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HEADACHES

In the September 2001 issue of the Journal of Manipulative and Physio logical Therapeutics was a report on the effectiveness of chiropractic care, specifically labeled “SMT” in the study, for patients with chronic headaches. The data for this report was gathered from nine trials involving 683 patients with chronic headache.

In this study chiropractic adjustments (termed SMT in the study) were compared to massage and medications for short term relief of up to six weeks after a month of care. The question of long term health benefits was not addressed. Results showed that the chiropractic group did better than the massage group. The group that received medication also showed relief however; the rate of side effects for the medication group was considerably higher than the chiropractic group. This difference gave a decidedly large advantage to chiropractic over the medication.

According to the report, the financial cost of headaches is great, with billions of dollars spent annually for lost productivity and treatment. The study also noted that medical practitioners have commonly treated people affected with headaches. Recently however, they are increasingly turning to non-medical or alternative therapies for relief. A recent study from Harvard University by Dr. Eisenberg reported that one of the most common alternative practitioners sought out for the treatment of headaches was the chiropractor. This study confirms what most chiropractors and their patients have already known, that chiropractic is one of the most effective avenues of health for headache sufferers.

Vectored upper cervical manipulation for chronic sleep bruxism, headache and cervical spine pain in a child. Knutson, G.J, Manipulative Physiol Ther Vol 26 No. 6 July/August 2003.

This is the case of a six-year-old who had chronic sleep bruxism (causing abnormal tooth wear), morning headaches and cervical spine (neck) pain.

Adjustments to the upper cervical spine using the atlas transverse process as the contact point. There was “complete relief” of her chronic symptoms along with elimination of abnormal joint and structural problems.

Occipital headaches stemming from the lateral atlanto-axial (C1-2) joint. Aprill C, Axinn MJ, Bogduk N. Cephalalgia 2002 Feb;22(1):15-22

The lateral atlanto-axial joints (C1-2) are capable of causing pain in the occiput, but few clinical studies have validated this source of occipital headache.. Patients presenting with occipital pain underwent diagnostic blocks of their lateral atlanto-axial joints if they demonstrated clinical features presumptively suggestive of a C1-2 origin for their pain. Of 34 patients investigated, 21 obtained complete relief of their headache following diagnostic blocks, indicating that a C1-2 source of occipital pain is not rare. [21/34 = 62%]. The clinical features used to select patients for blocks, however, had a positive predictive value of only 60%.

A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Tuchin PJ, Pollard H, Bonello R. Journal of Manipulative and Physiological Therapeutics Feb. 2000:23(2), PP.91-5.

This was a six month study of 127 migraine sufferers half of whom had diversified chiropractic adjustments. The other half was the control group. Subjects in the manipulation group demonstrated statistically significant improvement in migraine frequency, headache duration, disability and medication use. 22% of those undergoing chiropractic care reported more than 90% reduction in migraines after two months. About 50% reported significant improvement in severity of migraine episodes.

Evidence report: behavioral and physical treatments for tension type and cervicogenic headache. McCrocy D and Gray R Duke University. 2001.

This report from Duke University compares the effectiveness of drug and other therapies for the most common type of headache – the cervicogenic headache. The report stated that chiropractic is more effective for headache (both in frequency and severity) than other soft tissue therapies and that chiropractic is superior to drug therapy, providing markedly superior long-term results.

Encephalgia/Migraine. Bofshever, H. International Chiropractic Pediatric Newsletter Jan/Feb 2000

A ten year-old girl with chronic, severe migraine (6 times a week for the past 3 years) was unable to go to school due to the severity of her condition. She was treated at a Children’s Hospital by a neurologist.

Chiropractic examination revealed VSC at C1/C2. The patient’s headaches improved following her 3rd adjustment (one week) at which time she stopped using PeriactinT Syrup (prescribed by her pediatrician). By the third week she was back in school and started dance classes for the first time in 2 years, “and actually began to smile again.” She was leading a normal and healthy life for a child her age by the end of the 5th visit.

The anatomic basis for the effectiveness of chiropractic spinal manipulation in treating headache. Hack, GD Abstracts from the 15th annual upper cervical spine conference Nov. 21-22, 1998. CRJ, Vol. VI, No. 1, Spring 1999.

This paper is by the same doctor who led the team that discovered a musculo-ligamentous relationship between the cervical spine (neck) and the dura mater (covering of the brain stem). The author writes:

An increasing body of literature relates headaches to pathology affecting the cervical spine and a number of clinical trials have demonstrated that chiropractic spinal manipulation directed at the neck is valuable for managing headache.

Mobilization of the Spine. Grieve GP (1984) Churchill Livingston, London/New York, 4th edition, 22-23.

All those experienced in manipulation can report numerous examples of migrainous headaches, disequilibrium (vertigo), subjective visual disturbances, feelings of retro-orbital pressure, dysphagia, dysphonia, heaviness of a limb, extra segmental paraesthesia. Restriction of respiratory excursion, abdominal nausea and the cold sciatic leg being relieved by manual or mechanical treatment of the vertebral column.

Unconventional medicine in the United States, Eisenberg, DM et al., NEJM 28 May 1993. Pp.246-252.

Twenty-seven percent of Americans who visit alternative health care providers do so for headache relief.

The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for prophylaxis of migraine headache. Nelson CF, Bronfort G, Evans R, et al. Journal of Manipulative and Physiological Therapeutics, October 1998: Vol. 21, No. 8, pp 511-19.

This study compared the relative effectiveness of treating migraines with chiropractic care, the anti-depressant/anti-anxiety drug amitriptyline (brand name Elavil); and with a combination of both the drug therapy and chiropractic care.

Patients who received only chiropractic showed significant improvement, on a par with those given the powerful prescription drug (though without the side effects). The headache index, from a diary kept by each patient, showed chiropractic to have reduced the severity and frequency of headaches as well or better than the combined therapy or amitriptyline alone at each stage of the study.

Spectrum of pathophysiological disorders in cervicogenic headache and its therapeutic indications. Martelletti P, LaTour D, Giacovazzo M Journal of the Neuromusculoskeletal System 1995; 3:182-7.

Patients were diagnosed with cervicogenic headache (headache arising from neck structures) and received chiropractic care. The patients reported improvement.

 

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