Aug 01, 2017 by spinalcare

Headaches seem to surface at the worst of times, but then again, when is there a ‘good time’ for a headache?  Half of the battle in fighting headaches lies in understanding them.  The second half of the battle lies in taking action.


There are two classifications of headaches according to the International Classification of Headache and Disorders: primary and secondary headaches.  Primary headaches are more common and include: migraine, tension, and cluster headaches. Secondary headaches are caused by another condition, such as a sinus headache caused by sinusitis. A secondary headache that commonly presents itself into the chiropractic office are cervicogenic headaches, or headaches caused by pain sensitive structures of the neck. All headaches are not treatable in the chiropractic office.  Yet, cases of cervicogenic and tension headaches are treated daily at Spinal Care and we feel it is pertinent for our patients to learn why chiropractic care can help.


In most cases, the headache diagnosis can be determined when the patient is describing the onset of pain and confirmed when the doctor tests for motion and musculature throughout the head and neck regions.   If in the evaluation, your Spinal Care doctor will either determine that she can resolve the pain and explain how she will do it, or if it is determined that it is a headache that she cannot help resolve, she will help get you to a provider who can.


Cervicogenic Headaches

A cervicogenic headache is a secondary headache caused from muscles and hypersensitive joints of the neck. They are often one-sided and may or may not be accompanied with neck pain. To fully understand a cervicogenic headache we need to discuss trigger points. Trigger points are often referred to as “knots”.   They are contracted muscle fibers that can refer pain elsewhere when pressed. Healthy muscles are not tender and do not contain trigger points, knots, or tight bands. Trigger points make the muscle unable to function at its maximum because the fibers are already contracted, hence muscles that contain trigger points are unable to be fully strengthened.  Pain is often felt elsewhere when a trigger point is pressed and that is known as a referral pattern. There are common referral patterns with common trigger points in each muscle – this is consistent for most people.   These trigger points can be aggravated by stress and postural deficiencies.  Some common trigger points and their referral patterns are shown below.


While there are 6 main trigger points of the upper trapezius, one of the trigger points within the muscle can refer pain into the upper neck and head regions. These images ( depict common trigger point referrals (noted in red) caused by trigger points within muscles of the neck and jaw (noted by “x” marks).


Muscles of the base of the skull can refer pain around the ear, which is common in people with desk jobs. The importance of posture is addressed daily at Spinal Care and these small muscles are only one example. When spending hours in front of a computer it is easy to get stuck in a posture with your head projected towards the computer screen, which creates trigger points within these muscles. Perhaps the persistent headache you seem to get every day right before lunch isn’t from your co-worker yapping your ear off.

There are two parts to the sternocleidomastoid muscle (SCM). One part contains trigger points that refer pain into a distinct “headband” headache, while the other part has trigger points that refer pain around the eye.

The temporalis muscle in the jaw not only has trigger points that can trigger a headache, but it also has trigger points that can create a tooth ache.

Cervicogenic headaches are easily resolved by addressing the trigger points and posture in a few visits.  There is no need to attend appointments every week for the rest of your life at Spinal Care.  We fix cervicogenic headaches and teach you how to stay out of pain.


Tension Headaches

A tension headache is the most common form of primary headache. Tension-type headaches can last from 30 minutes to 7 days2. The headache is on both sides of the head and described as a “band-like headache”. While tension headaches are never pleasant, the headaches don’t typically stop patients from daily activities, as the headache doesn’t intensify with activity. A headache that is combined with nausea or vomiting is not a tension headache. The more frequent the tension headaches, the more likely you are to have the headache accompanied with skull and neck muscle tenderness. While light or sound sensitivity may be present with a tension headache, it is rare for both light and sound sensitivity to be present at the same time.

Headache Prevention

While traffic, family squabbles, and work stress are inevitable, there are some steps to take to prevent these common types of headaches.

  1. Stay hydrated! Drinking plenty of water will eliminate dehydration as a cause of the headache.
    2. Avoid sitting in a position for more than 30 minutes. Set a timer on your computer or phone to get up, move, walk around, and stretch once every 30 minutes throughout the day. This keeps the muscles pliable and prevents trigger points from developing.
    3. Low-impact exercise will help a tension headache, yet if you are prone to tension headaches, high-impact exercise may lead to the onset of one. Walking, hiking, biking, gardening, and water aerobics are fun examples of low-impact exercises.
    4. Teeth clenching and teeth grinding can lead to tension in the muscles of the jaw and neck. These muscles also connect onto the skull, which can create both tension headaches and cervicogenic headaches.

A 2011 Journal of Manipulative and Physiological Therapeutics study found that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches1. Like any injury, the earlier you are evaluated and treated, the better the prognosis.  Don’t suffer through weeks of headaches before being treated.  There is no need to be in pain when a few visits at Spinal Care will end the pain quickly.


Works Cited

1Bryans R, Descarreaux M, Duranleau M, et al. Evidence based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011; 34: 274-89.

2“Tension-Type Headache.” American Migraine Foundation. American Migraine Foundation, 8 Aug. 2016. Web. 05 July 2017.