NEAR DAILY HEADACHE
Edward Lichten, M.D.,PC
180 East Brown Street
Birmingham, MI 48009
80% of all headaches are muscle contraction/ cervicogenic/ and analgesic
The failure to diagnose cervicogenic headaches is the medical reason so many women are treated with multiple medications without success!
Chiropractic View on Muscle Headaches
Dentist's View on Muscle Headaches
The cervicogenic headache refers to the headache that develops primarily in women and is a headache "caused by the neck." There are three aspects to consider in this headache which is purely mechanical in nature:
- There are nerve roots that exit under the skull and travel through the five layers of muscles in the neck. When one gets a "stiff neck," the muscle spasm can constrict the nerve. The pain from this nerve, located at the base of the skull and approximately one inch from the midline, is referred to the forehead. Therefore, muscle contraction or cervicogenic headaches are felt as a tightening band across the forehead and into the eyes.
- Women are "constructed" differently from men. They lack the trapezoid development or "back muscles" that are needed to hold the head up straight. Women, more often then men, assume a "head forward" position. With the head drooping forward, there
is considerable strain on the trapezoid neck muscles and the nerves. Therefore, posture is the number one contributing factor to cervicogenic headache.
And women have to contend with the weight of breast tissue on the bra straps that cut into the trapezoid muscles. Since the breasts swell before the menses, the additional weight can cause additional strain on the muscles. As such, it is common to
find an increase in the incidence of cervicogenic headaches prior to menstruation.
- The injection of a few milliliters of a local anesthetic into the area of the occipital nerve will release the muscle spasm (trigger point) and immediately relieve the headache. These areas have been noted by Bonnie Prudent in her book on Myo-therapy
. Whether called tender spots, or myo-fascial spots, or trigger points, they are areas of muscle spasm.
There is no medicine or diagnostic test that is as inexpensive or as accurate in
making the diagnoses as is injection at the time of the headache.
Under these circumstances, it is easy to see why so many headache patients take medication almost every day. They get Analgesic Rebound, which means they get headaches from the medication they are taking for the headache! For example, caffeine dr
inks and drugs cause muscle contraction and many temporarily relieve muscle spasm. However, after 3-6 hours of sleep, the caffeine effect wears off and the individual wakes up with a headache. Then they take more caffeine!
There are multiple levels of cervical root involved in chronic
1. Occipital nerve C2-3
1. Inject 3cc of 1% lidocaine
with 1/2cc of dexamethasone at C2-3 notch (1 inch lateral to midline)
2. Palpate the C5-6 lateral vertebrae for triggers. Usual location is
directly lateral. Inject 1cc here.
3. Palpate the supra-spinatus
(trapezoid between neck and acromion (shoulder) for tightness. One inch
from plum line of ear is the scapular notch. Tenderness there shows the
subscapularis muscles to be in spasm and fixing the scapula-shoulder
complex from moving. Injections into the subscapulais may be needed to
resolve the pain issues.