Chiropractic Vs. Amitriptyline for Tension Headache Relief
If you are suffering with headaches, you are not alone. Tension headaches are a serious problem in our stress-filled society, especially when it comes to being able to perform common daily tasks. Duke University performed a population study, which showed that “[daily] activities were limited by 38% of tension-type headache attacks” and that “89% of tension-type headache sufferers reported that their headaches had negatively affected their relationships with friends, colleagues, and family.”1
To enable you to seek the appropriate care you need to get rid of the pain and get your life back, it is important to understand what causes these types of headaches. What we call tension headaches, the medical community calls “cervicogenic headaches”, which is a fancy way of saying that they are headaches caused by mechanical dysfunction in the neck. The cervical spine (the neck) is made up of bones, called vertebrae, that are separated by specialized cushions, called intervertebral discs. “Discs” are shock absorbers for the spine and protect the nerves that exit between the vertebrae. These nerves are branches from the spinal cord, which originates in the brain. The brain and the spinal cord are protected by the skull and the vertebral column, respectively. So, the first place where disruption in communication from the brain to the rest of the body can occur is where the nerves exit between the vertebrae.
Injuries such as whiplash from an auto accident, a slip and fall, or a sports injury, can cause individual joints of the cervical spine to become stuck, like suction cups. Thus, when the joints do not move normally, the connective tissues of the joint get irritated and cause inflammation. This condition is commonly known as osteoarthritis. One of the components of inflammation is swelling. This swelling and its resultant chemical irritants interfere with normal nerve transmissions. When the nerves that control the muscles of the neck get pinched, choked, or irritated, they will cause the muscles to become constantly tense, resulting in a tension headache. As a side note, we must remember that spinal nerves are very delicate. Beginning in the 1970’s, Dr. Chung Ha Suh, Ph.D and his colleagues at the Biomechanics Department of the University of Colorado demonstrated that it only took 10 mm Hg. of pressure (the weight of a dime) on a spinal nerve to decrease transmission in that nerve by up to 50%. In conclusion, it makes sense that if we restore normal joint function, inflammation will be reduced, normal nerve function and muscle tone will be restored, and the tension headache will be relieved.
Treatment options for tension headache sufferers are many and varied. We will review two popular approaches for safety and effectiveness: cervical manipulation and medication. In two controlled trials that Duke University reviewed, they found that cervical spinal manipulation, or what chiropractors call “adjustments”, resulted in “immediate improvement in headache severity…and [that] a course of manipulation treatments resulted in sustained improvement in headache frequency and severity.”2 In other words, consistent, repeated adjustments over a 6 week period resulted in fast-acting and lasting relief.
The effects and safety of amitriptyline, a headache drug, was compared with the effects of cervical adjustments for the treatment of tension headache in another trial. They found that amitriptyline had a greater effect on the reduction of headaches than adjustments during the 6 week trial period, but that adverse effects were much more common with the group taking the drug than those receiving adjustments. Only a 4% incidence of adverse effects were experienced by the cervical manipulation group. Conversely, a whopping 82% of the drug patients experienced adverse effects.3 Most importantly, after both treatments were stopped, the group taking the drug returned to the same headache frequency and level that they experienced before the trial, while the group that received adjustments sustained the improvements that they had maintained after the trial.4 It just goes to show what happens when the cause of a condition is treated versus just the symptoms.
In addition to the treatments discussed previously, the following video,
will demonstrate a simple, self-help method for temporarily relieving your headache until you can receive professional care. Remember, there is no such thing as a “normal” headache. Headaches are “common”, never normal, which is why you should seek professional help to determine the cause of your headaches and have them treated appropriately.All references are from the Duke University Evidence-based Practice Center/Center for Clinical Health Policy Research
Dr. Dana Williamson is a member in good standing of the Virginia Chiropractic Association. He is an expert in the natural treatment of headaches at his Chiropractic Centers of Virginia offices located in Richmond and Mechanicsville.
