Friday, March 24, 2023

Headaches can be very difficult to treat. A common approach is to use medications to relieve the symptoms. I am going to discuss some underlying contributors to headaches, which can be treated. When these contributors are addressed, the headaches often improve and if the underlying causes can be eliminated, the headaches improve on a long-term basis for lasting relief.

One area that needs to be assessed in anyone with persisting headaches is the neck or cervical spine. Commonly, the head and neck conspire together to cause headaches. This connection can be through nerves and through muscles, and even through the joints of the cervical spine.

When the neck muscles are tight and tender, they tend to contract and can sometimes go into spasm. You can visualize that the neck muscles are connected with the scalp muscles. So as the neck muscles contract, they pull on the scalp muscles. This pulling on the scalp muscles can lead to tension headaches. So if we can get the neck muscles to relax, the scalp muscles may loosen up, resulting in release of the tension headache.

The nerve supply to the scalp and face has contributions from the cervical spine. These nerve connections mean that if a nerve is irritated in the neck, that nerve can send a pain signal to the head. The nerves come off the spinal cord and go through a narrow space called the spinal canal, exiting the canal through a small hole called the foramen. When there is arthritis in the spine, bone spurs grow into the canal or foramen, narrowing the space around the nerve further. Also, the disc that is a cushioning material between the spine bones (vertebra), can also push out and pinch the nerve while it is in the spinal canal. Whether pinched by a bone spur or disc, the nerve may send a signal to the scalp and/or face, which can cause a headache. So by treating the pinched nerve, the headache will improve. A nerve can also be compressed if a muscle contracts around a nerve. In that case, we work at relaxing the muscle, which releases the nerve, which will also resolve the headache.

The joints of the neck are called the facet joints. The facet joints at each level have a characteristic referral pattern. This means that when a joint at a particular level in the neck is dysfunctional, that joint will refer pain to a predictable area in the neck, upper back or head. Several joint levels refer pain to the head, which results in a headache. By treating the dysfunctional facet joints, the headaches will improve.

A treatment that can address all these aspects of neck pain is prolotherapy. Prolotherapy is the use of a dextrose solution around ligaments and tendons, creating a mild irritation of the tendon or ligament. This leads to increased blood flow with healing factors that help strengthen the ligaments. This is important because otherwise, the ligaments and tendons do not get a lot of blood flow and do not heal well. When the neck ligaments are strengthened, neck pain will improve. When the ligaments are loose, the muscles tighten up to stabilize the neck, which as noted above, can lead to headaches. By strengthening the ligaments, the neck muscles can relax, and that releases the scalp tension.

Pinched nerves in the neck can also improve with prolotherapy because strengthening the ligaments improves the stability of the cervical spine. This makes the disc or bone spur less likely to irritate or pinch the nerve. This improves headaches, which are caused by a nerve that is irritated in the neck. Also, facet joints are surrounded by ligaments. By strengthening these ligaments, the dysfunction in the facet joints is improved so the associated headache also improves. Thus, prolotherapy improves the headaches. which are caused by neck abnormalities.

Another excellent treatment for headaches is neural therapy. Many headaches are caused by nerve imbalances. The autonomic nervous system functions best when in a state of balance between the sympathetic nerves (stress system) and parasympathetic nerves (relaxation system). In our fast-paced world, many of us are in sympathetic overdrive. Neural therapy uses procaine to modulate the autonomic nerves to restore nerve balance. Some of the targets that improve headaches include the scalp muscles, the nerves in the head and neck called ganglia and other structures including the sinuses, tonsils and scars in the head and neck area.

The ganglia are structures where nerve cells cluster so they have a wide range of influence along the area supplied by those nerve cells. Two common ganglia that are targeted for headaches include the stellate ganglion in the neck, which has a wide range of influence in the neck, head and even the arms; and the sphenopalatine ganglion in the skull, which is often involved in headaches. By blocking either or both of these ganglia, headaches may lessen in intensity or even resolve.

Sinus headaches respond very well to neural therapy. Sinus infections result from congestion and poor drainage. As the sinus fluid backs up, it becomes stagnant—an ideal environment for bacteria to thrive. A good metaphor is a swamp that becomes clouded with algae and bacteria. Compare this to a clean river that is flowing well with refreshing water. With procaine in the sinuses and tonsils, the autonomic nerves are balanced, enabling the sinuses to drain. This is complemented and enhanced by clearing the sinuses out further with the vapors of ozonated olive oil. By clearing the sinuses, the sinus headache resolves.

Another source of headache is abnormalities in the temporomandibular joint (TMJ). TMJ pain responds very well to prolotherapy. The TMJ is a small joint that is prone to instability. The muscles in the area of the TMJ tighten up to compensate for the looseness of the TMJ. Prolotherapy strengthens the joint capsule, which are small ligaments around the TMJ. The prolotherapy solution is applied to the joint capsule and to the small muscle tendons in the area of the TMJ. When the TMJ is successfully treated, the headaches caused by the TMJ will resolve.

In summary, multiple structures may be contributing to headaches. A prominent cause of headaches is the neck. These neck problems can usually be treated successfully with prolotherapy. Nerves in the neck and skull may be irritated or out of balance, and by addressing these nerve issues, headaches will often improve or resolve. By treating sinus congestion with neural therapy, headaches will also be treated successfully. A common-sense approach to treating headaches is to look for what structures might be causing the headaches and then successfully treat those structures. Rather than taking medications that mask the headache symptoms, this approach treats the causes of headaches which leads to long-term resolution.

Dr. Slaten is a pain wellness physician in Ridgewood, New Jersey For more than 20 years, he has been practicing regenerative techniques with great skill and an open mind. For more info, check out his website at www.njprolo.com or call Dr. Slaten with any questions at 201-882-1500.

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