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Posted on 10-06-2016

“I can’t believe how much my head hurts!”  I’ve been laid off from work for the last 3 weeks and worried about making my mortgage payment this month – I think the stress is getting out of control!  Pain starts in my neck and radiates into my head eventually making my whole head hurt, especially behind my eyes.  There are times I feel like my head might explode!  I can’t stand loud noises or even normal noise.  Over the counter medications aren’t touching it and I can’t drive if I take some of the medications my doctor prescribed.  I don’t know what to do next.”

This history is classic for the diagnosis of a tension-type of headache (TTH).  As unemployment rates reach new highs and stress levels climb, it is no wonder more and more people are presenting with this condition.  Even prior to the recession, TTH was the most common type of headache experienced by adults affecting 10-65% of the population.  The impact on daily living by TTH is significant as it disrupts daily activities, quality of life, and work.  These types of headaches, according to the International Headache Society (HIS), can last from 30 minutes to 7 days, do not include nausea/vomiting but may include increased sensitivity to light or noise (rarely both at the same time).  The most common frequency is less than 15 TTH’s/month.

Medication has been the primary medical form of treatment and some patients require the regular use of certain medications, even when headaches are not present - - as in some cases, it’s too late to start meds once the headache starts.  In these cases, Amitriptyline has been the most frequently prescribed medication and it’s considered the drug of choice for TTH.  Chiropractic spinal manipulation (CSM) has been reported to be helpful in a number of prior studies.  One reported equal benefit as Amitriptyline with 6 weeks of treatment.

A recent publication conducted a study using a new design where TTH sufferers with more than 10 headaches per month were randomly assigned to one of four groups: 1) cervical spinal manipulation (CSM) + amitriptyline, 2) CSM + placebo (fake) amitriptyline; 3) sham CSM + real amitriptyline; or 4) sham CSM + placebo amitriptyline.  That way, one can determine which of the two or, the combination of both is most beneficial.  An initial period of 4 weeks was followed by a 14 week treatment period. A headache diary was used to track headache frequency in the last 28 days of the treatment period.  Nineteen completed the study and the combined effect carried the most statistically significant result with a close second with CSM alone.  A larger sample size was recommended for a more statistically powerful evaluation.

This study is important as CSM by itself was found to be at least as (if not more) effective than Amitriptyline alone, which is the medication of choice for TTH.  Hence, if CSM or Amitriptyline alone are not found to be satisfying, the combination of the two is strongly supported by this study.

If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.  We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and look forward in serving you and your family presently and in the future.

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