Multi-Approach Treatment of Headaches

Chiropractic

Chiropractors successfully treat thousands of headache sufferers everyday. According to surveys, as many as 25% of the individuals seeking chiropractic care do so for the treatment of headaches.

Chiropractic has such good success in the treatment of headaches because most headaches are either soft tissue or neurologic in nature. Also, a significant portion of headaches originate in the tissues of the neck. And since chiropractors focus their treatment on the soft tissues of the spine, which includes the neck, the majority of headaches can be successfully managed with appropriate chiropractic care. Best of all, chiropractic treatments consist of only safe, natural, and noninvasive therapies that focus on correcting the cause of headaches, and not simply the short-term masking of symptoms.

Chiropractic treatment for headaches has been compared with other forms of treatments and in most cases, has excelled. To see the results of studies evaluating the effectiveness of chiropractic care in the treatment of different headache types, select the "Articles" link from the table above.

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Trigger Points

What are trigger points?

Trigger points are areas in muscle that are very irritable, show a band of tightness in the area of muscle itself, and when pressed produce a twitch within the affected muscle. A trigger point may produce not only pain in the affected muscle, but in a distant area, including locations in the head and neck, called referred pain. Trigger points may develop because of trauma, injury, inflammation, or other factors.

Can trigger points cause headaches or trigger Migraines?

Trigger points within muscles of the head, neck, and shoulders can cause headache by themselves, and this type of condition is often called myofascial pain. In addition, trigger points can be present in patients with Migraine, tension-type, post-traumatic, and other headache disorders, and can be worsening or perpetuating factors for the underlying headache condition.

What are trigger point injections?

A trigger point injection is a procedure where a medication, usually a local anesthetic, is injected into the painful muscle to provide relief. The pain relief should be experienced not only in the affected muscle, but in the area of referred pain as well.

Who should receive trigger point injections?

Patients that have specific trigger points that can be elicited with palpation (a firm touch) may experience the most relief from injections. They may be very helpful for immediate relief for severe pain in patients with an individual headache or Migraine attack, or can help treat an overall worsening of head pain in patients with chronic headache disorders who are having an exacerbation.

How are trigger point injections performed?

In the trigger point procedure, a health care provider inserts a small needle into the patient’s specific area of pain (trigger point) in a muscle. The injection usually contains only a local anesthetic, but occasionally may contain a steroid medication. This procedure can be performed in a doctor’s office and does not require sedation. The patient is positioned sitting or lying down. Your doctor will first palpate and identify the painful areas within a muscle. After identifying such trigger points, your doctor will inject those areas. Depending on how many trigger points are identified, more than one injection may be required. Some headache specialists perform trigger point injections along with peripheral nerve blocks in the same treatment session.

How do trigger point injections work?

The anesthetic medication will be injected into the muscle and will block pain receptors within the nerves surrounding the muscle, and in turn reduce the pain signals sent to the brain. If steroid medication is used, it reduces the inflammation and swelling of tissue around the nerves, which may help reduce pain. The needle without medication may even provide independent benefits mechanically. The needle separates, relaxes and lengthens the muscle fiber to provide further pain relief. This approach is called "needling" and may be used in patients with allergies to anesthetic medication.

Are trigger point injections safe?

The most common side effects are temporary pain and numbness at the injection site. Infection and bleeding may occur at the injection site but this can be avoided by cleaning the site before injection and applying pressure to the site after injection. Patients may also experience light-headedness after injections.

What can I expect after receiving trigger point injections?

Immediately after the injection, you may feel that your pain has remitted or lessened significantly, in both the affected muscle as well as the area of the referred pain in the head or neck. Some patients may not benefit at all, while others may have significant pain remission lasting for weeks. You can return to your daily activities immediately after the injections. We may repeat the procedure as needed and customize how often it is performed.

Summary

Trigger point injection is a procedure which can be performed at our office safely to treat headache and Migraines in certain patients. Consult with our doctor as to whether or not this treatment is appropriate for you.

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Physical Therapy for Headaches

What is the initial evaluation for headaches?

Our Physical Therapists spend about an hour on the initial evaluation. Their first concern is what is causing the headache or what type of symptomatic picture does the patient present. Second is what can they do to exacerbate the symptoms to help them localize the pain. Third is what procedures can they perform to alleviate the symptoms or at least change the clinical picture.

What physical therapy approaches are most helpful for chronic headache sufferers?

Our physical therapists look to determine if the use of effective treatments can help identify underlying causes creating your headaches. Trigger points, vertebral misalignments, spastic muscles and previous auto accidents and sports injuries that can alter the position of the neck causing headaches.

Does physical therapy produce permanent pain relief?

That depends. When a physical therapist can get at the root of a problem, such as poor mobility in a joint or muscle spasm or postural dysfunction, and address that problem, the results can be longer lasting. The patient may need to perform a few exercises in order to maintain the improvement.

How do you define a successful physical therapy outcome for headaches?

Pain decreases and life becomes easier. Daily activities are not so difficult. Range of motion is restored. Physical activity and exercise can be resumed without increasing pain. However, the most successful outcome is when a patient feels that success has been achieved and established goals have been met.

What is our multi-functional approach in solving headaches?

Our practitioners function as a group when treating problems. When treating a headache sufferer we jointly use the best of Chiropractic, Pain Management and Physical Therapy to help achieve your goals. Where is neck misalignment Chiropractic aligns the neck and reduces compensation and spasms. Where there are active trigger points pain management helps to reduce spasms and pain. Physical therapy works to provide relief of muscle spasms and pain by using soft tissue techniques. They also help in supporting the neck by strengthening the muscles. They also counsel on the use of pillows, sleeping positions and other forms of exercise that can be performed at home.

The most important part of care begins with the initial consultation where one of our doctors will sit down with you and listen to you describe your condition. We will then make a recommendation for your approval to begin care. Our approach will differ depending on your case and as you well know not every headache is the same, so the treatment must match the problem.

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