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Headaches.

Everyone has one at some point in their life.

What can osteopaths do to help?

Common Types of Headaches

Tension Type Headaches

Tension type headaches are described as a dull pain, tightness or pressure around the forehead or at the back of your skull extending down to the neck. Patients often describe the pain as a “band around the head”.

These are the most common type of headache in adults, affecting on average 46% of the population.

Peak prevalence is between the ages of 40 and 49 years, and they are more common in women. Tension type headaches can either be episodic, occurring less than 15 times a month or chronic, occurring more than 15 times a month for at least six months. The exact cause of tension type headaches is not fully understood however there are known triggers, including:

• Squinting

• Poor posture

• Tiredness

• Dehydration

• Missing meals

• Lack of physical activity

• Bright sunlight

• Noise

• Certain smells

• Stress and anxiety

Cervicogenic Headaches

Cervicogenic headaches are persistent headaches which are caused by referred pain from structures in the neck including the joints, muscles, nerves and blood vessels.

Patients suffering from cervicogenic headaches will often have altered neck posture and  reduced range of motion in the neck. The head pain is often aggravated by movement of the neck especially in extension (tilting your head backwards) and when pressure is applied into the structures of the neck. Patients may also experience some discomfort in the base of the skull, neck and shoulder regions.

Symptoms:

• Pain on one side of your head or face

• Steady pain that doesn’t throb

• Head pain when you cough, sneeze, or take a deep breath

• An attack of pain that can last for hours or days

• Stiff neck – you can’t move your neck normally

• Pain that stays in one spot, like the back, front, or side of your head or your eye

• Pain aggrivated by movements of the neck

Migraines

Migraines affect around 15-20% of women and 5-10% men and are the most common cause of episodic headaches. Most commonly, migraines occur before the age of 40 and cause headaches, sensitivity to light, sound or movement and sometimes even nausea and vomiting. The intensity of migraines varies from person to person, but usually results in the inability to carry out daily activity during an episode. Similarly, the frequency of attacks differs from an occasional inconvenience to frequent headaches, severely impacting quality of life. Previous theories suggest that migraines were primarily caused by the vascular system (blood vessels and blood flow) however its is now thought to be more of a neurogenic cause (originating from the nervous system).

Symptoms:

• Pain on one or both sides of your head

• Pain that feels throbbing or pulsing

• Sensitivity to light, sounds, strong smells and sometimes touch

• Nausea and sometimes vomiting

• Lightheadedness

• Visual disturbances including seeing flashing lights, zig-zag patterns or blind spots

• Numbness or tingling sensation in the hands, face, tongue and lips

• Dizziness

When you should seek medical attention

• If the headache comes on suddenly and is unlike anything you have experienced previously
• If the headaches are accompanied by a stiff neck, fever, nausea, vomiting & confusion
• If the headache occurred following an accident, especially if it involved a blow to your head
• If the headaches are accompanied by weakness or pins and needles in the face, numbness or slurred speech
• If the headaches are causing significant dizziness, fainting or visual changes.

How can Osteopathy Help?

Different osteopathic techniques can be used to help alleviate and treat these different types of headaches. Below is a brief overview of the research on how osteopathy can help!

Tension Type Headaches

For these types of headaches osteopathic spinal manipulation has shown to result in immediate improvements in pain and headache intensity. When this technique was compared to pain killers, the results were similar, but those receiving osteopathy reported significantly fewer side affects. Osteopathy has also shown not only to reduce pain but also improve stress, decrease tension and reduce anxiety, all which are significant triggers of tension type headaches. As well as spinal manipulation, techniques such as soft tissue therapy, spinal mobility exercise prescription, mobilisations, positional release and trigger point therapy have all shown to be affective in the treatment of tension type headaches in a variety of different clinical trials.

Cervicogenic Headaches

There have been multiple studies over the last 20 years which have looked at the ways osteopathy and osteopathic techniques can help people suffering with cervicogenic headaches. One study showed a significant reduction in pain and a fewer headaches (at 1 week and 12 months) when receiving spinal manipulation a tool commonly utilised during osteopathic treatment. This has been supported by a variety of other studies.

As well as spinal manipulation, spinal mobilisation has also shown to be more affective in the treatment of these headaches when compared to a medication used to treat migraines.

An article evaluating all the different types of treatment for these headaches suggested that manual therapies including osteopathy are important to consider in the management of Cervicogenic headaches. Techniques such as positional release, muscle energy techniques, cervical traction and gentle muscle stretching are particularly well suited for the management of these headaches. With multiple studies and articles supporting this.

Migraines

A study in 2008 looked at a range of different investigations on commonly used osteopathic techniques, including spinal mobilisation and manipulation for treating migraines. Thee studies compared these techniques to the drug amitriptyline and other pharmaceuticals. This study found that both mobilisation and manipulation when used together or separately was just as affective as amitriptyline. Similarly, a study in 2011 showed osteopathic treatments decreases pain, symptom persistence, as well as improving quality of life following treatment.

So, headaches. We all get one every now and then, look at the triggers mentioned in this blog to see what you can do to help yourself. But if you need a helping hand or want a professional opinion, get in contact.

The evidence speaks for itself.

WE CAN HELP WITH HEADACHES!

If your headaches are causing you pain or discomfort or are significantly impacting your quality of life. Get in touch and see how Osteopathy can help you. We’re based in the heart of Tunbridge Wells with easy access to the station.

Call: 07526485224

Email: aag.osteopathy@gmail.com

Book an appointment here

ADDRESS – OVERCOME – ACHIEVE

References:

Moraska, A. F., Stenerson, L., Butryn, N., Krutsch, J. P., Schmiege, S. J., & Mann, J. D. (2015). Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: A randomized, placebo-controlled clinical trial. The Clinical Journal of Pain, 31(2), 159–168.

Espí-López, G. V., Gómez-Conesa, A., Gómez, A. A., Martínez, J. B., Pascual-Vaca, Á. O., & Blanco, C. R. (2014). Treatment of tension-type headache with articulatory and suboccipital soft tissue therapy: A double-blind, randomized, placebo-controlled clinical trial. Journal of bodywork and movement therapies, 18(4), 576-585.

Ghanbari, A., Rahimijaberi, A., Mohamadi, M., Abbasi, L., & Sarvestani, F. K. (2012). The effect of trigger point management by positional release therapy on tension type headache. NeuroRehabilitation, 30(4), 333-339.

Mesa-Jimenez, J. A., Lozano-Lopez, C., Angulo-Díaz-Parreño, S., Rodríguez-Fernández, Á. L., De-la-Hoz-Aizpurua, J. L., & Fernández-de-las-Peñas, C. (2015). Multimodal manual therapy vs. pharmacological care for management of tension type headache: A meta-analysis of randomized trials. Cephalalgia, 35(14), 1323-1332.

López, C. L., Jiménez, J. M., de la Hoz Aizpurúa, J. L., Grande, J. P., & de Las Peñas, C. F. (2016). Efficacy of manual therapy in the treatment of tension-type headache. A systematic review from 2000 to 2013. Neurología (English Edition), 31(6), 357-369.

Tuchin, P. J., Pollard, H., & Bonello, R. (2000). A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of manipulative and physiological therapeutics, 23(2), 91-95.

Toro-Velasco, C., Arroyo-Morales, M., Fernández-de-las-Peñas, C., Cleland, J. A., & Barrero-Hernández, F. J. (2009). Short-term effects of manual therapy on heart rate variability, mood state, and pressure pain sensitivity in patients with chronic tension-type headache: a pilot study. Journal of manipulative and physiological therapeutics, 32(7), 527-535.

Chaibi, A., Tuchin, P. J., & Russell, M. B. (2011). Manual therapies for migraine: a systematic review. The journal of headache and pain, 12(2), 127-133.

Biondi, D. M. (2005). Cervicogenic headache: a review of diagnostic and treatment strategies. The Journal of the American Osteopathic Association, 105(4_suppl), 16S-22S.

Chaibi, A., & Russell, M. B. (2012). Manual therapies for cervicogenic headache: a systematic review. The journal of headache and pain, 13(5), 351-359.

Dermaid, C. S., Hagino, C., & Vernon, H. (1999). Systematic review of randomized clinical trials of complementary/alternative therapies in the treatment of tension-type and cervicogenic headache. Complementary therapies in Medicine, 7(3), 142-155.

Jull, G., Trott, P., Potter, H., Zito, G., Niere, K., Shirley, D., … & Richardson, C. (2002). A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine, 27(17), 1835-1843.

Voigt, K., Liebnitzky, J., Burmeister, U., Sihvonen-Riemenschneider, H., Beck, M., Voigt, R., & Bergmann, A. (2011). Efficacy of osteopathic manipulative treatment of female patients with migraine: results of a randomized controlled trial. The Journal of Alternative and Complementary Medicine, 17(3), 225-230.

Keays, A. C., Neher, J. O., & Safranek, S. (2008). Is osteopathic manipulation effective for headaches?. Clinical Inquiries, 2008 (MU).

Loder, E., & Rizzoli, P. (2008). Tension-type headache. Bmj, 336(7635), 88-92.

NHS Choices (2018). Migraines.. Retrieved from: https://www.nhs.uk/conditions/migraine/

NHS Choices (2018). Tension Type Headaches Retrieved from: https://www.nhs.uk/conditions/tension-headaches/

NHS Choices (2018). Headaches. Retrieved from:https://www.nhs.uk/conditions/headaches/