Headache (migraine headache, tension, cervicogenic)

Migraine headaches are caused by a release of a chemical into the brain; this causes the arteries to widen, increasing the pressure within the skull. This may give symptoms such as visual disturbances, numbness, nausea/vomiting and severe headache.

The headaches are characteristically one-sided and are thumping or throbbing in nature, sometimes associated with sensitivity to light, noise or smells, temporary numbness of the affected side or loss of co-ordination and concentration. Various triggers have been identified, most notably food sensitivities such as chocolate, sugar, orange juice, red wine, coffee, milk, yeast and artificial sweeteners. Also
tiredness, stress and mechanical problems in the upper part of the neck often exacerbate migraines.

Osteopathic treatment can be effective at dealing with these headaches, which are triggered by stress and neck conditions, and can reduce the frequency and intensity and even stop them in some cases.
Studies in 1995 of 218 patients with migraine found that Amitriptyline (a well established effective drug for migraine) reduced headache scores by 24% at a four week follow-up while spinal manipulation reduced the score by 42%. (Source: JMPT, Boline DC, Kassam PhD et al, 1995)

Tension headaches are the most common type of headache. They are often described as a tight or tension feeling like a 'hat band', around the head and sometimes behind the eyes. Pain usually comes on slowly over a period of time but may last for weeks or months. They can be no more than a mild irritation or may be completely debilitating, being more severe than a migraine. They may even give
symptoms such as dizziness, tiredness and nausea.

These headaches are associated with increased tension in the small muscles around the base of the skull, which can affect the blood supply to, or even entrap the nerves into, the scalp. This may be caused by trauma such as a whiplash injury, poor posture, jaw problems (TMJ) or increased stress.

Osteopathic treatment can effectively reduce the tension at the base of the skull or around the jaw, as well as helping to improve posture. Osteopaths will also advise on stress management techniques to help to eliminate this type of headache. There is some research evidence to support this*.

Cervicogenic headache literally means coming from the neck and there is increasing evidence that structures of the neck are commonly a source of headache. It's now known that there are connections between the muscles and ligaments of the upper neck and the covering of the brain and spinal cord. These structures are pain-sensitive if irritated and can lead to headache at the back of the head and the neck.

Although similar to tension headaches, they tend to have an element of neck pain and stiffness. They are often caused by muscular irritation as a result of trauma especially following whiplash injury, poor posture and most commonly due to degenerative conditions of the neck such as spondylosis or osteo-arthritis.

There is good research evidence that Osteopathic treatment is effective for these types of headache.* Treatment improves the function of the neck joints and removes the strain through the soft tissues (muscles and ligaments). This, along with postural changes and help with stress management, can prove particularly effective.

*Effectiveness of manual therapies: the UK evidence report. Chiropractic & Osteopathy 2010, 18:3 doi:10.1186/1746-1340-18-3 Article URL http://www.chiroandosteo.com/content/18/1/3