Headaches: A New (old) School of Thought

Houston, There is a Problem

Headaches continue to be underappreciated, under-diagnosed, and a largely unrecognized phenomenon in today’s society. Based on statistical analysis, approximately 96% of people experience headaches / head pain at some time in their lives.

According to the World Health Organization, globally, it has been estimated that prevalence among adults of current headache disorder (symptomatic at least once within the last year) is about 50%. Half to three quarters of adults aged 18–65 years in the world have had headache in the last year and, among those individuals, 30% or more have reported migraine. Headache on 15 or more days every month affects 1.7–4% of the world’s adult population. Despite regional variations, headache disorders are a worldwide problem, affecting people of all ages, races, income levels and geographical areas.

Contrary to popular belief, headaches are not an aspirin, Topamax, or some other drug deficiency. Yes, medications have the ability to mask or decrease the severity and/or prevalence of headache, but the etiology (source) of the headache is often ignored entirely. Many of those who live with headaches on a regular basis experience their pain despite being medically cleared and having “normal” results on imaging of the brain and neck (MRI, CT, PET, etc.).

Headache Classification
There are many types of headaches with a range of associated symptoms depending on the type. According to R.C. Schafer, D.C., there are four major common types of headaches: (1) occipito-cervical (2) vascular-trigeminal (3) vascular (4) temporomandibular traction. A headache is clinically classified based on its pain, pain quality, location, aura, duration, and additional associated symptoms and signs. Associated symptoms and signs can include earaches, eye pain, hypersalivation, neck pain, nausea, tinnitus, vomiting, bruxism (teeth grinding), sensitivity to light and certain sounds, shoulder and neck pain, decreased appetite, and many others.

What Causes the Pain?
There are many potential causes for chronic headache and head pain that will defy conventional diagnostics. In other words, these things may not necessarily show up on a scan of any kind, and if they do, they are often dismissed as inconsequential to the headache itself.

Some of these causes are as follows:
• Osseous (bone) Factors
      o Cranial bone / sutural restrictions
         Involves the dura and extracranial fascia
      o TMJ dysfunction
      o Sacrum or coccyx (tailbone) restrictions
      o Tension in the cranial / spinal dura mater
      o Upper Cervical Vertebral Dysfunction (C0-C3)
      o Dysfunction in the upper ribs, SC joints, and jugular foramen
• Muscular Factors
      o The Nuchal muscles – trapezius muscle, rectus capitus posterior minor, splenius capitus
      o The SCM muscle
      o Cranial Base musculature and Suboccipital Triangle
      o Occipitofrontalis muscle
      o Muscle of mastication (chewing)
• Arterial Factors
      o Intracranial arteries
      o Superficial temporal artery (pain on the top-lateral aspect of head)
      o Occipital artery (pain behind the ear)
      o Supraorbital artery (pain in the orbit and forehead)
• Venous Factors
      o Internal jugular vein (narrowing of the jugular foramen)
      o Intracranial sinuses
      o Veins in the cervicothoracic region
      o Lymphatic stasis
• Neural Factors
      o Cranial Nerve issues – CN V, IX, X, XI are commonly involved
      o Compression or traction due to increased CSF pressure, disturbed venous return at             jugular foramen

Much of the above is either not identified by conventional methods, or outright classified as being “insignificant” and not a “causal factor” in headache presentation.

Seeing the Unseen
In order to be able to address the etiology (source) of headaches/head pain, all of the above structures (and others) must be accurately assessed for “threats to function.” The above-listed structures can be assessed using sensitive palpation (touch) techniques applied to the cranium, spine, ribs, pelvis, and feet. This is part of a Manual Osteopathic Assessment. Using a highly developed sense of touch, a Manual Osteopathic Practitioner (such as yours truly) can assess tension stored in the tissue of the living cranium and throughout the somatic framework (physical human body). This type of assessment has proven particularly useful in cases where conventional diagnostics have no answer for the presentation/occurrence of symptoms (headache, etc.).

Once identified, a corrective process is initiated to help remove/release the stored tension (energy) so that the body can be free to do what the body does – self correct. That is the goal, for when the body is free of restrictions, and there is no evidence of a threat to the nervous system (central or peripheral), the Innate Wisdom of the body will handle the healing process on its own because…that is what the body is designed to do! As Rollin E. Becker, D.O., so eloquently stated, “You can only initiate treatment…all of the correction takes place between the time they leave and the next time they enter your office.”

It’s Not All Physical
In my experience, headaches/head pain can also be of biochemical and psychological/psycho-social origin. There is a myriad of nutritional factors that can contribute to headaches, including but not limited to: dysglycemia (blood sugar handling issues), magnesium deficiency, B vitamin deficiency (especially B6), copper toxicity, zinc deficiency, heavy metal toxicities, digestive issues (hypochlorhydria, endotoxicity, autointoxication, etc.), fungal/parasite infections, detoxification insufficiency, hormonal imbalance (usually related to other factors), and many others.

From a psychological/psychosocial standpoint, it is entirely possible for an individual to literally mentally stress themselves into recurrent headaches. This I know from personal as well as professional experience. There is much more that can be written here – in the interest of brevity I will leave this topic for later discussion.

What is the Action Plan?
As I have been known to say more than a few times, “Whatever it is you are dealing with, the cause is typically multi-factorial.” Meaning, it’s rarely just one thing that is the “cause” of your headaches/head pain. Yes, in the case of overt trauma to the head, whiplash mechanism/injury, concussions, etc., you are likely looking at physical issues as being the primary generator of headaches/head pain. In cases of chronic headaches/head pain in the absence of direct trauma or organic cause (tumor, etc.), one is likely dealing with several mechanisms at play. Such cases require a multi-disciplinary approach to correction.

In all cases of chronic headaches/head pain, a very thorough assessment of the structures listed in the What Causes the Pain section above is an absolute minimum requirement for recovery. Who can help you with that? A Manual Osteopathic Practitioner, such as myself, can definitely be a great place to start. However, this is not about me, and I am certainly not the only one skilled in helping those living with chronic headache/head pain. Many Chiropractors are skilled in assessment of these structures as well. A highly skilled Physical Therapist, CranioSacral Therapist, Reiki Practitioner, and all manner of Energy Workers may be able to help as well. The key is to find a Practitioner that resonates with you and with whom you are comfortable.

Always be your own health advocate. Be sure to ask your Practitioner questions – ask about their education and training, ask about their experience with cases like yours, and ask about their corrective strategy. Make sure you understand what is being done and why to at least some degree.

Also, understand the process and come to terms with the fact that one Practitioner may not have ALL of the answers (though s/he might, and that’s great too). One Practitioner may be able to help you go from 10 headaches a month down to 4, and it may take a different Practitioner to get you from 4 down to 1, and perhaps a third Practitioner to eliminate that last one headache each month. In my practice, each client offers me an opportunity to listen and learn. Once I get them to a point where I can no longer help them, I point them to the next step in the journey. That is what Life is all about – helping each other help ourselves.

Thank you for reading and it is my hope that something beneficial comes out of this article for you!

In Health & Happiness,
Brandon J. Alleman, OMP, HHP