Treatment for Headaches

Treatments for Different Types of Headaches

Two recent research reviews reveal that two common types of headaches that are often treated by chiropractors - cervicogenic headaches and tension type headaches - require different modes of treatment for best results.

Cervicogenic headaches:

· Pain originating from the cervical spine joints

· Prevalence is 4.1% in the general population

· 15-20% of all headaches

· Worse with neck movements or sustained postures

· Restricted cervical ranges of motion

· Neck or occipital pain

· Can travel to the face and head

Tension Type Headaches (most common):

· Pain originating from muscles

· Affects 46% of adults at some point in their lifetime

· Bilateral head pain

· Pressing, tightening feeling

· Not aggravated by physical activity

· Can be caused by:

o Hyperexcitable nerves from muscles of the neck and head

o Psychological stress

o Generalized increased pain sensitivity

o Genetic factors

These systematic reviews in 2020 show that:

· Spinal manipulation helped in the reduction of pain intensity, frequency and disability of cervicogenic headaches

· Soft tissue interventions helped in the reduction of pain intensity and frequency in patients with tension type headaches.

Our own chiropractic clinical guidelines (CCGI) coincide with these recent findings. They suggest that we perform spinal manipulation or prescribe neck exercises for cervicogenic headaches. The CCGI also recommends we prescribe general exercises, neck exercises or postural correction, and perform spinal mobilization or massage for tension type headaches. It is

therefore important to get the correct diagnosis of each type of headache, and then use the appropriate treatment methods and advice for best results.

Fernandez M et al. Spinal manipulation for the management of cervicogenic headache: a systematic review and meta-analysis. European Journal of Pain, 2020.

Kamonseki D et al. Effectiveness of manual therapy in patients with tension-type headache. A systematic review and meta-analysis. Disability and Rehabilitation, 2010.