Chiropractors can develop drug-free, non-invasive treatment plans to help correct spinal misalignments and poor posture which are leading causes of cervicogenic headaches.
Could you please start by explaining what cervicogenic headaches are?
Dr. Luke Stringer: Yeah, great question. Cervicogenic headaches are essentially headaches that are driven from the cervical spine, your neck. If you look at somebody’s posture and they’re standing upright and/or sitting down, their ear should be on top of their shoulder, which is good posture, good alignment. However, in corporate America, we’re required to sit all day, looking down and forwards. Incrementally, over time, a lot of our patients suffer with what we call anterior head carriage. That’s where your head starts to shift forwards. And also, with that, we can have a straightening of the lordosis so your neck curve starts to go straight. So, in turn, as your head shifts forward and your neck shifts forward, we have tiny muscles that anchor the occiput, that’s the base of your skull right in the back of your head, into the top two vertebrae in your neck, C to cervical 1, 2. That’s your atlas and axis. Those suboccipital muscles anchor the skull to those two vertebrae and their primary function is to rotate your head. However, if your head and neck shifted forwards and the neck started to go straight, these muscles now are under tension.
So, it seems to be our body can figure this out, right? We’re all adaptable. But incrementally over time, as you compound that sitting, hours, weeks, months, years that muscle tissue breaks down. When it breaks down, it gets repaired internally. We don’t run to the doctor after every trauma. The body heals and it lays down something called adhesion. Adhesion is like glue in the muscle. So now you’ve got unhealthy muscle tissue that’s stabilizing the skull and the top two bones in your neck. Well, those nerves that come out of the brain, into the brain stem, into the spine loop back into your head. They innervate eyes, ears, nose, throat. So, when those nerves are subluxated, aka they’re under stress, brain nerves can’t communicate, they are like stuck in a traffic jam. There’s no flow of information, so it manifests as a symptom. Symptoms at C1-C2 level can create headaches. Cervicogenic headaches are driven from the muscles and the joints shifting out of alignment in the base of your skull, which refers pain into the head.
What’s happening in the neck or the spine that can lead to cervicogenic headaches?
Dr. Luke Stringer: Yeah, great question. I think I just answered that one for you. So, when you evaluate the spine anatomically and you’re looking at an x-ray, you have seven bones in your neck, the top one should meet the bottom one, so you have a 42-degree curve. So, if you’re looking at posture (and not everyone has an x-ray system, you’re not Superman or woman), our ears should be on top of our shoulders.
So again, corporate America requires us as people to be sedentary. Well, we’re built to be upright. So, we have two legs, we’re bipedal and eyes are in front of our head because we’re supposed to be moving around. So, it’s foreign for our biomechanics to be pinned down to a desk. Not only that, we have cell phones, iPhones, tablets, all these things that are right down in front of us. So, when you look down, that’s called flexion. The weight of our head is, on average, 10 to 12 pounds, so if you’re looking down, gravity hits the head, the head shifts, the weight of your head shifts your head and neck forwards. So that top bone shifts in front of your bottom bone. In terms of posture, that’s going to be someone whose chin is way out in front of their chest. Then the spine, not always, but can, typically also go straight.
So again, when your neck shifts forwards and it goes straight, those suboccipitals, which are critically important while we’re treating and addressing cervicogenic headaches go under tension. The tension breaks muscles down, and the muscles are unhealthy. They then are not allowing those joints to articulate well. When they shift, we call this a subluxation, which is stress within the nervous system. Stress on the top two nerves in your neck are going to refer pain to the head and drive that cervicogenic headache.
Are there habits or postures that contribute to or cause cervicogenic headaches?
Dr. Luke Stringer: Yeah, absolutely. It’s all to do with flexion. Flexion is you looking down. There’s a medical phenomenon out right now. It’s been around for about a decade, tech neck syndrome or text neck. You walk through any chiropractor’s office or a physical therapy office, there’ll be a poster on the wall walking you through what happens. The average weight of the human head is 10 to 12 pounds. So again, when your top bone is on top of the bottom bone, ears are on top of the shoulder, the weight of your head is evenly distributed into the back of the spine. Hence, why the spine is curved and the bones are in the back so we can physically absorb gravity, right? But if we’re required to be looking down on our keyboard or looking forwards at our monitor or we’re just looking down on our iPad all the time, this can create that postural shift.
So again, if you walk down the street in downtown Chicago, you’ll see a lot of corporate athletes with that kind of chin way over the chest, the shoulders have rounded, and that’s just that corporate America posture. Posture is a window to your health. If you’re in poor posture, you’re chronically stressed. Chronic stress is going to drive symptoms such as cervicogenic headaches, and then a myriad of other symptoms.
Now people just take headache medicine when they get a headache. Why is that approach not effective or sustainable?
Dr. Luke Stringer: I think it depends on what kind of side of the spectrum you are on. Westernized medicine is allopathic. Allopathic medicine is set up on treating the symptom, not the cause. And it’s always a quick fix, right? Just take ibuprofen or some form of NSAID or some form of headache migraine medication. Well, that’s going to help with the symptoms, absolutely. There’s a time and a place for medication, absolutely. However, those medications, read the back, are only for short-term use. So, if you take an ibuprofen, it should be three to five days maximum use. The AMA have some good research on this in regard to chronic use and the negative, some serious health effects it can have.
So, if you are a corporate athlete and you have those postural changes and you’re suffering with headaches once, twice a week for an extended period of time, and you always take your medication, well, first of all, you’re only treating the symptom, you’re not addressing the cause. And obviously that can affect other bodily organs, such as your liver and your GI system. So clearly a lot of inflammation. And that drives a lot of the health symptoms.
Chiropractors are not physicians. We don’t prescribe. So, as chiropractors when we are evaluating cases such as cervicogenic headaches, we’ll go through a detailed analysis to figure out if the cervicogenic headaches are driven from spinal misalignment.
Cervicogenic headaches are driven from spinal misalignment. That’s why they’re called cervicogenic headaches. So, in chiropractic, we figure out exactly what’s going on and then create a treatment plan that is non-invasive and non-drug based. So, for example, in our practice, all those upper cervical joints should be moving. If they’re not, they’re subluxated, that’s stress, and we’re going to get them moving through adjustments.
Do you have that corporate posture? Is your head shifted forward? Has it driven your neck forward? Has your neck gone straight? Well, if it has, we have to get that spine in alignment to take tension out of the muscles and the joints. Then you’re going to be doing spinal traction.
What drives those posture changes is corporate America’s sedentary activity. So, if you are sitting all the time due to you having to work, and provide for your family, all those posture muscles, they are intrinsic, which means they pick up on moving, get weak and lazy. Our bodies are economical, so if you don’t need to use something then our body’s just not going to use it. Then the flexors in the front of your neck get weak and lazy, so your head starts to jut forward. Muscles between the shoulders get weak and lazy. Then our shoulders are rounding, which is going to drive those postural changes which drive the cervicogenic headaches.
So, in our practice we’re going through physical therapy to improve joint mobility. Then a stabilizing strength program to engage those postural muscles. So, if your spine moves well, it’s in alignment and you’ve got balanced muscle strength, then you’re not going to deal with headaches, objectively. And by going through a conservative approach, you’re not going to have to take medication and always rely on medication to just treat the symptom, instead of addressing the root cause.
For someone suffering from headaches, what is involved in an initial chiropractic exam to determine if they have cervicogenic headaches? And what is the treatment plan typically like?
Dr. Luke Stringer: I think we just answered that one, right? So, for anyone who comes into the practice, we’re doing a detailed history and consultation. Okay, when did the headache start? Have you had them previously? Was there any trauma involved? What does your occupation require you to do? What have you done to try and correct them? What makes them feel better? What makes them feel worse? What aggravates the symptoms? How is this limiting you in regard to feeling and function?
Detailed goal setting, we then get into a detailed exam. So, a palpatory exam at the spine, evaluating the joints for their range of motion and the tone of the muscle tissue and physically taking them through a range of motion exam. Going through an orthopedic exam, all the muscles and tendons that have been damaged and/or weak and lazy that are driving a lot of dysfunction in regard to limiting range of motion, create weakness, instability. Neurological exam, is this a neurological issue or is it a musculoskeletal issue? And then take some digital x-rays. Digital x-rays can allow us to evaluate your spine objectively. To see is to know.
And then we take those clinical findings and if we feel it’s something that we can help you with in regard to our approach to musculoskeletal pain, then we’ll go through our treatment recommendations. Whenever you evaluate the spine treatment recommendation, you always have to factor in what are the clinical findings and what are the goals of the patients, and then create a roadmap to get the patient from being in pain, suffering with the headaches, to where they need to be, whatever the goals are, sitting, focusing at work, working in order so they can get the promotion and then go through the treatment plan.
The treatment plan is predominantly going to be involving spinal adjustments to improve joint range of motion mechanics, taking stress off nerves which can, with nerves and stress, get rid of your symptoms. Spinal traction, if we have spinal misalignment, fostering technical chiropractic biophysics, the most researched form of chiropractic or based on evidence-based research, to get the spine in alignment. And then soft tissue therapy to break down muscle adhesion that’s sitting in their joints or the muscle that control joint moves such as the suboccipitals. And then physical therapy to adjust the muscle imbalances that occur from just being sedentary. When you blend that approach together, repetitively build that momentum, we can take care of symptoms such as cervicogenic headaches without drugs or surgery.
If you are interested in speaking with Dr. Luke Stringer visit www.southloopchiropractor.com or call (312) 987-4878 to schedule an appointment.
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