01.05.2024
Dr. John Conflitti
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Migraine headaches are among the most debilitating and dreadful neurological problems that exist. They may not be fatal, but the effect on someone’s quality of life can be dramatic. Imagine having days where the sight of light cripples you. Imagine having terrible nausea, and a constant pounding in your head so bad that you wish that someone would just cut the darn thing off your neck. Imagine that pain lasting for hours or even days at a time. You probably already know that feeling, and you’ve almost certainly been in the same room as someone going through a migraine attack. Fortunately, most people experience a migraine on rare occasion. However, there are those among us that experience these terrible headaches several times a month, and others even experience them on a DAILY basis. This is the typical life of a chronic migraine patient in my office. Many times these patients have seen several headache specialists. They’ve seen the best neurologists that the Mayo Clinic and Cleveland Clinic have to offer, and have been through every MRI and brain scan available. They’ve tried several different medication regiments, altered their diets, and spend their lives in fear of triggers like meat, wine, and sometimes caffeine. Many have even tried alternative therapies like acupuncture and conventional chiropractic with no change. When they finally sit down and speak with me, they’ve been suffering for years, and almost numb to the fact that they have constant pain in the head. Some look a little pale, others need the lights off in the office, and some even come in wearing sun glasses. All of them are a little doubtful and skeptical that their condition can be cured. Less Focus on Cure, More Focus on Cause When most people walk into a doctor’s office with an ailment, what they are most often searching for is a cure. Though migraines are terribly common, and have been around for centuries, a cure has been elusive for the millions of patients suffering on a daily basis. Over the counter migraine medications are usually a first line of treatment, followed by prescription medications. There is also a focus on removing triggers from a person’s life like chocolate, caffeine, and certain scents/perfumes. The truth is that headaches (especially migraines) cannot be treated as a simplistic disease that is the same in all people. Headaches are a dynamic entity with causes that are multi-factorial. Instead of looking at a migraine as a disease entity, it should be seen as a symptom of a neurophysiological process gone haywire. The Trigeminocervical Complex: The Pain Gate Keeper of the Head/Neck Don’t get hung up on the terminology, the name is not important for the casual reader. It is important to understand that near the top part of your spinal cord. In the area surrounded by your top 3 neck vertebra is a very important bundle of nerve cells. These specific nerve cells filter incoming signals from the outer covering of the brain known as meninges. They also filter incoming signals from the blood vessels of the brain, as well as signals that come from the neck. You see, the brain does not have any receptors that trigger pain. It’s kind of crazy to think about, but it’s true.  However, the outer protective covering of the brain, and the blood vessels are very pain sensitive. When the receptors from these structures get set off, then a cascade of events can take place leading to the blood vessels in the brain opening up and becoming inflamed. It’s important that we have ‘filters’ like the trigeminocervical complex around to make sure that not every pain signal gets to the brain. In that way, it acts like a gatekeeper. If it let every pain signal through, you would be in a state of pain without end. So what went wrong with the built-in gate keeper of pain to the brain? The normal alignment and movement of the head and neck serve as a buffer to pain signals that go into the gate keeper. When you lose the normal alignment, several things can happen. Blood flow in and out of the brain is compromised Inflammatory molecules stay in the brain’s blood supply longer Muscles and ligaments of the neck misfire Low grade inflammation persists in the joints of the neck Small muscles in the neck may pull against the brain’s outer covering When this happens, you have an environment where the trigeminocervical nucleus can get overloaded with pain signals without the buffer of signals from normal head and neck movement. All of a sudden, a seemingly harmless trigger can send someone with a tendency towards migraines can be sent in a downward spiral of a pounding headache. Correction not Cure Our focus is on correcting the Structural positioning rather than curing migraine headaches. The truth is that Structural Correction has benefits that go beyond treating or curing a specific illness or disease. Correction of Spinal Displacement does one thing, and only one thing: It mobilizes the self-healing, self-restoring potential within your own body. If we believe that our bodies were meant to be healthy, pain-free, and vibrant, then we must only find what is inhibiting the body’s self-healing potential.
04.04.2024
Dr. John Conflitti
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What’s a Normal Headache? This is truly one of the more frustrating things that I hear is when someone tells me about their “normal headache”.  From a physiology standpoint, it would seem silly for the human body to make head pain a normal part of body’s day to day functions. How do you know what type of headache you have? What type of treatments are best for each headache? We’ll break all of that down today. Tension Headaches These are the most common headaches, and what most people classify as a “Normal Headache”. This type is known for having a band like compression around the temples, forehead, or back of the head. Many people call this a stress headache because it is exacerbated by a person’s response to stressful situations. These headaches are typically mechanical in nature (tight muscles, associated with neck pain) There is a lot of variation in the duration and intensity of this type of headache. Even though the pain can become severe (as high as a 8 or 9/10 on the pain scale), the lack of neurological symptoms imply that the nature of the headache has a different origin. Most people control these headaches with massage, over the counter medications, and conventional chiropractic to provide short-term relief. Things like Yoga and stress management techniques are also popular treatments. Migraine Headaches A severe headache is NOT the same as a migraine. It’s important to recognize this because the nature of a migraine headache goes beyond mechanical dysfunction. Migraines are characterized by abnormalities in blood flow to the brain, which creates some distinct neurological symptoms. Most migraines feature: Severe headache Sensitivity to light Aura and other visual disturbances Nausea Pins and needle sensation Post headache hangover Treatments usually go beyond over the counter medications. Other headaches Of course there are several other types of headaches. Things like cluster headaches, sinus headaches, and trigeminal nerve pain fall into the spectrum of common headaches. Another emerging class of headache include those that come from chronic use of pain medication, which has led to a search for new drugs or non-drug therapies to try to manage this common debilitating problem. The truth is, because headaches are experienced differently by so many people, it might be best to figure out where headaches have a commonality. The Craniocervical Junction and the Trigeminal Nucleus The craniocervical junction is a fancy term for where the head meets the neck. A tremendous amount of research is going on in this part of the body because of how big a role it plays on the brain and overall neurology. One of the things that they have found is that this part of the body has a big influence on a part of the spinal cord called the trigeminal nucleus. The trigeminal nucleus is where the nerve cells exist that provide innervation for head, neck, face, jaw, the brain’s outer covering, and the blood vessels of the brain. Here’s a surprising fact: The brain itself does not feel pain When you feel pain in your head, it is coming from brain’s outer covering called the meninges, and the blood vessels. All of these structures feed into the trigeminal nucleus and this piece of anatomy tells our brain what it should feel. Symmetry Matters In the world of Chiropractic we find that symmetry of the cervical spine matters. When you lose your normal structural symmetry of the spine, then the trigeminal nucleus is less likely to work properly. That’s why headache patients usually respond so quickly to this unique type of care. Of course it may not help every person with headaches. The truth is that headaches can be affected by tumors, chemicals, and even food for some select cases. However, a gross majority of the population’s headaches are likely secondary to a structural shift of the head and neck.
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