The first thing you should know about the anatomy of a headache is that the
pain isn't coming from your brain. The brain itself is insensitive to pain and
therefore can't be a source of headaches. Almost everything else in the head and
neck can be, however, including the tissues covering the brain, the attaching
structures at the base of the brain and the muscles and blood vessels around the
scalp, face and neck.
In the case of vertebrogenic headaches, the referred pain originates in the
joints of the neck and their surrounding capsules, and travels to the head.
These joints, called facet joints, connect the seven spinal bones, called
vertebrae, in your cervical spine. (All headaches that originate in your neck,
whether myogenic or vertebrogenic, are classified as cervicogenic, meaning
cervical in origin.)
Positioned behind the vertebrae, facet joints allow for easy movement in the
spinal column and, at the same time, restrict excessive motion. The joint
capsule around each facet joint acts as a protective membrane and limits
movement between the vertebrae.
Problems that lead to vertebrogenic headaches begin when the facet joints and
joint capsules get irritated due to subluxations, trauma, abnormalities in the
cervical spine or prolonged poor posture.
This irritation can lead to inflammation in and around the facet joints and
can also irritate surrounding nerves. These irritated nerves become overexcited
and send confusing messages to the brain. When the brain receives the confused
messages, it doesn't understand that the source of pain is located only in the
facet joints in the neck. Instead, it interprets pain as originating in the
head.
For that reason, people with vertebrogenic headaches usually feel a dull,
constant pain that may begin in the neck but usually travels to the skull and
face. If these symptoms sound familiar, see your chiropractor, who can locate
irritated neck joints and implement a management plan to address
them.
Chiropractic Care
Your chiropractor can help decrease the frequency, intensity and severity of
your vertebrogenic headaches by ensuring proper joint motion and function,
maintaining optimal nervous system function and reducing muscle tension.
When you first visit your chiropractor with the condition, he or she will
probably examine your neck to find any reduced motion in the joints of your
cervical spine. In addition, he or she may also look for tight muscles or
changes in muscular tone that indicate problems. To assist in this diagnosis,
some chiropractors also take x-rays of the cervical spine to identify any
abnormalities.
To address any joint problems that are causing or contributing to your
condition, your chiropractor may perform an adjustment, also called spinal
manipulative therapy. An adjustment is a quick thrust with either the hands or a
tool called an activator that helps return motion to stuck or misaligned joints.
In addition, adjustments help relax tight muscles, stimulate the nervous system,
increase blood flow, and decrease irritation and inflammation.
Trigger point therapy is another technique your chiropractor may use. A
trigger point refers to a portion of muscle that is in a state of contracture.
In this state, the muscle fibers are shortened and tense, resulting in tight,
painful nodules or knots. Patients with vertebrogenic headaches often experience
these trigger points as a result of dysfunctional facet joints. When the joints
aren't moving properly, the surrounding muscles that attach to the vertebral
bones must work harder to facilitate movement of the spine. This makes them more
prone to fatigue and potential injury, which can lead to the formation of
trigger points.
To perform trigger point therapy, your chiropractor will press down on these
nodules, usually with his or her thumb, which separates the contracted muscle
fibers. When he or she releases the pressure, usually within 10 seconds, an
influx of fresh blood washes out irritants (like lactic acid) and brings in
oxygen, relieving pain and releasing the knot.
To prevent future muscle problems that can affect the facet joints, your
chiropractor may also recommend that you reduce stress. Stress can cause muscles
in the neck to tighten, and because of their attachment to the spine, these
tight muscles tend to pull on vertebrae, possibly leading to the joint
dysfunction that is the main cause of vertebrogenic headaches. Stress-reducing
activities, like deep-breathing exercises, aerobic exercises and stretching
exercises can help, as they release tension and relax stiff muscles.
Another technique your chiropractor might use to promote muscle health is the
application of electrical therapies like interferential current (IFC),
transcutaneous electrical nerve stimulation (TENS) and neuro-muscular electrical
nerve stimulation. These work by sending mild electrical impulses through the
skin into nerve fibers below, which causes the body to produce endorphins, its
natural painkillers. By aiming the impulses at injured or painful areas, your
chiropractor can cause these endorphins to interrupt the flow of pain signals
from the affected tissues to the brain. In addition, these impulses help reduce
inflammation and promote healing.
While ultimately such chiropractic care combined with a healthy lifestyle
will help you avoid headaches, they may not go away right away. If these are
severe, your chiropractor may refer you to your medical doctor for comanagement,
which may include the prescription of pain-relieving and anti-inflammatory
drugs.
Ultimately, however, you want to deal with more than just the symptoms. By
receiving chiropractic care for the joints and muscles in your neck, you can
help decrease the intensity of your vertebrogenic headaches. But to prevent
future occurrences, it's important that you learn about appropriate preventive
measures and alter your lifestyle accordingly.
