by Dr. Leah Hahn, D.C., F.I.C.P.A.
At least once a week, a patient visiting our office for the first time expresses their desire and strong need to get rid of headaches. It is, unfortunately, a common problem in our country and can be so incredibly debilitating. According to the Cleveland Clinic, 45 million adults in the United States suffer from long-term, reoccurring headaches. Of that 45 million adults, 28 million suffer from migraines. About 70% of this group has been shown to be women. It has also been shown that about 20 percent of children also suffer from headaches and migraines. Many reports have also stated that headaches are one of the most common reasons that Americans miss work or school--an estimated 157 million days of school and work lost yearly due to the pain.
If you watch American media you know that over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs) are often the routine treatment that Americans use to treat their headaches. But more and more people are becoming aware that if they use these type of NSAID pain relievers on a consistent basis, this can actually lead to chronic, long-term, daily headaches (NSAIDs can also cause severe stomach, liver, and kidney damage). Many of the individuals dealing with headaches that come into our office report that they have "tried everything"--often many different prescription drugs, OTC drugs, etc. Some have had injections, advanced testing like MRI or CT scans, and some have also tried alternative treatments like acupuncture. My hope is that we as a team at Body In Balance can provide a different perspective--one that is more holistic in nature that gives you functional reasons why headaches are occurring. I would also like to give you things that YOU can implement to prevent headaches and ways that we help our patients with headaches.
Headaches and Inflammation
Like so many other conditions that Americans deal with, there is an inflammatory component to headaches. When we perform tests during our exam process, more often than not, headache sufferers have extremely tight muscles in the cervical spine (neck) and often in the upper thoracic spine (upper back). Tests typically show inflammation in the muscle tissue and nerves associated with these parts of the spine as well. I will address how muscular tightness plays a role but let's first look at how inflammation can develop as well as increase the severity of a headache.
Inflammation is actually a natural part of the body's healing process. When you get a cut, one of the first stages of the healing process is to see redness around the cut. It typically hurts at this stage, looks red and a little puffy directly at the site of the cut. This redness, pain, and swelling are your body mounting the immune response and sending in cells to clean up the wound, eat up damaged tissue, and start the repair process. Inflammation is a critical step to the healing cascade that increases the speed and depth of the healing process. If this step is not completely performed, the healing process is not as efficient or complete. The problem occurs when the inflammatory process stays on board longer than it should--even worse when the inflammation becomes chronic.
What Causes Inflammation or Makes it Worse?
The three main causes of systemic inflammation in our society are stress, sugar, and eating foods that are not tolerated by your body. We have had great success in helping our patients with headaches but even better results when the patient is willing to assist the healing process with lifestyle changes. When inflammation is addressed by looking at the patient's unique triggers, the healing process is assisted in a tremendous way.
Stress in our life can be unavoidable. It is how we handle it that can make all of the difference. When someone is stressed, all of the things they feel they don't have time for in their routine become the most important activities to implement to protect themselves from stress physiology. Stressed people need more sleep (7 hours is the minimum in the research). I would prefer 8-9 hours of sleep for a patient dealing with a headache or if stress is high and more healing time is needed (especially when the goal is to prevent a headache).
Stressed people need to focus on eating more fats and protein. They also need to work on stabilizing their blood sugar. This is important during times of stress but if we are focusing on headache prevention, dietary intake should play a huge role in preventing/healing inflammation as well as stabilizing blood sugar (the two go hand-in-hand). When I start working with a patient on dietary issues that may be contributing to their headaches, I will often have the patient fill out a food journal. One of the common patterns I see is skipped meals or meals that are rich in foods high in carbohydrates, low in fiber, protein, and fat. These are called high-glycemic index foods (foods that easily convert to sugar). Without a patient eating a meal of candy, cake, and ice-cream (most patients know this isn't a good thing) patients are often eating a meal that easily converts to sugar by eating a meal high in grains, dairy, fruit, and/or starchy vegetables. This causes blood sugar to spike and then often drop very quickly. One of the easiest and most effective ways to change this is to look at the balance of the meal. We teach our patients to have a meal that is more moderate with protein, some healthy forms of anti-inflammatory fat (avocado oil, coconut oil, extra-virgin olive oil), as well as a larger source of low-glycemic vegetables (broccoli, spinach and other greens, cauliflower, asparagus, etc.). Eating like this on an every 3-4 hour basis can stabilize blood sugar and reduce inflammation as well as stress levels to the body. Patients have had great success in implementing this and seeing a decrease in their headaches, as well as weight loss, clearer thinking, increased energy--the list goes on!
Food, Inflammation, and Headaches
Because of the inflammatory component to headaches, finding out what foods create an inflammatory response in your body (individual to you) and avoiding these foods can have a tremendous healing effect on headaches and migraines. If we look very briefly at functional medicine, your digestive tract plays a huge role in how you process stress and inflammation. With antibiotic use, long-term NSAID use, high-stress levels, or eating foods that you are allergic or intolerant of, your gut can become inflamed. With inflammation of the gut, you may develop leaky gut in which you have food particles escaping from the small intestine, into your bloodstream. Your immune system then attacks the unwanted food particles in the bloodstream, creating an inflammatory response to these foods. This entire process burdens the body with unwanted toxicity that is then processed by the liver. As your liver is overworked and cannot keep up with the toxicity levels, problems like headaches, migraines, fatigue, allergies, sinus issues, sleep issues, digestive disturbances (gas, bloating, constipation, diarrhea, irritable bowel) can develop or increase.
What do we do about this? We run many IgG food panels that let us know what foods a patient is reacting to. MDs often look at IgE antibodies (these assessments measure the response in a patient's immune system that would cause an anaphylactic-shock type of reaction). IgG antibodies in comparison tell us what is causing an inflammatory response in your bloodstream. We then put a plan together to avoid the offending foods and improve digestive and liver health. When starting the program of avoiding offending foods, we often start with a liver, gut, and kidney detoxification program. These programs are individualized given the patient's needs, health history, as well as the severity of the digestive issues. Sometimes starting the day out with a hot cup of purified water with a wedge of fresh lemon is enough to stimulate liver cleansing (the lemon in the hot lemon water helps the body move towards a more alkaline state that is ideal for cleansing). Dietary changes can make this process happen more quickly. Sometimes more intense cleansing protocols are needed (we typically use medical-grade, FDA approved products that support and improve the body's ability to remove toxicity). This process can be a significant help to headache sufferers by decreasing inflammation and gives our patients specific strategies that can make a huge impact on decreasing headaches.
Hydration and Headaches
If digestive health does seem to play a role in our patient's headaches, they are also more likely to be prone to hydration issues. For both headaches and migraines, electrolyte balance can be key. What our patients drink is key--coffee and tea intake or any other type of beverage besides water does not count towards increasing hydration! Realize that a sign of dehydration is not ever really feeling thirsty. Hydration balance and cellular health is something we can measure in our office with a non-invasive test called Bio-Impedance Analysis. Healthy cells hold onto proper fluid and nutrient levels, whereas inflamed or damaged cells have difficulty with this (due to damage of the cell wall).
To change electrolyte balance and hydration levels, we encourage patients to drink between 50% and 75% of their body weight in ounces daily. I always warn patients that if they are really dehydrated they may feel like they are having to use the restroom constantly when they implement this! But, it is a process to increase hydration and eventually as a new balance forms, the body will start to hold on to proper water levels. I typically recommend electrolyte-enhanced water as the main water source to use as a patient is increasing water intake. That typically will allow the body to regulate hydration status, as long as there is enough water getting into the body. It is amazing how such a simple change in someone's lifestyle can have a huge impact on decreasing headaches, body aches, muscle cramps and improving energy levels.
Headaches and Spinal Function
At Body In Balance Wellness Center, we look at the whole picture. Another major component of headaches that we evaluate is the structure and function of the spine. When most of my patients think of the spine, they think of the bony part of the spine. When I speak and write about the spine, I am actually talking about the bony and the neurological part of the spine that is housed and protected by spinal bones. There are several common patterns that we see when a patient comes to us with headaches. One is a reverse cervical curve. When a side-view (lateral) Xray is taken of someone's neck, we are looking for the spine to have equal spacing between the bones, smooth edges to the bones, as well as a forward facing curve (think of a banana). Due to stressors like consistent computer work, driving for long time periods, looking down at an iPhone, tablet, etc., or a trauma like whiplash or sports injuries, over time, the forward curve of the neck can be lost. The structure can become very straight (what is often termed as "Military Neck") or the curve can become reversed in which it goes in the opposite direction that it should. This is very difficult for the spinal bones and can affect both the function of the bones and muscles of the spine. Even more importantly, it affects the amount of neurological stress in the patient's spine.
Neurological stress is often termed cord pressure. There is so much tension in someone's spine, it is inflamed, doesn't move appropriately, and the muscles become very guarded and tense around the spine. This situation can accelerate arthritis, as when the spine is misaligned and not moving appropriately, it increases the inflammation and the wear and tear on the joints. This goes hand-in-hand with increasing headaches, neck pain, and even migraines. In a situation like this, we often do a series of tests. We look at muscular function through surface Electromyography (sEMG) as well as thermographic testing to look at spinal patterns of inflammation. A common pattern seen in the sEMG tests that headache sufferers often deal with is muscles pulling in opposite directions around the cervical and thoracic spine. This type of muscular tension pattern causes a shearing-type tension on the spinal cord and nerves. On thermographic tests, we often see inflammation around the cervical and upper thoracic spine. This information (when necessary) is put together with Xray images. Often in a patient with headaches, you will see a combination of a very straight or reversed cervical curve on Xray as well as high muscle tension, asymmetry in the muscles, as well as inflammation in the neck and upper back.
NSA and Headaches
Another point that Body In Balance Wellness Center utilizes that makes us unique is that both Dr. Scott and myself are highly trained in a specific chiropractic technique called Network Spinal Analysis (NSA). There are over 100 chiropractic techniques, and NSA is one of the most researched, not just in the world of chiropractic, but in the world of alternative medicine. What Dr. Scott and I have always loved about NSA is that it uses an in-depth system to analyze where the spinal tension is originating from. We use sEMG testing, thermography testing, and when necessary, Xrays, to visualize how the spine is functioning, and with NSA, we can use measurements of the tension within the bone, the muscle, the neurological tension, as well inflammation within the connective tissue. We use a specific process to analyze how the body is coping with the neurological and muscle tension to determine how the body can best start to release this tension.
The best way I could summarize the piles of research that have been done on NSA chiropractic care is that it changes how the nerves of the spine are firing. We make specific contacts on the spine based on the analysis of tension patterns, decrease the amount of fight or flight autonomic nervous system activity, and increase the healing process. The greatest part for our patients is that this process is gentle, relaxing, and incredibly healing (there is no snapping and cracking or what most people picture with a chiropractic adjustment). Recommendations for adjustments are made based on the testing performed, and then the proper frequency of adjustments is determined to maximize the patient's result. Through this process, spinal health improves, stress levels decrease, healing is enhanced, and for so many of our patients, headaches decrease and eventually are corrected!
Headaches and Emotional Stress
The last piece of this that I would like to describe is the emotional connection to the patterns we identify and work within NSA. When the C1 vertebra (think very top of the spine) doesn't have its normal range of motion, or there is increased neurological tension in this area, it can cause headaches around the temples, forehead, and into the top of the head. It also specifically affects sinuses, eyes, ears, nose and the throat. But something most people are not aware of is that it can increase a level of emotional fear within the body that is often experienced as an overwhelming feeling. Whether life is overwhelming or not, these individuals often live with a consistent feeling of decreased well-being in the sense of "I can never catch up or get all of this done." I have to say I love it when our patients headaches go away and they feel this sense of emotional freedom from the constant "overwhelm."
When tension is stored at C5- C7 (think lower neck), patients often experience headaches that feel like tension throughout the neck, upper back, and often into the head. They are more likely to experience an emotional sense of anger and rage. Typically what lies beneath this is a sense of fear that again, the patient's physiology is enhancing. This area can again be a huge contributor to headaches, and when it is releasing tension as well as healing, patients feel an increased sense of wellbeing and report that they are handling their feelings of fear or anger so much more efficiently--or that it is gone!
Lastly, another common pattern we analyze and see with those experiencing headaches is lack of movement or increase tension around the C2 vertebra. C2 can increase headaches around the base of the skull. It can feel like constant tenderness or again, radiate pain into the head. The emotional pattern that is increased with C2 tension is the constant need to think. Thinking can then be used as a defense mechanism to feel less emotion. The constant thinking can be exhausting and make it very difficult for the body (and mind) to relax or heal. It is so rewarding for Dr. Scott and I to work with the spine and see a decrease in the amount of neurological tension, better movement of the spine, decrease in headaches, and an increased sense of wellbeing.
Dr. Scott and I, as well as the Body In Balance team, are committed to looking at the holistic picture of how we can help an individual heal. Headaches can be complex in nature--we could achieve the best hydration and lack of toxicity levels, but if the structure and movement of the spine were not considered, the patient could not fully heal. The same would occur if sthe tructure and neurological healing happened through NSA, but inflammatory foods, toxicity, or hydration were not considered, the patient may not fully recover. We look at the WHOLE picture--and depending of the patient's level of desire to change, we can address each aspect of physiology that needs support.
We, the team at Body In Balance include Doctors of Chiropractic, Health and Wellness Coaches, Personal Trainers, and Massage Therapists. As we use a team approach and have many tools available to us, we can develop a comprehensive, holistic plan to help our patients not only get rid of an issue like headaches, but also help address underlying health issues that are interfering with qthe uality of life. We want to help you with headaches or other issues you may be concerned with. To us, living in pain is not acceptable. We want you to thrive. We are here to support you in health and healing. Remember, create Health by Choice, not by Chance.