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n estimated 27% of women and 14% of men regularly suffer from severe headaches, including migraine headaches -- and these percentages don’t include the "nuisance" headaches that we all get from time to time.

Many people manage their headaches with over-the-counter or prescription drugs.

Trap: Medications provide only temporary relief. With continued use, they frequently cause rebound headaches -- the pain returns, sometimes more intensely than before.

Chiropractic care can help. It focuses on spinal adjustment (manipulation) and massage. The American Chiropractic Association reports that up to 14% of patients who see a chiropractor cite headaches as a primary concern. The success rate of treating headaches with chiropractic care can be superior in some cases to pharmaceutical management.

Example: A study in Journal of Manipulative and Physiological Therapeutics looked at 218 headache patients who were treated either with amitriptyline  (an antidepressant commonly used for migraine headaches) or with chiropractic manipulation. Initially, the treatments were equally effective, but only patients in the chiropractic group reported continued benefit one month after the treatments stopped.

HOW IT HELPS

Headaches often are caused by disorders in the neck and/or upper shoulders.

Example: Fixated (or "stuck") joints in the neck can cause muscle tightness that irritates nerves that travel up the back of the head. Relaxing these muscles with chiropractic joint and soft-tissue manipulation can reduce or even eliminate some headaches.

Many patients with headaches also need lifestyle adjustments. Poor sleep is a common cause of headaches. So is dehydration, which can disrupt the normal pressure of cerebrospinal fluid. People who hunch in front of a computer for hours at a time are more likely to get headaches than those who get up and move around regularly.

Chiropractic treatment is safe for the vast majority of people, but a complete history and an examination by a licensed chiropractor always are the first steps. Studies have shown that the risk for serious complications from spinal manipulation is significantly less than the risk for side effects from chronic use of common over-the-counter medications used for neck pain and headache.

Types of headaches and the best treatments...

NECK PAIN

Cervicogenic headaches originate in the neck, in the vertebrae below the base of the skull. The small muscles that attach to these vertebrae become excessively tight. The tightness can irritate the occipital nerves that radiate upward from the base of the skull.

Treatment: The chiropractor restores normal movement by manipulating the cervical vertebrae (neck bones). This relaxes the muscles... reduces irritation of the nerves... and interrupts the transmission of pain signals.

Cervicogenic headaches respond better to chiropractic manipulation than most other types of headaches. It is reasonable to start feeling some relief within six to 12 visits.

Also helpful: Don’t sleep on your stomach. You have to turn your head to the side. This greatly increases stress on muscles and vertebrae in the neck.

MUSCLE PAIN

Some people develop tender points between muscles in the neck and/or shoulders and the fascia  -- a thin layer of tissue that wraps around and supports the muscles. Pain spreads to the back of the head causing myofascial  headaches.

Treatment: Soft-tissue manipulation, in which the chiropractor uses his/her thumbs to gently massage and manipulate the muscles and fascia at specific trigger points -- areas where the pain is most intense. Pressing the trigger points increases circulation and causes the muscles to relax.

The patient may initially experience a slight increase in discomfort during treatment, though often the pain ebbs rapidly during or after treatment. Some patients notice a reduction in headache frequency or severity after one treatment, and many improve after three to five treatments.

MIGRAINE

Chiropractic manipulation of the joints and/or muscles won’t always prevent a migraine headache, but it can relieve migraine pain once it has already started.

Treatment: Chiropractors who also are trained in Eastern approaches, such as acupressure, may manipulate or massage each of these areas associated with migraine pain, including the web between the thumb and forefinger... the crown of the head... the area between the eyes... and/or the soles of the feet.