Headaches-Migraines

Headaches-Migraines (4)

US Chiropractic Directory Presents:

Headaches and Migraines


Headaches and migraines are significant issues that people worldwide suffer from. Chiropractic has been safely and effectively helping patents with headaches and migraines for over 100 years and The US Chiropractic Directory has create a forum of information involving the entire healthcare and scientific community to bring the public evidenced and researched based answers on how and why chiropractic works to help those with headcahes and migraines.

Headaches and Migraines:

Chiropractic Saves Federal and Private Insurers $13,680,000,000

and Resolves Many Issues Facing Emergency Rooms Today

A report on the scientific literature 


by Mark Studin DC, FASBE(C), DAAPM, DAAMLP

Published in Dynamic Chiropractic, Volume 29, Issue 22

It was reported by Doheny in 2006 that migraine headaches cost U.S. employers more than $24 billion annually, including direct health care costs and indirect expenses such as absenteeism. Doheny goes on to report that according to Michael Staufacker, director of program development for StayWell Health Management in St. Paul, Minnesota, "The programs are so few and far between because many companies ‘don't perceive it as a priority’" (p. 10).

Much of the public perceive headaches and migraines as normal occurrences. For example, a patient will enter a doctor's office and report they get normal headaches, not realizing that pain is never a normal occurrence. Symons, Shinde and Gilles (2008) highlighted a statement from http://www.iasp-pain.org saying that pain is "'an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage'" (p. 277). As a result of the public not taking many types of headaches as potential serious problems, they let the condition linger and that can lead to negative sequella.

According to Munakata, Hazard, Serrano, Klingman, Rupnow, Tierce, Reed and Lipton (2009) "...neuroimaging studies have provided compelling evidence that suggests progressive brain changes in persons with migraines...migraine frequency is associated with posterior circulation infarcts and diffuse white-matter lesions...Welch et al. showed that impairments in iron homeostasis in periaqueductal grey areas that were associated with migraine duration and chronic daily headache" (Munakata et al., 2009, p. 499).

Munakata et al. also reported that the economic impact of migraines in both direct healthcare costs and indirect costs of absenteeism is a huge economic burden. The direct cost of migraines ranges from $127 to $7,089 per and the indirect cost due to absenteeism ranges from $709 to $4,453 per victim, making migraines an economic burden to the individual, the insurer, the employer with absenteeism and increased benefits paid and local, state and federal entities who will experience a lowered tax base from lost wages. It was also reported that between 2005 and 2006 there were 1,729,555 physician office visits, 186,603 advanced imaging procedures, 59,589 other diagnostic procedures, and 22,168 hospital days with a primary diagnosis of migraine or headache; all of which are paid by private or public insurers or out of the pockets of individuals. In short, the costs are staggering and a burden to the economy.

Friedman, Feldon, Holloway and Fisher (2009) reported that acute headaches account for 5% of emergency department (ED) visits in hospitals. In addition, they also reported that "…the ED environment that may also contribute to unsatisfactory treatment response include limited physician contact time that may preclude a detailed history, overuse of ED by patients with substance abuse problems, the need for rapid triage, the competing distraction of patients with life-threatening conditions, and directives (or lack thereof) for care dictated by the referring physician…Thus, the treatment of migraine patients in the ED appears to be suboptimal and the high rate of recurrent headache may be attributed to underutilization of relatively ‘migraine specific’ treatment" (Friedman et al., 2009, p. 1164).

Nelson, Suter, Casha, du Plessis and Hurlbert (1998) reported on randomized clinical trials that took place over an 8-week course. The results showed there was minor statistical differences in outcomes for improvement during the trial period for chiropractic care and for amatriptyline and over-the-counter medications for treating migraine headaches. It was also reported that there was no statistical benefit in combining therapies. However, the major factor is that in the post-treatment follow-up period, chiropractic was 57% more effective in the reduction of headaches than drug therapy. In addition, it was reported that, with the drug group, "...58% experienced medication side effects important enough to report them. In the amatriptyline group, 10% of the subjects had to withdraw from the study because of intolerable side effects. Side effects in the SMT (Spinal Manipulative Therapy) group were much more benign, infrequent, mild and transitory. None required withdrawal from the study (Nelson et al., 1998, p. 511). Although this study was conducted 13 years ago, a more current study by Chaibi, Tuchin and Russell (2011) reported that that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be equally effective as propranolol and topiramate in the prophylactic management of migraine, supporting the previous findings. Although more research is desperately needed, the above conclusions give the public clear directions with migraines and headaches.

Using the 57% increased effectiveness that chiropractic has over drug therapy (leaving out the overlap that chiropractic could help without drugs) and the $24,000,000,000 ($24 billion) Americans pay for headaches and migraines, the savings would result in $13,680,000,000. back in the insurers, the public's and the government's pockets. In addition, if chiropractic reduced the necessity for emergency room visits by 57%, then the ED doctors could focus on what their primary purpose is, to save lives in urgent scenarios.

Chiropractic offers solutions to the federal government, local government, public and private insurance companies, eases the burden on emergency rooms and prevents unnecessary side effects of drugs that are not clinically indicated, with a more viable and proven drugless solution. Although much more research is desperately needed to explore the benefits of chiropractic with migraines and headaches, the research that is available clearly reports that chiropractic offers immediate solutions. These solutions will add to the economy of local, state and federal governments by increasing the tax base and productivity in the marketplace as a result of keeping workers at work and circulating money into local economies with increased paychecks at the end of the year and productivity avoiding absenteeism. The research is conclusive and chiropractic has solutions to many of the economic and societal problems in the United States and worldwide.

References:

1. Doheny, K. (2006). Recognizing the financial pain of migraines. Workforce Management, 85(16), 10-12.

2. Symons, F. J., Shinde, S. K., & Gilles, E. (2008). Perspectives on pain and intellectual disability. Journal of Intellectual Disability Research, 52(Pt 4), 275-286.

3. Munakata, J., Hazard, E., Serrano, D., Klingman, D., Rupnow, M. F. T., Tierce, J., Reed, M., & Lipton, R. (2009). Economic burden of transformed migraine: Results from the American Migraine Prevalence and Prevention (AMPP) Study. Headache, 49(4), 498-508.

4. Friedman, D., Feldon, S., Holloway, R., & Fisher, S. (2009). Utilization, diagnosis, treatment and cost of migraine treatment in the emergency department. Headache, 49(8),1163-1173.

5. Nelson, C. F., Bronfort, G., Evans, R., Boline, P., Goldsmith, C., & Anderson, A. V. (1998). The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. Journal of Manipulative & Physiological Therapeutics, 21(8), 511-519.

6. Chaibi, A., Tuchin, P. J., & Russell, M.B. (2011). Manual therapies for migraine: A systematic review. The Journal of Headache and Pain, 12(2), 127-133.

 

 

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Headaches & Migraine: Chiropractic vs. Medication

Effectiveness & Safety

 

In randomized clinical trials, chiropractic was 57% more effective in the reduction of headaches and migraines than drug therapy

A report on the scientific literature 


By Mark Studin DC, FASBE(C), DAPM, DAAMLP

It was reported in October of 2010 by Wrong Diagnosis that approximately 1 in 6,16.54% or 45 million Americans get headaches yearly, with many people suffering daily. While the statistical numbers vary based upon your source of information, it can be agreed upon that headaches are very common and shared among Americans at an epidemic rate. Taking into account that a single pill for many Americans to treat a headache can cost as much as $43, according to Consumer Reports Health Best Buy Drugs, the overall cost to our economy totals billions of dollars and we need to focus not on the treatment of the effects, but the root of the cause.

When you suffer from headaches, it affects every facet of your life and you search for immediate answers. Most often it is a medication, either over-the-counter or prescription as evidenced by the amount of money spent as previously reported. One of the first medications recognized for the potential treatment of headaches is amatriptyline, commonly known by brand names such as Elavil, Endep or Amitrol as reported by Robert on About.com in 2006. It is also used as an antidepressant. This medication has made up a large part of the billion dollar industry along with over-the counter-medications. Although in many instances, this drug is indicated, the question that arises is what are the risks of taking this widely used medication?

The potential side effects of this medication targeted for headache sufferers, according to drugs.com (n.d.), are: blurred vision, change in sexual desire or ability, constipation, diarrhea, dizziness, drowsiness; dry mouth, headache, loss of appetite, nausea, tiredness, trouble sleeping, and weakness. Severe allergic reactions can be: rash, hives, itching, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue, chest pain, confusion, dark urine, delusions, difficulty speaking or swallowing, fainting, fast or irregular heartbeat, fever, chills, or sore throat; hallucinations, new or worsening agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still, numbness or tingling in an arm or leg, one-sided weakness, seizures, severe or persistent dizziness or headache, severe or persistent trouble sleeping, slurred speech, suicidal thoughts or actions, tremor, trouble urinating, uncontrolled muscle movements (such as in the face, tongue, arms or legs), unusual bleeding or bruising, unusual or severe mental or mood changes, vision problems, and yellowing of the skin or eyes. Over the counter remedies of NSAID's or aspirin have a long list of their own of side effects.

The safety of chiropractic, in spite of rhetoric from naysayers, has been documented in clinical trials by Miller and Benfield (2008), who reported on children younger under 3 years old, "the youngest and most vulnerable population..." (p. 420). There was one reaction reports for every 749 adjustments which was typically crying. None were reported to have any serious side effects.

In adults, clinically, the majority of any side effects are soreness that is transient. This is based upon this author's 30 years of clinical experience and teaching doctors of chiropractic who are trained in creating an accurate diagnosis, prognosis and treatment plan. To say that more serious side effects cannot happen is irresponsible. However, they are rare, non-life threatening and usually transient in nature, no different than infants. To ensure the best outcomes, like with any professional, you have to verify the doctor's credentials and experience, which is best accomplished by securing a copy of the doctor's curriculum vitae (his/her academic and professional credentials).

Nelson et. al. (1998) reported on randomized clinical trials that took place over an 8-week course. The results showed there was minor statistical differences in outcomes for improvement during the trial period for chiropractic care, amatriptyline and over-the-counter medications for treating migraine headaches. It was also reported that there was no statistical benefit in combining therapies. However, the major factor is that in the post-treatment follow-up period, chiropractic was 57% more effective in the reduction of headaches than drug therapy.

Bryans, et. al. (2011) confirmed Nelson's findings and reported that spinal manipulation (adjusting) is recommended for patients with episodic or chronic migraines with or without aura and patients with cervicogenic headaches. This follow-up study is not a comparison or comment on the use of drugs. It simply demonstrates that chiropractic is a viable solution for many and can save the government and private industry billions in expenditures both in health care coverage, loss of productivity and avoidance of absenteeism in industry creating a new level of cost as sequella to headaches.

Medications and other forms of invasive care are often necessary and it is critical for a trained doctor to perform an accurate history and physical and when indicated, advanced diagnostic testing (CAT scans, MRI's, etc.) to ensure there aren't more serious underlying complications. However, based upon the results of the research provided by Nelson et al. (1998) and Bryans et. al. (2011), it should be chiropractic first, drugs second and surgery last to render better outcomes with less potential side effects and a quicker return to productivity.

 

References:

1. Wrong Diagnosis. (2010, October 6). Prevalence statistics for types of headaches and migraine conditions. Health Grades Inc. Retrieved from http://www.wrongdiagnosis.com/h/headache_and_migraine_conditions/prevalence-types.htm

 

2. Consumer Reports Health Best Buy Drugs. (n.d.). Treating migraine headaches: The triptans, Comparing effectiveness, safety, and price. Health.org. Retrieved from http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/triptanFINAL.pdf

 

3. Robert, T. (2006, May 26). Amitriptyline: Headache and migraine drug profiles. About.com. Retrieved from http://headaches.about.com/od/medicationprofiles/a/amitriptyline.htm

 

4. Drugs.com. (n.d.). Amitriptyline side effects. Retrieved from http://www.drugs.com/sfx/amitriptyline-side-effects.html

 

5. Miller, J. E., & Benfield, K. (2008). Adverse effects of spinal manipulative therapy in children younger than 3 years: A retrospective study in a chiropractic teaching clinic. Journal of Manipulative and Physiological Therapeutics, 31(6), 419-423.

6. Nelson, C. F., Bronfort, G., Evans, R., Boline, P., Goldsmith, C., & Anderson, A. V. (1998). The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. Journal of Manipulative & Physiological Therapeutics, 21(8), 511-519.

7. Bryans, R., Descarreaux, M., Duranleau, M., Marcoux, H., Potter, B., Ruegg, R.,... White, E. (2011). Evidenced-based guidelines for the treatment of adults with headache. Journal of Manipulative & Physiological Therapeutics, 34(5), 274-289.

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Saturday, 16 October 2010 18:29

Headaches and Chiropractic

Written by

Headaches and Chiropractic Care

A report on the scientific literature 


By Mark Studin DC, FASBE(C), DAAPM, DAAMLP
 

It was reported in October of 2010 by Wrong Diagnosis that approximately 1 in 6,16.54% or 45 million Americans get headaches yearly, with many people suffering daily. While the statistical numbers vary based upon your source of information, it can be agreed upon that headaches are very common and shared among Americans at an epidemic rate. Taking into account that a single pill for many Americans to treat a headache can cost as much as $43, according to Consumer Reports Health Best Buy Drugs, the overall cost to our economy totals billions of dollars and we need to focus not on the treatment of the effects, but the root of the cause.

While there are many types of headaches, including common headaches, migraine headaches, cluster headaches, and tension headaches, the one thing to keep in mind is that there is no such thing as a "normal headache." You are not supposed to get headaches as pain is an indicator of a problem and your body’s mechanism of letting you know something is wrong and you need to go fix it.

One of the most common and less understood headaches is the "cervicogenic headache." This is a syndrome characterized by chronic pain around the head that is associated with either the bony structures of the head or the muscles of the neck. This has also been associated with migraine headaches. In a study by Biondi (2005), 64% of migraine sufferers reported associated neck pain/stiffness with their migraine attacks. 31% experienced neck symptoms before the headache, 93% during the headache phase and 31% during the recovery phase. Therefore, cervicogenic headaches are also a component of the migraine headaches and can be treated. One of the hallmarks of determining if there is a cervicogenic component of any headache is to change the position of your head and if you increase, activate or alter the pain pattern, there is a component.

According to Haas, Spegman, Peterson, Aickin, and Vavrek (2010), spinal manipulative care (chiropractic adjustments) resulted in a reduction in pain from cervicogenic headaches of up to 50% for the group that received adjustments for up to 24 weeks, the length of the study. The researchers also noted a decrease in over the counter medication during the 24 weeks of the study. Haas, Schneider, and Vavrek also reported in 2010 that at 12 weeks, 85% showed improvement with varying degrees of improvement ranging from a small improviement all the way up  to 100% with similar findings at 24 weeks.

Chiropractic has been proven to reduce, and in many instances totally eradicate, headaches. The financial cost to headache sufferers for drugs is staggering. Costs for chronic headaches can also include loss of paychecks when sufferers are unable to work, disability costs to insurers and loss of production of workers to industry when their employees cannot perform their jobs on a daily, weekly or monthly basis. Research has concluded that chiropractic has a drugless solution that works.

These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with headaches. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.



References:

Wrong Diagnosis. (2010, October 6). Prevalence Statistics for Types of Headaches. Retrieved from: http://www.wrongdiagnosis.com/h/headache/prevalence-types.htm

Consumer Reports Health Best Buy Drugs. (n.d.). Treating Migraine Headaches: The Triptans, Comparing Effectiveness, Safety, and Price. Retrieved from: http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/triptanFINAL.pdf

Biondi, D. M. (2005). Cervicogenic Headaches: A Review of Diagnostic and Treatment Strategies. Journal of the American Osteopathic Association, 105(4), 16-22.

Haas, M., Spegman, A., Peterson, D., Aickin, M., & Vavrek, D. (2010). Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: A pilot randomized controlled trial. The Spine Journal, 10(2),117-128.

Haas, M., Schneider, M., & Vavrek, D. (2010). Illustrating risk difference and number needed to treat from a randomized controlled trial of spinal manipulation for cervicogenic headache. Chiropractic & Osteopathy, 18(9), Retrieved from http://www.chiroandosteo.com/content/18/1/9

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Friday, 23 April 2010 20:13

Migraine Headaches and Chiropractic

Written by
Migraine Headaches and Chiropractic

A report on the scientific literature 


By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
 
Thousands of people in the United States suffer with headaches and many do not realize there are different types of headaches that are a reaction to a variety of causes. One of the major tenants of Chiropractic is to find the cause of the problem instead of chasing symptoms. Although Migraine headaches are truly caused by changes in the flow of blood in the brain, many people refer to any headache that is severe enough to negatively affect their day a “migraine”. Many of these cases are people who have headaches on a regular basis, and for whatever reason, they slowly get worse over time. This usually results in increases in medication dosage, prescription of more dangerous drugs with more side-effects and decreases in quality of life. The research paper being reviewed stated “The estimated costs of migraines in the United States is over $17 billion per annum [year]”.1 (p 91)
This research study that was published in 2000 was titled “A randomize controlled trial of chiropractic spinal manipulative therapy for migraine”. This was designed “To assess the efficacy of chiropractic spinal manipulative therapy [Chiropractic Adjustment}  in the treatment of migraine”.1 (p 91). This study followed others that had delivered similar results. 
The authors state “However, the level of evidence is steadily increasing to the point where there is now seen to be a moderate level of efficacy for Chiropractic SMT [Spinal Manipulative Therapy/ AKA Chiropractic Adjustment] in the treatment of headaches or migraines”1 (p95). The paper also reported “The mean number of migraines per month was reduced from 7.6 to 4.1 episodes. The greatest area of improvement was medication use, for which participants were asked to note the use of medication for each episode. A significant number of participants recorded that their medication use had reduced to zero by the end of the 6-month trial”.1(p95) Expressed in other terms, 72% of participants reported significant improvement! 
When administered by trained Doctor of Chiropractic, adjustments to the neck are safe and effective. This study has also show that Chiropractic care results in the reduction of medication utilization, some of which have significant long term side-effects having a profound effect on your long term health. Chiropractic chooses to use a safe and scientifically effective approach to the management of migraine headaches and if you are suffering, Chiropractic care is just what the doctor ordered!
1.       Tuchin PJ; Pollar H; Bonello R. A randomize controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of Manipulative and Physiological Therapeutics 23(2): 91-5, 2000. 

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