Headaches are a common source of pain for a large number of Americans.  95% of women and 90% of men have had at least one in the past 12 months.  And for about 45 million of us, those headaches are chronic.

While a wide variety of over-the-counter and prescription medications have been developed to relieve this pain, they generally do little to address the underlying cause of the problem.  In addition, many of these compounds can have unwanted side effects, particularly if they’re used often, over a prolonged period of time or in combination with other medicines.  A growing awareness of both the limitations and risks of pharmaceuticals has led many headache sufferers to explore alternative approaches to managing them, including chiropractic.

Understanding Headaches

Headaches occur for many reasons and can vary greatly in their intensity and duration.  They may arise on their own (these are termed “primary headaches” and account for about 90% of all headaches) or be triggered as a result of some other health condition (described as “secondary headaches”).  Chiropractic physicians most commonly encounter three types of headaches in their work.

• Tension headaches are primary headaches that are brought on by unrelieved muscular contractions in the head, neck and shoulders, usually as a result of stress that cannot find an outlet.  These muscular contractions can themselves become the source of broader tension and stress throughout the body, setting in motion a feedback loop that eventually produces a headache.

• Migraine headaches are also primary headaches.  They are sometimes referred to as vascular headaches because they happen when blood vessels in the head suddenly expand, or “dilate”.  However, we know that the nervous system and genetic factors are also leading contributors.  Sufferers report a wide range of triggers and related symptoms.  Research into the exact cause of migraines is ongoing, and the condition has stubbornly resisted efforts to find a pharmaceutical “silver bullet”.

• Cervicogenic headaches are secondary headaches produced when pain begins in the neck or back of the head and is referred to the forehead or the area behind, in and around the eyes.  Trauma, chronic tension and disease are some of the more common initial sources of neck pain that is referred to the head.  Trigger points in the neck, shoulder blade and spine may also be sources of these headaches, though they can be much more difficult to identify.

How Chiropractic Can Help

There is a large and growing body of medical research that suggests chiropractic care can be effective in preventing or reducing the frequency and severity of primary headaches.  There is also some evidence that it may have benefits for cervicogenic headache sufferers.

Chiropractic manipulation of the spine and neck is used to improve the alignment of the spine and relieve muscle tension.  It also reduces nerve irritation and improves vascular flow.  Your chiropractic physician may also include massage and other therapies as part of a well-rounded treatment plan.  He or she will likely suggest exercise, stretching and relaxation techniques as well as nutritional strategies designed to help prevent future headaches.

If you or someone you know is looking for lasting relief from chronic headaches, we encourage you to call your doctor of chiropractic today.  The sooner you make the call, the sooner we can help you put an end to the suffering.

Headaches and Chiropractic.  American Chiropractic Association.  Accessed August 2011.

http://www.acatoday.org/content_css.cfm?CID=2186

Encyclopedia of Alternative Medicine.  AltMD.  Accessed August 2011.

http://www.altmd.com/Articles/Headache–Encyclopedia-of-Alternative-Medicine

Information for Patients.  American Headache Society.  Accessed August 2011

http://www.achenet.org/education/patients/index.asp

Research Spotlight:  Study of Spinal Manipulative Therapy for Neck-Related Headaches Reports Findings on Dose and Efficacy.  National Institutes of Health, National Center for Complementary and Alternative Medicine.  Accessed August 2011.

http://nccam.nih.gov/research/results/spotlight/041310.htm

National Institutes of Health MedlinePlus.  Accessed August 2011.

http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm

What is Sciatica?

Many people use the term sciatica incorrectly. Sciatica is pain along the path of the sciatic nerve which extends from the lower back down each leg. Sciatica is a symptom (like itching), it is not a diagnosis (like Parkinson’s disease). Sciatica can range from an occasional nuisance to excruciating pain that makes walking near impossible. There can be multiple underlying reasons for your sciatic nerve pain. A chiropractor can help find the root cause of the problem with an exam and may also order some diagnostic imaging such as an x-ray, MRI or CT scan to examine the underlying structures.
To answer the question, ‘what is sciatica’ it is helpful to explain some of the relevant anatomical structures. The sciatic nerve is both the longest and the widest nerve in your body. It begins in the lower back as five separate nerves that extend from five different vertebrae – L4, L5, S1, S2, and S3. These nerves meet up to form one large bundle which runs through the buttocks and down the entire length of the leg. The sciatica nerve is responsible (directly or indirectly) for nearly all the sensation in your leg including the skin of the thigh and gluts.
Sciatica occurs when there is compression or irritation of the sciatic nerve. The pain is felt in the low back and leg, but the site of the pain isn’t always the site of the underlying issue. Since the sciatica nerve is so long and travels around or through the large muscles of the buttocks, it takes an expert to determine if the pain is coming from disc compression, from muscle spasms or from something else. Again, sciatica is a symptom, not a diagnosis.
While sciatica is most often associated with pain, other symptoms may be present such as tingling, numbness, or muscle weakness. The pain can be nearly constant or intermittent. If you think you are experiencing sciatic nerve pain, keep a record of the location, duration and intensity of the pain. Your specific history plays an important role in determining the cause of the pain.
Treatment for sciatica depend on the underlying cause, so there is no one recommended course of treatment for all sciatic pain sufferers. Chiropractors use a variety of non-invasive approaches that include spinal manipulation, physical therapy, targeted stretching and active muscle release. They’ll also discuss the role that nutrition and hydration play in reducing tissue inflammation and keeping discs healthy. The spine, discs, muscles and soft tissue all have a role to play in sciatica and should be evaluated and treated as a connected system.
The most important thing to take away from this article is that sciatica (sciatic nerve pain) is a symptom of an underlying condition. You’ll only start to get better once the underlying condition is identified and this is done through a combination of an exam, history and recommended diagnostic imaging.

Pain coming from compression or irritation of the sciatic nerve is called sciatica. Sciatica – which can include pain,
tingling, numbness and muscle weakness – is really a symptom indicating an underlying problem, not a diagnosis in and
of itself. This article will explore in detail the findings of a recent controlled study
comparing spinal manipulation (chiropractic) and surgery for people whose sciatica did not respond to traditional medical treatment approaches. The study discussed here was conducted by the National Spine Center in Alberta Canada and
published in October of 2010 in the Journal of Manipulative and Physiological Therapeutics1. The
40 study participants all had sciatica lasting over 3 months which had not responded to
treatment with pain medications, lifestyle modifications, physical therapy, massage therapy or
acupuncture. They had all been referred by their primary care physicians to spinal surgeons who
had deemed them appropriate surgery candidates. Instead of having all the patient proceed with surgery, they were split into two groups – one group to undergo a surgical microdiscectomy and the other group to be treated with
standardized chiropractic spinal manipulation by a single chiropractor. (If not satisfied with the
results they obtained from their assigned method, the patients were allowed to switch to the
other treatment plan after 3 months.)
So what happened? Both groups made significant improvements over baseline scores – meaning
that they saw noticeable improvements whereas previous approaches had failed. A full 60% of
the study participants benefitted from chiropractic spinal manipulation to the SAME degree as if
they underwent surgery. And, after l year there was no difference in outcome success based on the treatment method. That means that a full 60% of people referred for surgery by their
primary care physicians and accepted as surgical candidates by the neurosurgeon could
actually get similar results with chiropractic. That is a lot of potentially unnecessary cutting,
anesthesia and ER time.
There is one paragraph in the results section of this study that is easy to overlook, but incredibly
important. There were originally l20 candidates of which 60 met the study criteria and were
asked to participate. Of these 60, 20 refused. Why? Because they had never been offered spinal
manipulation as an alternative to surgery! They didn’t want to participate in the study and be
randomly placed in the surgery group without first trying the spinal manipulation! This is
incredibly telling. Not only does it demonstrate that there is still a lot of education about
chiropractic that needs to happen among the public and among primary care providers, it also
demonstrates that people understand the risks and costs of surgery and want to exhaust other
possibilities first.
This was the first study to ever look at people who had failed traditional medical management
of sciatica. Currently most patients that fail ‘conservative care’ are referred for a surgical
evaluation. Now we know that 60% of these folks could avoid surgery and get similar long-term
outcomes with chiropractic.
Please share this article with anyone considering surgery for sciatica.

1 McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ., Manipulation or microdiskectomy
for sciatica? A prospective randomized clinical study. J Manipulative Physiol Ther. 2010;
Oct;33(8):576-84.