EBHSG - JULY 1996 MEETING NOTES

TOPIC: "A HANDS ON APPROACH FOR THE TREATMENT OF

HEADACHES; A UNIQUE CHIROPRACTIC PERSPECTIVE"

Craig Weinston, D.C., a Walnut Creek chiropractor specializing in the treatment of head and neck pain, spoke at the July 9, 1996 meeting on his interdisciplinary approach to the management of headaches. The meeting was held at John Muir Medical Center in the Ball Auditorium from 7:30 to 9:00 pm. 33 were in attendance.

Dr. Weinston began by saying "where we feel pain is not necessarily the problem." Different therapies for headache were noted:

· Pharmaceuticals · Hypnosis

· Biofeedback · Homeopathy

· Massage · Visualization

· Physical therapy · Martial arts

· Acupuncture · Chiropractic

Dr. Weinston told us the causes, signs, symptoms, and treatment of the three different types of headache:

A. Cervicogenic Headache—comes from the neck. Nerves in the neck can refer pain to the different parts of the head. Chiropractic is to see that bones and joints are working properly.

Causes of cervicogenic headaches:

1. Trauma (car accident, sports injury).

2. Postural strain (also called micro trauma, or repetitive trauma)--(slumped posture, military posture, forward head posture).

--None of these three postures is good. Forward head posture (and then with the chin up) causes tightening of the neck and upper back muscles.

--The following things can cause forward head posture: eye strain, grinding teeth, using two pillows which lifts the head forward.

3. Cervical osteoarthritis (degeneration).

Signs of cervicogenic headaches:

1. Muscle tender points.

2. Spinal fixations/hypomobility.

3. Decreased range of motion.

4. Straightening of cervical curve.

Symptoms of cervicogenic headaches:

1. One or both sides.

2. Begins at neck, spreads forward.

3. Mild to moderate sensitivity to light, blurring, and nausea.

Treatment for cervicogenic headaches:

1. Spinal joint adjustments.

2. Postural mechanics correction.

3. Biofeedback/relaxation/breathing.

B. Myofascial Headache—muscular (sustained contraction of neck muscles).

Dr. Weinston explained the processes that occur when there is sustained contraction of the neck muscles:

Decreased oxygenation -- trigger point development -- muscle fatigue -- decreased pain threshold -- fear, anxiety, and emotional stress -- shallow chest breathing.

Therefore, the head and neck suffer increased vulnerability to normal daily stresses, resulting in pain.

Treatment for myofascial headaches:

Myofascial release and stretching, i.e., massage, yoga. "Keep muscles long."

C. Migraine Headache—current theories on the cause of migraine headaches focus on a neurovascular intracerebral disorder involving impaired serotonin regulation.

Triggers for migraine headaches:

1. Hormonal shifts.

2. Food/nutritional/chemical allergies.

3. Blood clotting/platelet aggregation.

4. Tobacco smoke.

5. Dental/jaw stress.

6. Fluourescent lights/monitors.

7. Emotional stress.

Treatments for migraine headaches:

1. Avoidance of environmental triggers.

2. Pharmaceutical medications.

3. Relaxation/coping practices: a. Biofeedback.

b. Meditation/visualization/hypnosis.

c. Relaxation/abdominal breathing.

4. Spinal manipulation/myofascial therapies.

5. Alternative therapies, including acupuncture, homeopathy, herbal medicine.

Dr. Weinston mentioned a theory that cervicogenic--myofascial--migraine headaches are on a continuum.

Each person has to find his own path to relieving the pain of headaches. Dr. Weinston listed the muscles in the head and neck that can be massaged:

• Lots of small muscles at the back of the skull (trigger points).

• Trapezius muscles at the top of the shoulders.

• Temporalis muscles on either side of the head (at the temple).

• Jaw muscles.

• SCM muscle on either side of the neck (sternocleido mastoid).

People tend to overstretch the muscles in the neck. Dr. Weinston showed x-rays of the necks of three persons (looking from the side). One person had proper posture where the vertebrae in the neck made a slight S curve, and two others displayed varying degrees of forward head posture, where the S curve was straightened out somewhat. Your vertebrae are bones with a disk in between, made up of cartilage and joint fluid and gas. A chiropractic adjustment is done to get movement back--to keep joints moving. Neutral positioning of the head and neck is most important. When a person juts his head forward, the disks between the vertebrae are compressed, and as one gets older, they degenerate faster.

There is a huge variation between chiropractors and the treatments they offer. Some chiropractors only do manipulation, while others also do massage therapy and stretching of the muscles.

If, after seeing a chiropractor on a regular basis for three months, you don’t see any improvement, it is time to try something else. It is a trial and error process.

When asked the difference between a chiropractor and a physical therapist, Dr. Weinston replied: "A chiropractor is a primary care physician. The patient can come in off the street and the chiropractor will do a full work up. A physical therapist can only see a patient who has been referred to him by a physician."

In choosing a chiropractor, Dr. Weinston gave the following tips:

1. Look out for advertisers of free exams, x-rays, etc.

2. Get a referral from someone you trust.

3. Look for advanced graduate degrees in the chiropractic profession.

4. Look for professionalism--how the person is known in the community.

Dr. Weinston was asked where the headrest in your car should be set. He said to adjust the headrest so it hits you right in the back of the head, and then raise it 1/2".

He asked us if we all wore seat belts. He said that seat belts increase the incidence of whiplash in car accidents, but since it is more important to stay alive--and legal--we should always use them.

Attached is a handout provided by Dr. Weinston.

The notes provided above were taken by an EBHSG volunteer and have not been reviewed by the speaker for accuracy. If you have any questions regarding the notes, please contact the East Bay Headache Support Group.

The intention of the East Bay Headache Support Group is to provide information and resources. It does not provide medical advice, which should be obtained directly from a physician.