Headaches
WHY SEE AN OSTEOPATH FOR HEADACHES?At a recent meeting of forty osteopaths, the speaker (a G.P with a special interest in headaches) described types of headache and asked us to move to whichever corner of the room best described the headache we experience. By the time we had all moved only two people remained in the centre of the room i.e. only two people out of forty felt that they do not suffer from headaches. The lecturer told us that this was fairly representative of the population as a whole. So why see an osteopath for headaches?
Headaches are rarely simple. Consider the diagnosis “classic tension headache”. Where does the tension come from? Is it work stress? Emotional stress? Postural stress? Or simply “distress” caused by a mixture of all of the above? Establishing the cause/type of headache is key to being able to suggest an appropriate strategy for management. Many headache sufferers find osteopathic treatment helpful providing that their headaches are not due to conditions that fall beyond the scope of osteopathic treatment.
There are no diagnostic tests for tension headaches; the crucial tool for diagnosis is taking a detailed case history. Osteopaths are trained to listen to the patient’s story carefully, ask the right questions and screen out patients who present worrying symptoms that may necessitate an urgent referral.
When someone consults an osteopath, in addition to taking the history, an examination is performed and the information gathered is used to make a judgement on whether this individual’s headaches are likely to respond to osteopathic treatment.
The common diagnosis of stress or tension type headaches is often reached when there are no other obvious causes and when the symptom picture is consistent with tension arising in the muscles under the base of the skull. However having a label does not always help the patient understand the mechanism that has created the muscular tension or how to help the pain other than to take pain killers. The vast majority of the public who are given a diagnosis of tension headache are likely to believe that this equates to being stressed. This may not be the whole picture. Take for example the case of an office worker who does not exercise and sits slumped over a computer all day causing muscle tension to build up under the base of the skull i.e. “postural stress”. In this case once the cause has been established, an osteopath can help by advising on posture, suitable exercises, how to create a more ergonomic work station, and by treating the spine to improve mechanical function, decrease muscle tension and help the patient to become “fit to sit”.
Headaches can be complicated, it may take a combination of factors coming together to precipitate a headache, for example, a poor night’s sleep, skipping breakfast and driving for three hours. Our aim is to try and unravel the complexities of the headache and establish the contributing factors.
When someone’s neck becomes painful or stiff, the muscles tighten and over work in an attempt to protect the neck. Unfortunately this can be counter productive causing more stiffness within the small facet joints which can aggravate any pre-existing degenerative changes in the cervical spine, nerves can become compressed or irritated and muscular tightness can even alter the blood flow up to the brain contributing to the precipitation of a migraine type headache.
An osteopath can assess the spine to see whether muscle tension or a mechanical imbalance is contributing to a headache. Not all problems start in the neck! A problem lower down the body as far away as the foot can affect the balance of the pelvis, spine and ultimately lead to muscle tension in the neck.
Factors that appear unconnected or insignificant can play a part. Being tired not only alters the chemical balance in the body but may contribute to postural stress i.e. “too tired to sit” encourages slouching and places more mechanical strain on the spine, particularly in the neck, resulting in muscular tension and eventually headaches. Other contributory factors may be carrying heavy loads, awkward sleeping positions or an occupation which places a strain on the neck e.g. lifting heavy objects off high shelves, painting ceilings etc.
Many patients find the osteopathic approach helpful for the management of their headaches. Quite often a two-tiered approach is most useful, using medication as prescribed by the GP whilst addressing any musculoskeletal problems using osteopathic treatment. When a patient consults an osteopath at the O.H.C. a case history will be taken, an examination performed and a working diagnosis established and explained. Not only do we aim to deliver effective osteopathic treatment to resolve mechanical/musculoskeletal symptoms but see it as paramount to give advice tailored to suit the individual. Posture, sleeping positions, exercise, diet, lifestyle etc are all subjects which may need addressing to help a patient understand how best to help themselves.