The term “Headache” is something that everyone knows, wether it is from personal experience or someone you know. But not all headaches are the same. Part of working with a wide variety of patients and their needs is being familiar with the different types and what they mean for the person.
Some of the most common types of headaches include:
- Tension Headache
- Migraine Headache
- Sinus Headache
- Hypertensive Headache
- Cluster Headache
- Post Traumatic Headache
- Cervicogenic Headache
It is not always as simple as putting a label on the type of headache a person has. The symptoms tend to blend across types and the way they present, and quite often are as unique as the person who has them. This can make it difficult for a doctor to say for sure which type of headache you are experiencing, and which treatment is going to provide short term relief and a long term solution. Part of the equation is looking at the anatomy that is creating the pain signal.
One important thing to understand is that, although it can feel as though your the pain is coming from inside your head, there are actually no tissues in the brain (proper) that generate pain! In other words, it is a signal coming from outside the brain that is being transmitted to say something is not going the way it should.
Although there are other, more serious causes of headaches (Tumors, stroke, etc…), this is fairly rare and not the first place to start. We are going to delve into the causes of the more “typical” headaches people experience on a regular basis.
Anatomy of a Headache
1. The Arteries in the Brain -
A great amount of focus has been on studying the arteries of the brain, and understanding what their role is in headaches. It is still not completely understood the exact mechanisms that result in a migraine, but we do know that one piece of the puzzle is that when migraines do occur, there is swelling in the arteries of the brain and resulting inflammation of the nerves of the arteries. The transmission to the trigeminal ganglion from the nerve endings cause pain “piece” of a headache.
This is why a primary focus of many pharmaceutical drugs used (to treat the symptoms of migraines) are aimed at the reduction of this swelling of arteries.
2. The Nerve Roots: C1, C2, C3
Quite often people first begin to have headaches after a head and/or neck injury. Whiplash or concussion can result in the the uppermost nerves in the neck to become irritated. The resulting pain that is generated is often felt on the back and top of the head. When this injury to the upper cervical spine is left uncorrected, it can result in continual disturbance of these nerves… something known as occipital neuralgia.
The nerves coming from the top of the neck3. The Role of the Meninges
"The organs of the central nervous system (brain and spinal cord) are covered by 3 connective tissue layers collectively called the meninges." (1)
It is likely that you recognize the term “Meningitis”. (This literally means “Inflammation of the Meninges”) A really bad headache can be a secondary condition (symptom) of meningitis… and the meninges can contribute to the pain of a headache even when there is no meningeal infection.
Various studies have shown the connection between the sub-occipital muscles connect into the meninges. That tension on this sheath around the CNS (Central Nervous System) may be contributing to certain headaches. (2) From the article: "...These mydural bridges have been associated with the etiology of cervicocephalic headaches, and cervicocephalic pain syndromes."
4. Head and Neck Muscles
There is a strong correlation between tension (type) headaches and the musculature of the neck and head. While the influence of these muscles in headache were exaggerated over the years, certain muscles do play a role in pain felt “in the head.” Pain that is referred into the head can originate from muscles like the splenius capitus.
Patients suffering from TMJ often have correlated headaches as well. The contraction of the muscles of the jaw (temporals, master, and pterygoids) can generate pain as well.
Muscles commonly associated with headache
5. Dysfunction of the Joints of the Neck
The brain is continually receiving information from the joints of the neck and spine. This is an integral piece of posture and its connection to the neurological functions of the spinal cord. When these joints are shifted out of position for long periods of time (Chronic) it can result in irritation. “Cervicogenic” headaches are a result of this dysfunction of the neck joints. Although more difficult to classify, they are commonly seen in people who have had whiplash and/or head injuries (TBI and concussion).
What is the Connection?
Now for the interesting part! The commonality in what we have discussed is the neurology, and specifically the trigeminal complex.
Trigeminal Nerve ComplexPhotograph: Science Photo Library
This specific bundle of nerves it is the main “clearinghouse” for most of the pain signals for the head and neck. All of the neural information from the first 3 spinal nerves (C1-C3), the jaw muscles, skin of the face and the meninges is transmitted through and processed by this Trigeminal Complex. Trigeminal Neuralgia is a severe form of a common problem.
What does this mean? If we can affect the function of the trigeminal complex, then we can (positively) affect a person’s headache disorder.
How Structural Correction of the ADC can help
Here at Precision Chiropractic, we focus on making specific, image guided correction of the top part of the neck. (Upper Cervical spine). Earlier we touched on how the first 3 spinal nerves are involved with the transmission of pain involved in a headache, but they are also involved in the information relay about posture and how you relate to the world around you.
Normally, with the head and neck in a normal relationship/position, data (information) is transmitted to the brain and everything functions optimally. When someone has a structural shift at the in the neck, such as an Atlas Displacement Complex, the information is jumbled and the signal into the brain results in “Pain” being the overriding message. This is why focusing on the nerves at the top of the neck is so vital… proper function can interrupt the process of a headache before it arrives full on!
Diagram showing how the nerves from the neck meet with the trigeminal nerves Image credit to Dan Murphy, DC thechiropracticimpactreport.com
One reason we are so successful in helping folks with headaches is because we are addressing a common physical component that is mostly overlooked. It is not that we are treating the different types of headaches differently; rather we are address the common factor, which is quite often the Atlas Displacement Complex through our unique approach with in chiropractic. (3)
Precision Chiropractic has a unique focus called structural correction. It is based in Williston, Vermont and serves the greater Burlington area and Chittenden County, Vermont, Norther New York and New Englad. It is the only office in Vermont to follow utilize the NUCCA protocol for upper cervical correction.
1. https://medlineplus.gov/ency/imagepages/19080.htm
2. Enix, Dennis E., DC, MBA, Scali, Frank, DC, Pontell, Matthew E., BSc, "The cervical myodural bridge, a review of literature and clinical implications" J Can Chiropractic Association 2014; 58(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025088/
3. Woodfield HC 3rd, et al. Biomed Res Int. 2015;2015:630472. doi: 10.1155/2015/630472. Epub 2015 Dec 10. "Effect of Atlas Vertebrae Realignment in Subjects with Migraine: An Observational Pilot Study."
4. Hubbard, Todd A, Kane, Janice D., "Chiropractic Management of Essential Tremor and Migraine: A case Report" J Chirop Med. 2012 Jun;11(2): 121-126
https://www.ncbi.nlm.nih.gov/pubmed/23204956