Frequently, a chronic headache resistant to treatment is due to a disorder of the cervical spine, which may be cured by manipulation. Certain mechanical changes in the cervical spine may cause an intermittent or a continuous headache. These changes respond well to manipulation. The pain can spring from the neck. Some people do not believe in the possibility that pain can radiate from the neck to the head.
An experiment was carried out by Kellgreen. A concentrated saline solution was injected in the area where the cervical spine first joins with the head, producing tenderness and headache in the forehead region. This proved a connection between the neck and the forehead.
Important changes have been found in the cervical spine in cases of headaches. These relate to disturbances in the lumin of the vertebral artery which passes through the transverse process of the cervical vertebrae and supplies blood to the brain.
Sometimes the therapeutic effect of cervical manipulation helps us to confirm whether a particular headache is of cervical origin. Sometimes a headache is produced by the head being kept in a certain position; keeping it in the opposite direction relieves the headache. Sometimes manual traction at the neck relieves the headache. These are indications that headaches may be of cervical origin, and manipulation succeeds.
Embryologically, the head and the first and second cervical vertebrae are formed by the first and second cervical segment. As they originate from the same segments they ought to have some relationship between them. So any abnormality at the level of the first and second cervical vertebrae can give rise to pain in any part of the head, the temple and the forehead. As it happens elsewhere, local pain at the level of the cervical vertebrae may be completely absent and the patient may complain only of a headache.
This type of headache may come on while waking up in the morning. It may be felt in the back of the head or the front of the head, or may be only in the forehead. This begins to ease after some hours and is much better by mid-day. The patient is free from headache till the next morning. As the years pass by, the headache may tend to last longer during the day. It responds well to manipulative treatment.
Dr.Bicker’s staff is of the opinion that headache is due to stretching or tension in the muscles, vessels or the outermost sheath of the spinal chord. It is due to these mechanical reasons, the pain starts in the upper neck muscles, and spreads to the upper back and head. It may be associated with stiffness and pain in the upper neck. It occurs off and on. The headache seems to spread from the neck to the head rather than from the head to the neck. There can be other causes of headaches too. Keeping that in mind, a detailed of the patient can help in pin-pointing the cause of the headache.
Other Possible Causes of Headaches
Eye strain due to defective eyesight
Sinusitis
Toothache
Digestive disturbances
Neurological problems, e.g., an intra-cranial tumour
Allergy
Cardiovascular diseases
Psychogenic (mental) frustration
Upper cervical pain may be caused by:
An intra-cranial tumour of the posterior fossa (portion) of the skull
A disease of the upper cervical spine such as tuberculosis
Malignancy
At times differentiation is difficult. But distinction is important, as headaches arising from the neck can most easily and lastingly be relieved. So it is a great pity when the right diagnosis is not made and the right treatment is not administered. An old man is often told that his headache is due to high blood pressure. In fact, it may be completely unconnected and it may be due to upper cervical osteoarthritis. Cervical manipulation can relieve pain on the lateral side of the face. This pain often has rhythmicity and may be associated with a running nose or watering of the eyes. It may radiate to the upper jaw or even the lower jaw. The patient is often referred to a dental surgeon or oral surgeon.
Osteopathic examination may show tenderness over the side of the second and third cervical vertebra on the same side, and if the X-ray picture is clear, manipulation will be successful in many cases and the pain will subside.