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Will You Need Surgery

For Your Headache?

I certainly hope not. Unless you've got a brain tumor, surgery is rarely an option considered by people with benign headaches. When I say benign, I mean not caused by cancer or some other serious medical disorder. Benign headaches can, in fact, be quite disabling and completely disrupt a person's quality of life. Work and exercise routines may add psychological or physical stress and make the headaches more acute, curtailing activities.

Although most headaches are treated conservatively, surgeons have recently begun to take an interest. Dr. Jansen of Germany (Jansen J. Surgical treatment of cervicogenic headache. Cephalgia 2008;28 Suppl 1:41-4.) recently reported on a group of 60 patients operated on for headache. They had headaches caused by neck problems, commonly called cervicogenic headaches. These types of headaches respond very well to chiropractic adjustments. In Dr. Jansen's study, he reports removing the disks of C4, C5, and C6 levels in different patients. He analyzed the results over two years later and found that about 36-37% had deterioration of their condition. Although Dr. Jansen thinks surgery should be considered more often based on his case series, the lack of a control group makes his results suspect, modest as they are.

Surgery is really a very last step in the treatment palette patients should consider. Unfortunately, many patients consider only medications as options for headache management. Some patients will consume so much over the counter medication that their headache is actually aggravated by the heavy use of pain killer medications. Many of these patients will benefit from gradually weaning off of the drugs, if they are in fact medication induced.

Cervicogenic and tension-type headaches can commonly result from whiplash trauma and other acceleration injuries of the head and neck. This type of trauma can sprain the cervical ligaments and disks, and cause tears in muscle fibers. Tension-type and cervicogenic headaches have been shown in randomized clinical trials to respond favorably to chiropractic adjustive care. These studies have also shown minimal side effects when compared to certain medications. This is especially true for tension-type medication treatments.

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