Transcript
Dr. Riley:
Unfortunately, headaches are one of the more common diagnosis that we see here at Tulsa Spine and Rehab. I think going back to what I’ve spoken about, diagnosis is the key. It’s important that we diagnose the headache appropriately. Is it a migraine headache, attention headache, cluster headache, there’s something called a cervicogenic headache? And a cervicogenic headache is actually one that we’ve shown to have some really good outcomes here at the clinic. A cervicogenic headache means it’s coming somewhere from your neck. We’ve had good response with some migraine headaches, cluster, tension, but I’d like to say that the mechanical neck pain that contributes to the headache, we’ve had the best outcomes with that type of patient. And anytime I see a headache patient, there’s two things that I’d like to visit with them about initially. We talk about environmental factors, history, and then obviously, physical complaints.
So, going back to environmental history with that patient, I might ask them what they do for a living. Do they sit for extended periods? Ergonomically, are they set up correctly? What is their sleep environment like? Do they use a pillow? How old is their mattress? Because many times a lot of those things come into play, and potentially can contribute to this tightness and soreness throughout the upper traps, upper back and into the neck, base of the skull. So, I like to counsel many of those patients on do we need to make some tweaks or some revisions, modifications to your ergonomic positions. Is it time maybe for a new pillow? Should we look into a new mattress? What is your sleep position? Those types of things. So, I like to have those discussions with the patients initially to see if we can start to make some changes at home.
And then secondly, obviously, their physical exam findings. Do they have spasm? Do they have tightness? Do they have inflammation, swelling throughout their neck and upper back? So, first line of defense as a chiropractor, I want to check joint mechanics, biomechanics throughout the neck and the upper back. Are there joints or facet joints that are stuck? Are they not moving well? Is there opportunity for us to reestablish proper mechanics or motion into those joints? Then we’ll do a soft tissue assessment. What are the soft tissues like? Is there chronic tightness throughout a paracervical or a scaling, whatever the muscle may be? Is there an opportunity to use deep tissue massage, or active release therapy, some form of assisted stretch or maybe even dry needling?
And the goal of those therapies would be to release, obviously, the tightness and soreness where those soft tissues attach. Because if it’s chronically tight and we can get that to loosen up, it’s going to take some pressure off where it connects. Pardon me. High intensity laser, another great tool here in the clinic that we used for reducing inflammation and spasm. So, effectively, what this high intensity laser is doing, it’s reducing inflammation and tightens that muscle, in turn should reduce tightness and soreness. And we’ve spoken about this in the past. I’m a big believer in active care, exercise, therapy, those types of things. So, I’d like to make the patient accountable.
If I feel like it’s a good idea in the patient would benefit from it, we might make some recommendations on some exercises, some strengthening things to their neck that would limit how much they have to come in. Maybe get them doing a few things on their own. So, related to headaches, all different kinds of headaches, mechanical headaches, cervicogenic headaches, we treat frequently here at Tulsa Spine and Rehab with chiropractic, deep tissue massage, assisted stretch, high intensity laser, exercise, with some very good results. And lastly, I’d like to say, what’s great about we’re doing, we’re not using medications, we’re not using injections. We’re taking a very conservative approach to give you the most efficient, positive outcome.
