Worsening Migraine Attacks

December 9, 2009 by dean · Leave a Comment 

Worsening Migraine Attacks are decreased significantly by cervicogenic (neck) treatment. Recent evidence suggests that migraine is an increasing condition in which over time, the attacks become more frequent, more severe, less responsive to medication, and perhaps lasting longer.

Research has shown that by decreasing information (surgically) from cervical (neck) nerves deceases the long term worsening of the migraine process. The natural progression of cervicogenic (neck) headache is exactly the same – if it is left untreated, cervicogenic headache becomes more frequent, more severe and eventually becomes continuous. This indicates that with the passage of time the neck disorder is gradually worsening (and it is likely to be loss of function or stiffness). This research supports the idea that cervicogenic (neck) disorders are the reason for not only worsening of the migraine process but also for the migraine process in the first place i.e. sensitisation of the brainstem.

Now I am not suggesting that migraine sufferers rush off and have the relatively minor surgery performed in this study (in fact I respectfully suggest that skilled treatment of the neck would have achieved the same result), but this research clearly demonstrates disorders of the upper neck are significantly involved in the migraine process.

Cheers

Dean

(Perry CJ, Blake P and Goadsby PJ Intervention altering the natural history of chronic migraine. Is chroni?cation of migraine headache a harbinger of peripheral afferent nerve involvement? Cephalalgia 2009; 29 (Suppl. 1):1–166)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Hemicrania Continua and Cluster Headache

November 25, 2009 by dean · Leave a Comment 

One sided headache is like to respond to neck treatment

One sided headache is likely to respond to neck treatment

Are They Related to Cervicogenic Headache?

A diagnosis of Hemicrania Continua just means you have constant pain on one side of your head (just like Cluster Headache) and shares other similar symptoms with Cluster Headache.

Cervicogenic (neck-related) headache, according to the medical model of headache and migraine, is also a one sided headache.

Research shows that Cluster Headache can be relieved by treating the neck and therefore because of the similarity of Hemicrania Continua to Cluster Headache, Hemicrania Continua.

To review the list of posts related to Hemicrania Continua go to the ‘Home Page’ and you can key in ‘ Hemicrania Continua’.

Cheers

Dean

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Post-traumatic Headache

November 21, 2009 by dean · Leave a Comment 

Neck disorders can be responsible for headache

Neck disorders can be responsible for headache

Whiplash or post-traumatic headache for some reason seems to be a controversial headache – perhaps because the only explanation for it might be that it results from a neck injury – and there is reluctance by some authorities to accept that neck disorders can be responsible for headache (especially given that post-traumatic or whiplash associated headache presents just like a migraine or tension-type headache?)

To review my previous posts on post-traumatic or whiplash associated headache. Please go to the ‘Home Page’ and key in either ‘Post-Traumatic Headache’ or ‘Whiplash Headache’.

Cheers  Dean

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Post-traumatic Headache and Migraine or Tension Headache – What’s The Difference?

November 3, 2009 by dean · Leave a Comment 

It was shown that headache sufferers had neck disorders after concussion

Research showed post concussion headache sufferers had neck disorders

In a recent study of 348 patients who had experienced concussion it was found that ongoing headache after 3 months was not caused by head or brain injury – but resembled Tension Headache or migraine possibly brought on by stress.1

Other research has shown sufferers of headache following concussion have significant disorders of their upper necks.2

These studies along with surveys which show that post-traumatic headache can be classified as either migraine or tension-type headache3-5 suggest that the underlying mechanism of migraine or tension headache is a neck disorder/injury.

Just more evidence indicating that neck disorders are likely to be the source of not only post-traumatic headache but also migraine and tension-type headache.

Cheers

Dean

(5. De Benedittis G, De Santis A. Chronic post-traumatic headache: clinical, psychopathological features and outcome determinants. J Neurosug Sci 1983;27(3):177-186

3. Haas DC. Chronic post-traumatic headaches classified and compared with natural headaches. Cephalalgia 1996;16:486-93

1. Stovnera L, Schradera L, Mickeviciene D, Surkienec D, Sand T. Headache after concussion. Eur J Neurol. 2009;16:112-120.

2. Treleaven J, Jull G, Atkinson L. Cervical musculoskeletal dysfunction in post-concussional headache. Cephalalgia 1994;14:273-9

4. Weiss HD, Stern BJ, Goldberg J. Post-traumatic migraine: chronic migraine precipitated by minor head or neck trauma. Headache 1991;31(7):451-456)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Migraine and Stress

October 22, 2009 by dean · Leave a Comment 

When stressed, muscles shorten, joints move abnormally, pain is referred to the head

When stressed, muscles shorten, joints move abnormally, pain is referred to the head

One of the most common triggers reported by individuals with migraine is stress.1-5 Approximately 76% of migraine suffers report identifiable triggers and of those 80% report stress as a common trigger.6

When we get stressed our muscles shorten ‘asking’ the vertebra to which they are attached, to move. If however the joint is stiff, messages from shortened structures for example capsules, ligaments and muscles, which are there to prevent the joint from moving too much, are not allowing the joints to move normally and pain is referred to your head – stress without a neck disorder does not result in headache.

A skilled examination of the movements of the upper neck can confirm this for you.

Cheers

Dean

(2. Chabriat H, Danchot J, Michel P, Joire JE, Henry P. Precipitating factors of headache. A prospective study in a national control-matched survey in migraineurs and nonmigraineurs. Headache. 1999;39:335-338.

1. Hung CI, Liu CY, Wang SJ. Precipitating or aggravating factors for headache in patients with major depressive disorder. J Psychosom Res. 2008;64:231-235.

4. Karli N, Zarifoglu M, Calisir N, Akgoz S. Comparison of pre-headache phases and trigger factors of migraine and episodic tension-type headache: Do they share similar clinical pathophysiology? Cephalalgia. 2005;25:444-451.

6. Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia. 2007;27:394-402.

5. Martin PR, Milech D, Nathan PR. Towards a functional model of chronic headaches: Investigation of antecedents and consequences. Headache. 1993;33:461-470

3. Rasmussen BK. Migraine and tension-type headache in a general population: Psychosocial factors. Int J Epidemiol. 1992;21:1138-1143)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Advanced Headache and Migraine Courses

September 23, 2009 by dean · Leave a Comment 

Level 11 course in The Netherlands

Level 11 Course in Roermond, The Netherlands

Following on from the Level I course in Roermond, I presented an Advanced (Level II) course.

Level II is a two day course where delegates (primarily physiotherapists) are introduced to the recent research in relation to headache and migraine (which suggests that headache and migraine are not different conditions but are just different different expressions of the same condition) and also to the approach I have developed which not only confirms if a neck disorder is the source of headache or migraine but also which spinal segment is the cause.

After at least 6 months of using my approach, the course delegates are invited to attend a one day (Level II) course where the approach is revised, and importantly questions and issues are answered/discussed. I am pleased that these courses are always fully subscribed and often go on beyond 5.00 p.m.!

Whilst I examine and treat patients on both Level I & II courses, I have now been asked to present longer courses in which patients are examined and treated over a 2 week period ….. now that will be a ‘Master Class’!

Cheers

Dean

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Migraine – An Unrecognised Cervicogenic Headache?

September 15, 2009 by dean · Leave a Comment 

Migraine Sufferers have a significantly reduced range of neck movement

Migraine Sufferers have a significantly reduced range of neck movement

It is interesting to note that ongoing investigation into the role of cervicogenic (neck) disorders in migraine sufferers has revealed significantly reduced range of neck movement when compared to non headache sufferers. Just more information to add to the growing body of evidence which supports the possibility that the sensitisation of the brainstem in migraine sufferers may be caused by a neck disorder.

Cheers

Dean

(Bevilaqua-Grossi D, Pegoretti KS, Goncalves MC, Speciali JG, Bordini CA, Bigal ME. Cervical Mobility in Women With Migraine. Headache 2009;49:726-73)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Worsening Migraine Attacks Decreased Significantly By Cervicogenic (Neck) Treatment

September 11, 2009 by dean · Leave a Comment 

Long term worsening of the migraine process

Long term worsening of the migraine process

Recent evidence suggests that migraine is an increasing condition in which over time, the attacks become more frequent, more severe, less responsive to medication, and perhaps lasting longer.

Research has shown that by decreasing information (surgically) from cervical (neck) nerves deceases the long term worsening of the migraine process. The natural progression of cervicogenic (neck) headache is exactly the same – if it is left untreated, cervicogenic headache becomes more frequent, more severe and eventually becomes continuous. This indicates that with the passage of time the neck disorder is gradually worsening (and it is likely to be loss of function or stiffness). This research supports the idea that cervicogenic (neck) disorders are the reason for not only worsening of the migraine process but also for the migraine process in the first place i.e. sensitisation of the brainstem.

Now I am not suggesting that migraine sufferers rush off and have the relatively minor surgery performed in this study (in fact I respectfully suggest that skilled treatment of the neck would have achieved the same result), but this research clearly demonstrates disorders of the upper neck are significantly involved in the migraine process.

Cheers

Dean

(Perry CJ, Blake P and Goadsby PJ Intervention altering the natural history of chronic migraine. Is chroni?cation of migraine headache a harbinger of peripheral afferent nerve involvement? Cephalalgia 2009; 29 (Suppl. 1):1–166)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Migraine, Tension Headache, the Neck and Sensitisation of the Brainstem

August 22, 2009 by dean · Leave a Comment 

Is a neck disorder relevant?

Information from the neck - is a neck disorder relevant?

It is generally agreed and it has been demonstrated that the brainstems in migraineurs and tension headache sufferers are sensitised.

The brainstem is influenced by 4 systems:

information from structures inside the head – head scans which fortunately in over 95% of headache and migraine sufferers the scans are clear, will eliminate this factor

the diffuse noxious inhibitory control system – this is poorly understood, but it is the mechanism which acts when you hit your thumb with a hammer and your headache seems less painful – hardly an attractive treatment option!

the serotonin system – serotonin desensitises the brainstem – if there is not enough then the brainstem becomes sensitised – so it makes sense to optimise your production of serotonin – diet, exercise, sunlight and perhaps a L-tryptophan supplement (after checking with your doctor)

information from the neck – get your neck checked. Many of us have a neck disorder, but is it relevant? This can be determined by, when examining the neck, temporarily reproducing familiar head pain which lessens as the technique is sustained. In my 21000 hours of experience this occurs in over 90% of headache and migraine conditions. My approach as a diagnostic tool is unparalleled in the manual therapy area and is in accordance with the views of traditional medicine.

Why does it have to be complicated?

The last two systems are within your control – you can take steps to address these.

Cheers

Dean

(Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd edn. Cephalalgia 2004; 24(suppl.1):1-151

Katsavara Z, Giffin N, Diener HC, Kaube H. Abnormal habituation of ‘nociceptive’ blink reflex in migraine – evidence for increased excitability of trigeminal nociception. Cephalalgia 2003; 23:814-819

Katsavara Z, Lehnerdt G, Duda B, Ellrich J, Diener HC, Kaube H. Sensitization of trigeminal nociception specific for migraine but not pain of sinusitis. Neurology 2002; 59:1450-1453

Kaube H, Katasavara Z, Przywara S, Drepper J, Ellrich J, Diener HC. Acute migraine headache. Possible sensitization of neurons in the spinal trigeminal nucleus? Neurology 2002; 58:1234-1238

Jull G, Bogduk N, Marsland A. The accuracy of manual diagnosis for cervical zygapophyseal joint pain syndromes. Med J Aust. 1988 Mar 7;148(5):233-6

Milanov I, Bogdanova D. Trigemino-cervical reflex in patients with headache. Cephalalgia 2003; 23:35-38

Nardone R, Tezzon F. The trigemino-cervical reflex in tension-type headache. European Journal of Neurology 2003; 10(3):307-312

Nardone R et al Trigemino-Cervical Reflex Abnormalities in Patients with Migraine and Cluster Headache. Headache 2008; 48(4):578-585

Sandrini G, Cecchini AB, Milanov I, Tassorelli C, Buzzi MG, Nappi G. Electrophysiological evidence for trigeminal neuron sensitisation in patients with migraine. Neurosci Lett 2002; 317:135-138

Sjaastad O, Fredricksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. Headache 1998; 38:442-5)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.