Headaches and Chiropractic

Headaches are a common problem that can be triggered by many different factors, from stress to an undiagnosed spinal injury. If you suffer from headache, chiropractic can help!

Watch our video below, or browse our other articles to learn more about how Chiropractic can help ease the pain of headaches and migraines.

 

 

Articles:

Chiropractic Effective for Headache Treatment

Cervicogenic headache and chiropractic

Chiropractic Treatment for Migraine

Headache, Diet, and Exercise

Preventing Migraine with Exercise & Chiropractic

Treating Headaches with Chiropractic

What causes radicular pain after an auto collision?

Radicular pain, or radiating pain, is caused by interference or pinching of the spinal nerves. This results in pain, tingling, or numbness in parts of your body far from the actual source of the problem.

If your spine is injured, there are a number of things that can affect the nerves.Injured ligaments and muscles can cause inflammation of the nerve root, which can disrupt the function of the nerve. If a spinal disk is damaged, it can cause the disk to bulge or herniate, pinching the nerve. And if the spinal joints begin to calcify, it can cause spinal stenosis, or a narrowing of the canal that the spinal nerves pass through.

All this can lead to a number of conditions such as sciatica, carpal tunnel syndrome, low-back pain, shoulder pain, and more. It’s crucial to treat these conditions to prevent further nerve damage or worsening symptoms.

The key to treating radicular pain is to pinpoint its source in the spine. After determining the root of your pain, a chiropractor can relieve pressure on the impinged nerves. This allows the nerves to heal by reducing inflammation and irritation.

Multiple studies have confirmed the efficacy of chiropractic adjustments in alleviating radicular pain. If you’re looking for a natural, effective pain relief, chiropractic could help. Call our office to learn more.

References

Christensen KD, Buswell K. Chiropractic outcomes managing radiculopathy in a hospital setting: a retrospective review of 162 patients. Journal of Chiropractic Medicine 2008; 7(3):115-25.

Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. Journal of Manipulative and Physiological Therapeutics 2007;30:135-139.

Rodine RJ, Vernon H. Cervical radiculopathy: a systematic review on treatment by spinal manipulation and measurement with the Neck Disability Index. Journal of the Canadian Chiropractic Association 2012; 56(1):18-28.

Whiplash or Fibromyalgia?

A recent study published in the journal Pain sheds some light on the ongoing debate about the causal relationship between neck injuries sustained during a car accident and the development of the pain condition fibromyalgia. Chiropractors commonly treat patients with both conditions, and separating these diagnoses can improve treatment. The latest research suggests that fibromyalgia may be overdiagnosed in patients who have a history of whiplash injury due to a motor vehicle accident.

People with fibromyalgia experience a range of life-disrupting symptoms, include general and localized pain, fatigue, and difficulty sleeping. Neck and shoulder tenderness is one common indicator that practitioners use to diagnose fibromyalgia; general pain lasting longer than three months is another. However, these symptoms also are common among patients experiencing the lingering effects of whiplash. Some past research has shown that people with neck injuries incurred in a motor vehicle accident are 13 times more likely to develop fibromyalgia than those with other injuries. Other studies have questioned these conclusions.

Researchers at the University of Washington set out to investigate the prevalence of fibromyalgia in whiplash patients with persistent neck pain. They questioned whether the most common set of criteria used for diagnosing fibromyalgia may rely too heavily on evaluating trigger points located in the neck and shoulder. The study participants included 326 individuals with whiplash-associated neck pain that had lasted longer than 3 months. The participants were enrolled in a 6-week treatment program for their symptoms that consisted of educational therapy sessions.

The researchers evaluated the patients for fibromyalgia both at the beginning and the end of the program. Two sets of criteria were used to diagnose fibromyalgia: the standard guidelines and adjusted guidelines that discounted the importance of pain in the neck and shoulder area. Using the standard guidelines, the researchers initially diagnosed 14% of the whiplash participants with fibromyalgia. This rate dropped to 8% using the adjusted guidelines.

These findings suggest that health practitioners who treat patients with persistent neck pain, such as chiropractors, may be led to significantly overdiagnose fibromyalgia in their patients. People with a history of whiplash-associated injuries should be aware of this unintended bias, and report their injury history.
Robinson JP, Theodore BR, Wilson HD, Waldo PG, Turk DC. Determination of fibromyalgia syndrome after whiplash injuries: Methodologic issues. Pain. 2011 Mar 16.

Whiplash, Referred Pain and the Central Nervous System

The most frequent symptoms after whiplash injury are headache and neck pain, which are understandable, since the neck is directly injured during a rear-end collision. Many auto injury patients, however, experience a much wider range of symptoms. Arm pain, shoulder pain, back pain, TMJ pain, and dizziness are also very common symptoms, and these are difficult to ascribe to direct trauma. A new study shows us that these other symptoms are actually related to the initial neck trauma, through the process of referred pain.

Referred pain is pain that is perceived in one area, but that originates in another. Researchers believe that referred pain occurs when pain signals from injured tissue activate adjacent nerves in the spinal cord or brain. These adjacent nerves then cause the brain to perceive pain in the area of the body innervated with those nerves.

Referred pain can be induced, even in pain-free people. In a new study from Sweden, researchers set out to determine whether whiplash patients had a different referred pain response to stimulus than non-whiplash subjects.

The authors started with 12 patients and 12 pain-free control subjects. Referred pain was created by electrical stimulation of the shoulder and the upper arm. The electrical stimulation level was set by the test subjects, and was adjusted to create five progressive levels of pain – innocuous, pain threshold, 2 out of 10, 4 out of 10, 6 out of 10 (on a scale of 1 to 10).

The results showed a dramatic difference between patients and controls:

  1. Pain-free subjects required almost three times more stimulation to reach the designated pain levels than did the whiplash subjects.
  2. While the controls reported limited areas of referred pain, the whiplash patients reported a much wider area of referred pain.
  3. Whiplash patients showed a unique type of referred pain. In healthy individuals, induced referred pain was always distal to the stimulation (or further from the center of the body), but in the whiplash patients, half of the patients had referred pain that was proximal to the stimulation.

These findings are important in understanding the nature of whiplash injuries. As previous studies have shown, some whiplash patients demonstrate “central hypersensitivity,” a phenomenon where the central nervous system becomes over-stimulated from the injury to the spine.

According to the literature, a certain percentage of patients are susceptible to chronic pain after an auto injury. In these patients, central nervous system changes may develop in reaction to pain, which can, in turn, increase the patient’s sensitivity to pain. It is critical to identify these patients early on after injury, in order to break this cycle. Sensory tests, such as pressure pain threshold testing, are an important diagnostic tool, since they can help us identify those patients with a posttraumatic stress reaction.

Kosek E, Januszewska A. Mechanisms of pain referral in patients with whiplash associated disorder. European Journal of Pain 2008;12:650-660.

Whiplash Symptoms – Low Back Pain

Over the last 10 years, hundreds of studies have been done on the problem of whiplash, and most of those studies have focused on the most common symptom of the diagnosis: neck pain. This concentration of research has resulted in a clear understanding of how a rear-end collision can result in injury.

Low back pain from whiplash

Shear forces occur when one part of the
spine moves in one direction while another
part of the spine moves in a different direction.

Shear forces can cause tearing or stretching
of the soft tissues that hold the spine together.

The primary reason why rear-end collisions cause injury is that the human spine is designed to withstand vertical forces, while a rear-end collision is a horizontal force. The vertical forces are known as “axial” forces. The horizontal forces, known as “shear” forces, cause unnatural movements of the cervical spine and can result in damage to the ligaments of the neck.

A new study has now shown that a similar injury mechanism occurs in the lumbar spine as well. Inspired by the research on the cervical spine, the authors of this study applied the same methodology to the low back.

They placed a cadaver in a standard automotive seat and placed acceleration-measuring devices in the vertebral bodies of T1, L1, L3, and L5. The seat was placed on a platform that was subjected to rear accelerations of 5g and 8g, or speeds of approximately 8 and 12 mph, respectively. The researchers collected acceleration data at a rate of 10,000 samples per second. Radiographs were taken of the spine before and after the tests.
The study found that different parts of the lumbar spine experience different strains during a rear-end impact:

“The anterior shear strains had mostly a biphasic response. Spinal strains started at about 30 msec after impact and peaked at the T12 vertebra at approximately 120 and 370 msec, whereas in the L4 vertebra, it peaked at 200 and 380 msec. The anterior strain patterns of the L4 and T12 vertebrae were in diametrically opposite directions.”

The direction and strength of the forces suggests that the car seat rapidly accelerates into the occupant’s spine, causing the thoracic and lumbar curves to straighten.

Low back pain after whiplash

The authors of the study carefully examined the forces involved in the spine during the test impacts. They found that the car seat exerted about 1500 Newtons (approximately 337 pounds) of force, in a fraction of a second. The authors relate this to how the lumbar spine can be injured in rear end collisions:

“In the current study, no bony injuries were observed in the lumbar spine, either by visual inspection or by radiographic studies. In the absence of clear bony pathology after rear-impact collision, we propose that irritation of or injury sustained by the richly innervated spinal soft tissues (i.e., muscles, ligaments, capsules) plays an important role in the pathogenesis of lumbar pain after whiplash injury. This proposition is supported by work of others who performed lumbar spinal segment shear tests and showed that soft-tissue injuries occurred with a shear load as low as 1200 N.”

The 1500 Newtons of force was reached in the 5g test, which was equivalent to an 8 mph collision. So, according to this preliminary study, the car seat back exerts enough force during such a collision to injure the connective tissue of the lumbar spine.

Fast A, Sosner J, Begeman P, et al. Lumbar spinal strains associated with whiplash injury. American Journal of Physical Medicine and Rehabilitation 2002;81:645-650.