Edward Lichten, M.D.,PC
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Reference Article:
Manipulative Therapy Helps Treatment of Tension-Type Headaches

Carman A. Ciervo, DO, Associated Professor of Clinical Family Medicine,
Michael J. Warner, DO, Assistant Professor Clinical Osteopathic Sciences/ Family Medicine

University of Medicine and Dentistry of New Jersey. National Headache Foundation. Fall 1994, Number 90, page 3.

Muscle Contraction-- Occipital Neuralgia -- Tension-type Headaches

Just because you have a headache doesn't mean it's "all in your head." Sometimes the muscles of the neck and shoulders can cause or contribute to head pain. There are different types of headache, and their causes and contributing factors can vary greatly. For this reason, it is important that every headache patient undergo a careful exam to establish the correct diagnosis. Once the diagnosis is made, a treatment plan tailored to the patient can be developed.

One of the most common types of headache is the tension-type, or muscle contraction headache. These headaches can be caused or aggravated by muscle spasms of the shoulder and neck. When muscles are in spasm, they become painful and sometimes irritate nerves that can produce pain at the base of the skull and the scalp. The cause of these muscle spasms may be major or trivial. A rear end motor vehicle accident transmits an enormous amount of force to the neck. As a protective response, the muscles tighten. Unfortunately, long after the sprains have healed, the muscles may remain in spasm. Maintaining the neck or spine in one position for prolonged periods of time, such as sleeping in a chair, extended driving or working at a computer may also cause muscle spasm.

Manipulative therapy is often helpful as part of a comprehensive plan in treating tension-type headaches. Those patients who experience severe or frequent tension-type headaches may be advised to follow a program consisting of medication, diet, stress reduction and manipulative therapy. Manipulative therapy sometimes referred to as "laying on of the hands," is usually administered by an osteopathic physician (D.O.), physiatrist (physical medicine specialist) or chiropractor (D.C.).

Manipulative therapy of the muscles and bones can decrease muscle spasm and restore normal motion to the spine. Some clinicians accomplish this by quickly stretching the muscles. Other techniques are more passive and keep muscles in prolonged contraction so that they relax more deeply when released from fatigue.

A treatment called "counter-strain" requires the identification of a tender point on the muscle or spine. The body is then placed in a position of comfort for 90 seconds. This allows the muscle spasms on the affected side to decrease, and further encourages relaxation by taking the strain off the stretch receptors inside the muscles.

The benefits of manipulative therapy depend on the individual. Many headache patients prefer to take less medication, so this may be an additional option. For some patients, manipulative therapy can be used as a sole source of relief when the headaches are not too frequent or severe.