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Chiropractic and headaches

Headache is an extremely common condition that affects the quality of life and interferes with the work of a significant portion of the population. It is the third leading cause of visits to chiropractors in North America.

There are various forms and causes for headaches, and anatomical studies help explain much of it. The primary nerve responsible for sensitivity and motor function of the neck, face, and scalp is the fifth nerve, called the trigeminal nerve. This is confirmed in part by a classic article on the topic: "Much of the innervation of the face is provided by the fifth pair of cranial nerves, the trigeminal nerve. It descends from the cerebral gray matter and connects with the nerves of the first, second, and occasionally the third and fourth cervical vertebrae (C1, C2, C3, C4), forming branches and linking to other neurons in all these segments. This means that if a neuron receives information from two different cervical segments (such as C2 and C3), painful stimulation of one may result in pain perception in another cervical region. This 'connection' of nerves generates a pattern of pain perception throughout the head. Pain in the forehead may be the result of trigeminal stimulation (such as in sinusitis), but it can also result from cervical stimulation (such as subluxation/misalignment). Similarly, pain in the back of the head - the occipital region - (which is greatly innervated by roots coming from C2) may not originate in the occipital area, but arise from nerves that connect to the trigeminal nerve or cervical nerves. In anatomical terms, any headache can be caused by activation of the trigeminal nucleus (a cluster of nerves that will form the trigeminal nerve) or be caused by structures innervated by other cranial nerves - facial, glossopharyngeal, and vagus - or by the three nerves of the upper cervical spine (these are other nerves that come from the neck and go to the head and scalp). Given the appropriate stimulus and the connections the nervous system makes, any structure innervated by these nerves can be capable of producing a headache." Recent studies in scientific literature demonstrate that chiropractic and its procedures are recommended for cervicogenic headache and chronic or occasional migraine with or without aura, as well as exercises targeting the neck flexor muscles (see here for how to perform cervical retraction) and, to a lesser extent, joint mobilizations. Treatment modalities typically used by chiropractors include chiropractic adjustments, posture education, ice/heat, massage, Nimmo technique, stretching, and strengthening, aiming to improve quality of life, reduce pain, and promote proper bodily function.

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