http://advancedbacksolutions.com/dasblog/2010/11/09/TensionHeadachesChiropracticOptions.aspx
Livonia, MI Chiropactor, Dr. Kevin Venerus posted an interesting article on his Livonia Chiropractic blog about tension headaches. In his post, he suggests that recent findings have resulted in a conclusion that the cause of "tension-type" headaches is not due to muscle tension as it was once thought. His point is that the muscle tension as measured in "tension-type" headaches and the presence of "tender trigger points" in the upper, middle and lower neck is not unique to these headaches and are also found in the same frequency and severity in headaches of other known causes.
I respect Dr. Venerus' attempts to stay on top of the latest research, however I must take issue with the conclusions. From a purely logical standpoint, the fact that muscle tension and trigger points occur in headaches of other known causes does not mean that muscle tension and trigger points are not a source of headaches in and of themselves. One might question whether there is another mechanism that we just haven't found and that would be a reasonable consideration, but it is premature to dismiss muscle tension and/or trigger points as a potential cause of headaches.
In my practice, there are relatively few headaches that do not respond to some degree to an adjustment. I typically will find a reduction in muscle tension and trigger point intensity after treatment and so this is not a mystery to me. On the other hand, when the mechanism is not strictly musculoskeletal (ie. when it is not simple spinal subluxation), and thus remains active post-adjustment, it is reasonable to expect that the headache will return at some point. At that point, I advise a patient to pay close attention to body temperature (early indication of possible viral or bacterial infection), any dizziness, nausea, etc (possible migraine or other cuases), and to work on postural exercises. And I will advise the patient on measures to be taken at home to reduce the muscle tension and trigger points.
Cadaver dissection protocols developed over hundreds of years, consistently destroyed a connection between the Rectus Capitus Posterior Minor muscle at the base of the neck and the dural tissues encapsulating the cervical spinal cord and lining the cranium. We know that the pain sensing nerve endings in the brain are confined to dural membranes and vasculature, leaving the actual brain cells without the ability to produce pain sensation. We also know that vascular pain (ie. migraine) has unique qualities and characteristics absent in a typical tension-type headache. The headache that one gets with brain injury is typically a result of stretch or tension in the dural membranes resulting from swelling. The finding of the fibrous connection between the RCPM muscle and the dura mater at the base of the neck, the acknowledgement of the presence of muscle tension in relation to headaches of all etiologies, and the reduction and frequent resolution of "tension-type" headaches post-adjustment with notable persistent reduction in muscle tension and trigger point activity do support the contention that this is truly at least one of many causes for headache pain.
My point here is that muscle tension and trigger points are not mutually exclusive of other headache causes and so we cannot conclude that just because muscle tension and trigger points exist in the presence of other known headache causes that they are not a source or cause of headache in and of themselves.
Interesting article Dr. Venerus... thank you. Let's keep an eye out for further developments and keep taking care of neck subluxations in headache patients as I know you continue to do so well.
Livonia, MI Chiropactor, Dr. Kevin Venerus posted an interesting article on his Livonia Chiropractic blog about tension headaches. In his post, he suggests that recent findings have resulted in a conclusion that the cause of "tension-type" headaches is not due to muscle tension as it was once thought. His point is that the muscle tension as measured in "tension-type" headaches and the presence of "tender trigger points" in the upper, middle and lower neck is not unique to these headaches and are also found in the same frequency and severity in headaches of other known causes.
I respect Dr. Venerus' attempts to stay on top of the latest research, however I must take issue with the conclusions. From a purely logical standpoint, the fact that muscle tension and trigger points occur in headaches of other known causes does not mean that muscle tension and trigger points are not a source of headaches in and of themselves. One might question whether there is another mechanism that we just haven't found and that would be a reasonable consideration, but it is premature to dismiss muscle tension and/or trigger points as a potential cause of headaches.
In my practice, there are relatively few headaches that do not respond to some degree to an adjustment. I typically will find a reduction in muscle tension and trigger point intensity after treatment and so this is not a mystery to me. On the other hand, when the mechanism is not strictly musculoskeletal (ie. when it is not simple spinal subluxation), and thus remains active post-adjustment, it is reasonable to expect that the headache will return at some point. At that point, I advise a patient to pay close attention to body temperature (early indication of possible viral or bacterial infection), any dizziness, nausea, etc (possible migraine or other cuases), and to work on postural exercises. And I will advise the patient on measures to be taken at home to reduce the muscle tension and trigger points.
Cadaver dissection protocols developed over hundreds of years, consistently destroyed a connection between the Rectus Capitus Posterior Minor muscle at the base of the neck and the dural tissues encapsulating the cervical spinal cord and lining the cranium. We know that the pain sensing nerve endings in the brain are confined to dural membranes and vasculature, leaving the actual brain cells without the ability to produce pain sensation. We also know that vascular pain (ie. migraine) has unique qualities and characteristics absent in a typical tension-type headache. The headache that one gets with brain injury is typically a result of stretch or tension in the dural membranes resulting from swelling. The finding of the fibrous connection between the RCPM muscle and the dura mater at the base of the neck, the acknowledgement of the presence of muscle tension in relation to headaches of all etiologies, and the reduction and frequent resolution of "tension-type" headaches post-adjustment with notable persistent reduction in muscle tension and trigger point activity do support the contention that this is truly at least one of many causes for headache pain.
My point here is that muscle tension and trigger points are not mutually exclusive of other headache causes and so we cannot conclude that just because muscle tension and trigger points exist in the presence of other known headache causes that they are not a source or cause of headache in and of themselves.
Interesting article Dr. Venerus... thank you. Let's keep an eye out for further developments and keep taking care of neck subluxations in headache patients as I know you continue to do so well.
Mission Viejo Chiropractic
24896 Chrisanta Dr. #120
Mission Viejo, CA 92691
(949)360-1112
If you want to reach more from Dr. Venerus' Livonia Chiropractor blog, fee free to visit it. If you need a chiropractor in Livonia, MI, you can find him at:
Advanced Back Solutions
10988 Middlebelt
Livonia, Michigan 48150
No comments:
Post a Comment
Your comment will be posted after I have reviewed it.