What Are Cervicogenic Headaches?

Headaches are a very common problem that can have multiple causes ranging from stress to trauma.  To make matters worse, there are MANY different types of headaches. One such type is the “cervicogenic headache” (others include migraines, cluster headaches, etc.).

The main distinction between the symptoms associated with cervicogenic headaches and those associated with migraine headaches are a lack of nausea, vomiting, aura (a pre-headache warning that a headache is about to strike), light and noise sensitivity, increased tearing with red eyes, one-sided head, neck, shoulder, and/or arm pain, and dizziness. The items listed above are primarily found in migraine headache sufferers.   The following is a list of clinical characteristics common in those struggling with cervicogenic headaches:

Headache

  • Pain is localized or stays in one spot, usually the back of the head, frontal, temporal (side) or orbital (eye) regions.
  • Moderate to severe pain intensity.
  • Intermittent attacks of pain that last hours to days.
  • Pain is usually deep, non-throbbing, unless migraines occur at the same time.
  • Head pain is triggered by neck movement, sustained
  • Unilateral (one-sided) head or face pain (rarely is it on both sides).
  • awkward head postures, applying deep pressure to the base of the skull or upper neck region, and/or taking a deep breath, cough or sneeze can trigger head pain.
  • Limited neck motion with stiffness.

Infrequently, the cervicogenic headache sufferer can present with migraines at the same time and have both presentations making it more challenging to diagnose.

The cause of cervicogenic headaches can be obvious such as trauma (sports injury, whiplash, slip and fall), or not so obvious, like poor posture. A forward head posture can increase the relative weight applied to the back of the neck and upper back as much as 2x-4x normal. Last month, we discussed the intimate relationship between the upper two cervical vertebra (C1 & C2) and an anatomical connection to the covering of the spinal cord (the dura) as giving rise to cervicogenic headaches. In summary, the upper three nerves innervate the head and any pressure on those upper nerves can result in a cervicogenic headache. Doctors of chiropractic are trained to examine, identify, and treat these types of potentially debilitating headaches.

Chiro-Trust.org

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Chiropractic and Obesity

Chiropractic methods are traditionally sought after for pain relief for neuromusculoskeletal conditions or from pain arising from the nervous and musculoskeletal systems. But in the tradition of chiropractic, the WHOLE PERSON is cared for, not just a select region of pain. For example, when a low back pain patient first comes to the office, their history form includes detailed information about their overall health, not just their chief complaint (eg. “low back pain”). A thorough case history form will ask about past accident history, past hospitalizations, current medication list, family and social histories, occupational history, habit history, and a review of all the body’s systems (cardiovascular, respiratory, endocrine, EENT, genitourinary, skin, digestive, blood/lymphatic, and more). Doctors of chiropractic treat the WHOLE person so when obesity is present in a patients, they see treating it as part of the healing process. Granted, the main focus is usually given to the primary or chief complaint, but we must look at all the reasons as to why the low back hurts, especially since, in MOST cases, the cause of low back pain (LBP) is multimodal (there is more than one single cause), though the LAST activity prior the back “…going out,” typically gets the blame. Also, most of us who have had LBP have had it more than once. In fact, most studies report that if you’ve had LBP in the past, you can EXPECT to have it again. That is why your doctor will examine and identify ALL the possible reasons as to why the back was injured and manage everything they can.

ChiroIn addition to all the historical information gathered, a family history of obesity is very relevant in these cases. Also, thyroid deficiency can make weight loss next to impossible since it regulates our metabolic rate and when sluggish, we simply can’t break down fat efficiently and fluid is usually retained (another cause for weight gain). Your doctor of chiropractic may ask what you and your family typically eat. Is it “fast food” or does it consist of whole foods in a well-balanced diet? How about snacking habits? These can “undo” a lot of good if there are abuses in that department. Chiropractors will often integrate exercises into the treatment plan as regaining flexibility, strength, stamina, and coordination ALL help, not only the LBP, but also allows for aerobic activity to be better tolerated and enjoyed. If you experience pain every time you get up to walk, you will react by modifying or stopping that activity.

To continue the example above, doctors of chiropractic will look at all possible causes for low back pain and address things like a short leg, flat/pronated feet, knee, hip, and pelvic issues as all of these can affect the frequency, intensity, and duration of LBP. These possible issues can also impede one’s efforts to exercise, and in fact, may worsen every time they try. Your doctor must FIRST reduce the “cause” of the LBP by decreasing inflammation (“RICE”: rest, ice, compress, elevate). He or she will manipulate within the patient’s tolerance to restore spinal and extremity joint function so exercises do NOT hurt.

They can then guide the patient in the process of integrating exercises into their lifestyle GRADUALLY so he or she can identify any exercise that may be too much for them at that particular time. Of course, nutritional consulting with diets that may include calorie counting / restriction diets, the “Paleo” or caveman diet, low carbohydrate diet, and many other options will be considered. Discussing what the patients has tried in the past that seemed to work, as well as those approaches that failed, is important so they don’t waste time.

Chiropractors WANT to help patients find ways that can be continued for the long-term that they like, that make sense, and that work. THEN, the patient can be in control of their weight, their low back pain, and their lives.

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Chiropractic Adjustments vs. Acupuncture vs. NSAIDs

Wouldn’t it be nice if we could assess three common types of treatment for neck and back pain to determine which is the most effective? Here is a look at three studies that compared three popular forms of care for chronic spinal pain to determine the short-term and more importantly, the LONG-TERM benefits of chiropractic manipulation, acupuncture, and non-steroid anti-inflammatory drugs (NSAIDs, like Advil).

The FIRST published study included a pilot group of 77 patients complaining of chronic spinal pain (neck, mid-back, or low-back pain). These patients were separated into one of the three treatment groups and received either NSAIDs, acupuncture, or chiropractic manipulation. Patients received care for four weeks with outcome measures (questionnaires) used to assess changes in pain and disability. After a 30-day time frame, only patients who received chiropractic manipulation (CM) reached a level of statistically significant improvement, supporting CM to offer the best SHORT-TERM BENEFITS for those with chronic back/neck pain.  Spine Pain

The SECOND study included 115 patients, again randomized, to receive either one of the same three treatments, but this time the outcome data was gathered two, five, and nine weeks after the start of treatment. Again, those who received chiropractic manipulation (CM) experienced the best overall improvement at nine weeks.

The THIRD study involved follow-up from the same patient group from the SECOND study two years later. Once again, participants completed outcome assessments that measure pain and disability. This time, the results showed that only patients in the chiropractic manipulation group maintained long-term improvements in pain and disability.

There have been other studies looking at the efficacy and benefits of SMT (spinal manipulative therapy) both in comparison with other forms of care (as presented here) as well as with different conditions or diagnoses. Perhaps the most exciting results were published in 2008 by the International Bone and Joint Decade 2000-2010 Task Force on Neck Pain.

They divided patients into four groups (Group 1: Neck pain with little to no interference with activities of daily living – ADLs; Group 2: Neck pain that limits ADLs; Group 3: Neck pain with radiculopathy or radiating arm pain from a pinched nerve; Group 4: Neck pain with serious pathology such as cancer, fracture, infection, and/or systemic disease.)

The researchers concluded that chiropractic care was highly recommended especially in Grades 1 and 2 (which includes the majority of neck pain sufferers). Interestingly, many multidisciplinary physician groups now incorporate chiropractic care as part of their “team” approach, which also offer pain management in the form of medications, injections, PT, and when necessary, surgery. They have seen the value of spinal manipulation for neck pain and often seek out chiropractic because it’s safe, beneficial, and cost effective.

Chiro-Trust.org

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Can Pregnant Women Receive Chiropractic Care?

Pregnancy is a beautiful experience, and we all want to provide the best environment for both mom and baby. The question of whether or not chiropractic care is safe during pregnancy is frequently raised by the newly-expectant mother as she plans for a healthy pregnancy. Chiropractic care during the nine-month time frame is a common practice, as many moms require professional care for biomechanical complaints (most notably back pain) or they simply want to feel “their best.”

A “normal” pregnancy is defined as “about 40 weeks, ranging between 37 and 42 weeks from the point of fertilization to delivery.” It’s the “norm” NOT to know exactly when fertilization happens, so we typically calculate the expected gestation period from the point of the woman’s last normal menstrual period. During the first trimester (the three-month period starting on the first day of the last menstrual period through the thirteenth week), the fertilized egg implants into the womb. This period of time is usually asymptomatic unless morning sickness occurs. Because the mom is often unaware of being pregnant, medication use and alcohol intake should be carefully watched FROM THE MOMENT SHE STARTS TRYING TO BECOME PREGNANT!

During the second trimester (the fourteenth to the twenty-seventh week), most women feel GREAT! No more morning sickness, increased energy, and by now, fetal movements are a pleasured sensation! Ultrasound during this time will be able to detect any problems, as well as identify the child’s sex.

chiropractic-during-pregnancyThe third trimester starts at the twenty-eighth week and finishes with the birth of the child. As the baby grows to fill the womb, the mom usually becomes more uncomfortable, especially in the last two to three weeks when the contractions begin that are needed to move the child down into the birth canal in preparation for birth. A vaginal delivery usually occurs within 24 hours of labor, and if labor does not occur by week 42, it may be induced by using medications that purposely initiate labor (such as pitocin).

With this as a foundation, chiropractic offers the pregnant mom many benefits. First regarding safety, a 2009 literature review found 33 references on this subject and concluded the results revealed a favorable outcome regarding the use and safety of chiropractic care throughout pregnancy. The authors concluded that chiropractic is a safe and effective means of treating common musculoskeletal complaints that often affect pregnant women. The use of chiropractic includes (but may not be limited to): making the pregnant mom feel more comfortable during her pregnancy, helping to facilitate an uncomplicated labor and delivery process, and to help control low back, mid back, and/or neck pain during the nine-month process. They reported that 50% of all pregnant women experience back pain during their pregnancy and 50-75% experience back pain during labor. The study points out that only 21% of pregnant women with back pain consult their medical physician about it. More than seven out of ten expectant mothers in a study who sought chiropractic treatment for back pain benefited from care. There are also special techniques some chiropractors are certified in such as the “Webster Technique” in which pediatricians and midwives will frequently refer the pregnant mother to a certified DC to move the fetus from a breach position to a head down (proper) position.

 
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How Does Chiropractic Work?

Many people seek chiropractic care when their back goes out or their neck tightens up. But how does this form of care actually work? What are the benefits of receiving chiropractic care for nerve dysfunction compared with other healthcare options?

Let’s take a look!

First, let’s discuss how the nervous system “works.” We have three divisions of the nervous system: the central, peripheral, and autonomic nervous systems. The central nervous system (CNS) includes the brain and spinal cord, and it’s essentially the main processing portion of the nervous system. The spinal cord is like a multi-lane highway that brings information to the brain for processing (sensory division) and returns information back to the toes, feet, legs, and upper extremities from which the information originated (motor division). For example, hiking on a mountain trail or simply walking requires constant input to and from the CNS so we can adjust our balance accordingly and not fall. These “sensory-motor pathways” are essential and allow us to complete our daily tasks in an efficient, safe manner as information is constantly bouncing back and forth between the brain and the rest of the body.

The peripheral nervous system (PNS) includes a similar sensory/motor “two-way street” system relaying information back and forth from our toes/feet/legs and fingers/hands/arms to the spinal cord (CNS). And if this isn’t complicated enough, we also have “reflexes” that, for example, allow us to QUICKLY pull our hand away from a hot stove to minimize burning our fingers.

Reflexes allow the information to “skip” the brain’s processing part so quicker reactions can occur. The autonomic nervous system (ANS) includes the sympathetic and parasympathetic divisions that basically “run” our automatic (organ) functions like breathing, heart rate, digestion, hormonal output, and more. There is constant communication between the ANS, PNS, and CNS that allow us to function in a normal, balanced way… unless something disrupts them.

There are obvious conditions that interfere with this communication process that include (but are not limited to) diabetes (with neuropathy), frost bitten or burned fingers, peripheral nerve damage from conditions like carpal/cubital tunnel syndromes, thoracic outlet syndrome, and/or pinched nerves in the neck, mid-back, low-back spinal regions, as well as conditions such as multiple sclerosis (MS), Guillain-Barre Syndrome, after a stroke (spinal cord or brain), and after trauma with resulting fractures where nerve, spinal cord, and/or brain damage can occur. These are “obvious” reasons for delayed or blocked neurotransmission.

chiro-Deal-Cuda-chiropractic-care

There are many other less obvious injuries or conditions that can result in faulty neuromotor patterns and nerve transmission of which chiropractic services can benefit. The “subluxation complex” is a term some chiropractors use to describe the compromised nerve transmission that may occur if a nerve is compressed or irritated due to faulty bone or joint position along the nerve’s course. Reducing such nerve compression typically allows for a restoration of function. A good illustration of this is a patient who suffers from a herniated disk in the neck with numbness and tingling down the arm to the hand. The goal of treatment (for all healthcare professionals) is to remove the pinch of the nerve.

To realize this goal, doctors of chiropractic utilize spinal manipulation and mobilization in addition to other non-surgical, non-drug approaches that may include exercises, nutritional advice, home-care such as a cervical traction unit, and other anti-inflammatory measures (ice, modalities like low level and class IV laser, electric stimulation, pulsed magnetic field, and more). Given the minimal side-effect risks and well-reported benefits, it only makes sense to try chiropractic FIRST and if you’re not satisfied, your doctor will help you find the next level of care.

Chiro-Trust.org

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Balance & Dizziness – Chiropractic can Help

Many people seek chiropractic care for low back, mid-back, neck pain, and pain in the extremities, but what about balance and/or dizziness, as they often go together? Can chiropractic management help people suffering from frequent falls due to balance and/or dizziness problems?

Let’s take a look!

When considering treatment for balance, we must talk about the “proprioceptive system.” The way the body “communicates” between all the various body parts is by proprioceptors—which are located in skeletal muscles and joint capsules—that relay information to the brain. This information from the various body parts is then integrated with incoming information from the vestibular system (inner ear). The brain also relies heavily on the cerebellum located in the back of the head, which is largely responsible for coordinating the unconscious (automatic) aspects of proprioception.

The ability to maintain balance, such as when standing on one leg (eyes open and closed), is dependent on the ability for ALL THREE of these systems to work properly, and like any other skill, “…practice makes perfect!” Please try standing on one leg and then shut your eyes. Can you feel your ankle, foot, leg, and the rest of your body struggle to keep you balanced?anatomy-ear-27154624

For those of us under age 60, it’s “normal” to be able to balance on one foot with eyes closed for 25 seconds (or 10 and 4 seconds if you are between 60-69 or, 70-79 years old, respectively)! Scary, isn’t it? But don’t feel bad, as most of us can’t do this at first. With practice and the right exercises, you will be able to do it. Your “kinesthetic sense” CAN BE improved, and your doctor of chiropractic can guide you in the process. So, how does dizziness fit into this picture?

Let’s talk about the ear!

Our ears have two jobs: hearing and balance.

The outer ear catches sound and funnels it to the eardrum which vibrates and moves three little bones that transmit the information to the cochlea and finally to the brain allowing us to hear sound.

Deep inside the ear is the “vestibular apparatus,” which is the organ of equilibrium that assists in balance. Here, three semi-circular canals are filled with fluid and two sac-like structures located at the base called the utricule and saccule. The fluid in the canals flows past little hair-like structures that are connected to nerves that relay information to the brain, telling it where we are in space (horizontal—laying down, vertical—standing) and if we’re moving forwards/accelerating or moving up/down (like in an elevator).

There are little tiny “stones” in these two sacs that move the little hair-like structures but they can dislodge into the canal and alter the flow of fluid (like a rock sticking out of a flowing river creating eddy currents), which alters the direction the little hairs bend, resulting in vertigo or dizziness as the brain is receiving conflicting information from the hairs bending in multiple/different directions.

This is called “BPPV” (benign paroxysmal positional vertigo), which is brief episodes of vertigo immediately following a change in head position such as rolling over in bed, getting up from sitting or laying, etc. This is the most common cause of vertigo.

If you Google “BPPV,” you will find different exercises that can move these little stones back into position (Brandt-Daroff and Epley’s maneuver), both of which work well often within a day or two. This is a good place to start, and if the balance/dizziness (vertigo) doesn’t improve, then you should consider other possibilities such as inner ear inflammation or acute vestibular neuritis, Meniere’s disease, vestibular migraine, acoustic neuroma, blood pressure issues, medication side effects, and more. Your chiropractor can teach you the Benign Paroxysmal Positional Vertigo (“BPPV”) exercises and perform cervical adjustments, which can also help significantly.

Chiro-Trust.org

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Chiropractic and Leg Length

Chiropractic and Leg Length

Because the spinal cord is housed by the spine and the exiting nerve roots communicate with the autonomic nerves that basically run our organ function, maintaining alignment of the spine and pelvis is very important to minimize nerve irritation and subsequent health-related problems. The focus of this article is on leg length, its effect on our posture, methods of assessment, and treatment.

Lansing Chiropractic Clinic Front Desk

Leg length plays and important role in posture. When there is a difference in leg length, the pelvis cannot maintain a level position, and because the spine’s base is the pelvis, it cannot stay straight if there is a leg length discrepancy.

Doctors of all disciplines realize the importance of leg length, especially orthopedic surgeons as they consider a hip or knee replacement! There are many causes of leg length issues, and some include a genetic predisposition (inherited) or trauma during bone growth years.

From a treatment standpoint, a heel lift (with or without arch supports) can be placed into the shoe on the short leg side. Unfortunately, there is not a 1 to 1 mm correction of the leg length deficiency with heel lifts. In adults, it has been reported that about a 66% correction occurs, which means a 10 mm lift would result in around a 6.6mm leg length deficiency correction.

Many doctors have found that it is usually wise to GRADUALLY increase the amount of heel lifting, and so patients often start with a 5mm lift and at one week intervals, increase it to the next height, such as 7mm, followed by 9mm, and so on. At 12mm (0.5”), problems with the heel lift being pushed out of the shoe and/or sliding forwards in the shoe may prohibit the use of these thicker lifts after which point the bottom of the shoe can be built up by a shoe cobbler (some services can be found online as well).

Chiro-Trust.org

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For the health of your loved ones… choose chiropractic.

The professionals at my clinics, Lansing Chiropractic Clinic & Wellness Medical recognize that you have a choice when it comes to your preferred chiropractor.

A 7-year study (Journal of Manipulative and Physiological Therapy, May 2007)showed that patients whose primary physician was a chiropractor, experienced the following.

  • 60% less hospital admissions
  • 59% less days in the hospital
  • 62% less outpatient surgeries
  • 85% less in pharmaceutical costs

That’s why we want you to be as relaxed and informed as possible about our practice: #muscle, #bone, #joint, connective tissue health issues, and treatment options.
Whether you are suffering from back pain, neck pain, wh14237567_10154950384325016_83062962817660871_niplash, carpal tunnel, migraines or chronic headaches, we’ve created an information-rich website chirolansing.com to give you 24/7 access to an array of the most common chiropractic topics.

– Eighty percent of Americans experience one form of Back Pain or another during the course of their lives. More men over the age of 45 are disabled by back pain than any other condition. It is the third most common reason for surgeries. Because of this, people complaining of back pain cannot be easily diagnosed. This is because the spine is such an incredibly complex structure of bones, muscles, nerves, joints, tendons, and ligaments. Injury or disease affecting any one or more of these structures can often trigger an episode of pain.

The more you know, the more comfortable we hope you and your family will be with our practice.  Make your first step to better #health, call us today to set up an #appointment. 708-895-3228.


Other Studies by leading medical journals in recent years have confirmed the benefits of chiropractic care:

  1. A 1993 report by the Ontario Ministry of Health concluded that chiropractic care was the most effective treatment for lower back pain. The agency also recommended that chiropractic care be fully integrated in the Canadian government’s health care system.
  2. In 1994, the federal Agency for Health Care Policy and Research published its Clinical Practice Guidelines, which asserted that spinal manipulation was effective in reducing pain and speeding recovery among patients with acute low back symptoms without radiculopathy.
  3. A 1996 New England Journal of Medicine study of outcomes and costs for acute low back pain found that patients treated by chiropractors were significantly more satisfied than those who saw primary care, orthopedic or managed care practitioners.
  4. A 1996 study in the journal Spine echoed that study and found that patients who sought chiropractic care were more likely to feel that treatment was helpful, more likely to be satisfied with their care, and less likely to seek care from another provider for the same condition, compared to those who sought care from medical 14317420_10154950396340016_7730302894750604186_ndoctors.
  5. In 2001, the Center for Clinical Health Policy Research at Duke University concluded in a study that spinal manipulation resulted in almost immediate improvement for cervicogenic headaches, or those that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.
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What’s a Herniated Disc, Pinched Nerve, Bulging Disc…?

There are many terms used to describe spinal disc problems, but it is best to focus on an understanding of the medical diagnosis. This article clarifies common disc conditions such as a herniated disc, pinched nerve, and degenerative disc disease.

Source: What’s a Herniated Disc, Pinched Nerve, Bulging Disc…?

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Acetaminophen

Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009.

With 100,000-plus hospital visits a year by users, it’s also the most likely to be taken inappropriately.

In fact, improper use, coupled with the drug’s narrow safety margin, means “a large fraction of users [are] close to a toxic dose in the ordinary course of use,” according to the Food and Drug Administration.

But for the sake of discussion, let’s ignore the safety issues for a moment. Is acetaminophen an effective pain reliever in the first place? Not for low back pain and pain attributable to knee / hip osteoarthritis, conclude the authors of a recent meta-analysis. The just-published review of 13 randomized trials has yielded “high-quality evidence” that paracetamol (acetaminophen) does not reduce pain intensity or disability, and does not improve quality of life, in the short term for people experiencing LBP; and provides only “minimal, short-term benefit” for people suffering from hip or knee pain caused by OA, stating that “the small effects … are not likely to be meaningful for clinicians or patients.”

Back to the safety issues surrounding acetaminophen, which the meta-analysis did little to dilute. According to the review researchers, “high-quality” evidence suggests paracetamol use results in a fourfold risk of an abnormal liver function test. Not surprising, since acetaminophen misuse (overdose) is now the most common cause of acute liver failure (exceeding all other medications combined) and the second most common cause of liver failure requiring transplantation.

In fact, the FDA has mandated that all acetaminophen-containing prescription products feature a “black box” warning (the administration’s strongest safety statement) noting an overdose can cause liver failure and even death; and have been urged to place similar language on OTC acetaminophen products.

How often do you use acetaminophen-containing over-the-counter and/or prescription medications for you LBP and OA pain, even as you pursue relief through chiropractic care?

How often do you take these drugs for your spinal / OA pain instead of visiting a chiropractor?

As this meta-analysis suggests, acetaminophen is ineffective for these types of pain. So give chiropractic a try – a proven natural pain reliever.

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Acetaminophen

By Editorial Staff – source: newsletter.html?articleId=2110

Resources:

Machado GC, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised, placebo-controlled trials. Brit Med J, 2015;350. Full text available online.
Dal Pan GJ. “Acetaminophen: Background and Overview.” FDA Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, June 29, 2009.
Greenlaw E. “Your Guide to Over-the Counter Pain Relief. OTC Pain Relief: Understanding Acetaminophen.” WebMD.com.
Healy M. “Acetaminophen in Rx Drugs: For Liver’s Sake, Lower the Dose.” Los Angeles Times, April 28, 2014.
Gerth J, Miller TC. “Use Only as Directed.” ProPublica, Sept. 20, 2013.

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