metabolic disorders - hypoxia, hypercapnia, hypoglycemia, dialysis
    • increased blood pressure - acute pressor response to toxin or medication, pheochromocytoma, hypertensive emergency, hypertensive disorders of pregnancy
  • psychologic causes - depression, anxiety, hypochondriasis, malingering, somatization disorder, somatoform pain disorder, fixed delusion, phobias, conversion, Factitious disorder
  • other possible causes - chronic fatigue syndrome, fibromyalgia
  • cold stimulus headache - rapid ice cream eating increases risk for cold stimulus headache; 145 middle school students were randomized to eat ice cream 100 mL in < 5 seconds vs. > 30 seconds, 27% vs. 13% reported ice cream headache (BMJ 2002 Dec 21;325(7378):1445)