129! Can You Believe That?

There are more than 129 different classifications of headaches . . . But only one matters to you . . . YOURS!

Headache Demographics

•  50 million people in the U.S. experience headaches
•  28 million are plagued with migraine headaches
•  12 million suffer with chronic daily headaches
•  20% of children report living with headaches
•  157 million work days are missed due to headaches
•  $24.7 billion in costs to U.S. employers

Globally, the percentages of the adult population with active headache disorders are

•  46% for general types of headaches
•  42% for tension-type headaches
•  11% for migraines
•  3% for chronic daily headaches

On the World Health Organization's ranking of causes of disability, this would bring headache disorders into the 10 most disabling conditions.

That is why many believe there is a Headache Epidemic!

Those experiencing headaches fully understand that they can be a debilitating problem that can degrade life in various ways by

• Jeopardizing your employment and limit your lifetime earnings 
• Decreasing your potential from becoming all you could be 
• Interrupting family life in enjoyment and responsibility

Some headache terminology

1. Symptoms:  How you “feel.”  “I have a headache or I have a stomachache.
2. Source:  The cause of the symptom; Remember; a headache is a symptom.
3. Referred pain:  (which is a symptom) is felt a considerable distance from the pain source.
4. Trigger point:  Reactive soreness within a muscle which causes referred pain.

EMERGENCY headache symptoms

Sometimes a headache signals a serious underlying condition. Seek emergency evaluation if any of the features below are present:

•  Sudden onset of severe headache
•  Confusion, seizure, double vision, weakness, numbness or difficulty speaking
•  Onset after a head injury, fall or bump

What are headaches?

Headaches are defined as pain in the head or upper neck.

Types of headaches

Primary headaches

  The source for the headache is IN the head. 

Included are tension, migraine, and cluster-type headaches.

Tension-type headaches

• The most common of the primary headaches.
• As many as 90% of adults have or will have Tension-Type Headaches.
• Tension-Type headaches are defined by their frequency:

• Infrequent < 12 headaches / year
•  Frequent = 12-180 headaches / year
•  Chronic > 180 headaches / year

Migraine headaches

• The 2nd most common of the primary headaches.
• It is estimated that over 28 million people experience migraine headaches.
• Families with at least one person suffering from migraines spend about 70% more on annual healthcare expenditures, compared with migraine-free families.
•  Medication costs account for most of the increased financial toll.

Cluster headaches

• Cluster headache, nicknamed "suicide headache", is a neurological disease that involves, as  its most prominent feature, an immense degree of pain.
• They are named cluster headaches for  their periodic episodes that occur in “clusters.”
  Clusters headaches are rare affecting < 1% of the population.

Secondary headaches

The source for the headache is NOT IN the head.  Included are head and neck trauma, medication overuse, and cervicogenic (from the head) headaches.

Head and neck trauma/repetitive strain headaches

Arising from historic, recent, or current traumatic forces into the body/neck/head.  A relatively small amount of force may be required to upset and harm the small joints of the cervical spine (neck).  The following incidents can be precursors to headaches:

• Motor vehicle collisions
• Athletics (both contact and non-contact sports)
• Everyday slips and falls
• Any head trauma (concussion)
• Work incidents 
• A deconditioned body reacting to unaccustomed hard physical work 

Medication overuse headaches

Headaches are the #1 reason for an individual to take over-the-counter medication.

Many people are taking both prescription and over-the-counter pain relievers.  They do it because they don't know what else to do, are desperate, and/or are hooked. 
They're in pain, and even if they're already on a prescription, they're easily influenced by slick television commercials for medications designed to treat headaches.

Question:  If medication is the answer, shouldn’t our headaches be cured?

The Dosage Calculator/Estimator

    A calculation of the amount of medication an “average” headache sufferer takes:

Mary experiences Chronic Tension-Type Headaches. She has 15 headaches per month.  She takes
•  2 - 250mg OTC NSAIDs 2 times a day when she has a headache.  Follow along and discover how many milligrams (mgs) she has taken for her headaches:
• 2 Pills per dosage x 250 mg each pill  = 500 mg per dosage
• 500 mg per dose 2x per day = 1,000 mg per headache day
• 1,000 mg per headache day x 15/month = 15,000 mg per month
• 15,000 mg per month x 12 months = 180,000 mg per headache year
• 180,000 mg per headache year x 7 years = 1,260,000 total milligrams!
• 1,260,000 milligrams - are you kidding?

That is the equivalent of almost 3 pounds of pain killers!

Question:  If 1,260,000 milligrams didn’t “cure” Mary’s headaches…how many more milligrams will will it take to "fix" her headaches or will she by choice stay on the old merry-go-round?

So if medication doesn’t cure headaches - as we have seen in Mary’s case, and quite possibly your own case - what does the medication do to the headache? 

Medication covers up the superficial symptoms of the headache.   It’s as simple as that.

MEDICATION DISCLAIMER

1. Do not stop any medication without first speaking to the doctor that prescribed that medication.
2. I am not in any way whatsoever anti–all medications.  Some medications are life saving (including mine).  I am opposed to the mindset that all of society’s problems can be overcome by popping a pill, especially over-the-counter pain medication.  Just look at the numbers of visitors to the emergency department due to pain-killer overdoses or addiction.

Cervicogenic headaches

• Cerviogenic headaches originate from the cervical spine (neck).
• Cervicogenic headaches comprise over 14% of all headaches.

• “The concept that headache pain can emanate from cervical dysfunction is still completely foreign to most of the medical profession.”
Nikolai Bogduk, MD, PhD, Professor of Anatomy, Director,
Newcastle Bone and Joint Institute, Newcastle, Australia.

Source vs. Symptom

The key factor in treating any condition, headaches included, is to uncover the source of the condition - not merely the symptoms of the condition.  Dr. Robert E. Berry, Orthopedic Surgeon.

“When Medicine Makes Headaches Worse”

Overusing painkillers actually lowers the level of serotonin, a chemical in the brain.  A decreased level of serotonin can change how a person experiences pain.  Dr. Seymour Diamond, chairman of the National Headache Foundation.

Over-the-counter medications containing aspirin, acetaminophen (such as Tylenol), and Ibuprofen (such as Advil) can all cause rebound headaches.

However, overuse of medications that combine these painkillers with caffeine, such as Excedrin or Anacin, are even more likely to cause a problem.

The transformation of an intermittent headache to a daily headache often results from the overuse of over-the-counter or prescription pain relievers.

"Sufferers of rebound headaches can gradually get to the point where they are taking staggering doses of painkillers.  We see patients who use upwards of 10 to 20 tablets per day.  My all-time record holder was a patient taking 35 Excedrin a day!  I simply don’t know how he tolerated them."  Timothy R. Smith, MD, RPh, Medical Director, Mercy Health Research, St. John’s Mercy Medical Center, St. Louis.

Posture and Headaches

Posture has a significant impact on your headache profile.

Spinal pain, headaches, blood pressure, pulse, and lung capacity are among the functions most easily influenced by posture.  American Journal of Pain Management.

Making the Case for Chiropractic Care

With stress and pressure added to the neck and upper back, the muscles, ligaments, bones, and discs can lead to referred pain that is FELT in the HEAD.

1. Duke Study (Duke University Evidence-Based Study, 2001).
Spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and longer-lasting relief of tension-type headaches than a commonly prescribed medication.

2. JMPT (Journal of Manipulative Physio. Therapeutics 1995 18(3):148-54).
Found that spinal manipulative therapy is an effective treatment for tension headaches.

3. JMPT (Journal of Manipulative Physio. Therapeutics 1998;21(8):511-9).
“Spinal manipulation should be considered a treatment option for patients with frequent migraine headaches.”

4. Spine (Hurwitz. Spine 1996;21:1746-1760).
Almost without exception, chiropractic manipulation of the neck was found to be superior in terms of reducing tension headache frequency, intensity, and improving functional status of patients when compared to other standard medical treatments.

5. Headache (Featherstone HJ. Headache 1985;25:194-8).
Although migraine and tension type headaches are generally considered to be separate conditions, there is support in the literature that they represent a continuum with several common underlying mechanisms including cervical spine dysfunction.

Revealing Comments from Front-Line Scientists

“Overall, chiropractic has the advantage of reducing pain, decreasing medication, and requiring fewer passive modalities.”
Andrew Cole, MD, Associate clinical professor of Rehabilitation Medicine, Univ. of Washington.

"Orthopedics Today" recently praised Chiropractic with the article, “Time to Recognize Value of Chiropractic Care, Science and Patient Satisfaction Surveys Cite Usefulness of Spinal Manipulation.”

“There are a lot of myths about chiropractic care. I decided to look into each of these myths, and what I found is that chiropractic education, side-by-side, is more similar to medical education than it is dissimilar.
Jack Zigler, MD, Orthopedic Spine Surgeon, Texas Back Institute.

“Chiropractic spinal adjustments have consistently been accepted by independent government and scientific bodies as being a valid form of treatment.”
Scott Haldeman, DC, MD, PhD.