Migraine and tension headaches 

How the neck is moving, can be the cause of headaches.

Understanding of cervical spine biomechanics is important in understanding the mechanism of any injury and headaches.

Biomechanics is basically a science, which applies physical and mechanical laws to biological structures like muscles, ligaments, joints and various other structures. Since the human spine is populated with many of these structures in a complex web it is possible for changes in these structures or changes in the position of the skull (occiput or C0) on top of the cervical spine to affect the biomechanical abilities of the cervical spine to hold the head vertical and therefore affect normal movement at that level. Also, because of the close proximity of vital anatomy like cranial nerves, the spinal cord, the brainstem, arteries and other blood vessels it stands to reason that any change in cervical spine biomechanics may well have a detrimental affect on these vital structures and hence affect a person's overall health. We are all accustomed to the disastrous consequences for someone who breaks their neck (cervical spine) or who sustains a dislocation of fracture of cervical vertebrae. Certainly dislocations or fractures in the upper cervical spine are invariably fatal or can be neurologically detrimental. What consequences, symptoms or other problems do people experience that do not exhibit any visible (as viewed on basic X-ray, CT scan or MRI) dislocation or fracture of the cervical spine? Nothing? What happens when a person receives a significant blow to the head, which may or may not result in unconsciousness? Nothing? Just because normal radiographic analysis results in a diagnosis of "Within Normal Limits", does this mean that there has been no damage to cervical spine biomechanics? I suggest not.

It's just not plausible that nothing happens to the structures that maintain biomechanical stability. It stands to reason that at the very least ligaments can be stretched briefly and at the other end of the scale stretched beyond their elastic limits or even tear. In these cases it can be the very anatomy of a person, their age and their physical strength that determines whether they are fatally inflicted or just have some minor neck pain. Of course, there are many people in between who have chronic pain and dysfunction for years yet Doctors can find nothing wrong with these people using the tools and methods at their disposal.

All things, which are influenced by gravity, are normally stable when the centre of gravity is in synchronisation with the forces and weights affecting them. Thus it is clear that a structure like the human spine with the head sitting atop the cervical spine is mechanically stable when the head is directly over the pelvis. A biomechanically stable spine is characterised by a head sitting vertical to the cervical spine and the eyes, jaw, shoulders and pelvis, which are level with the horizon. There should be neither rotation of the head, shoulders, pelvis nor any anterior or posterior lean of the spine from the cervical spine down to L5. Any deviation from the centre will induce axial loading forces, and alter the weight bearing structures throughout the body. No more is this evident than in the cervical spine. Changes in the biomechanical structures holding the skull on to the atlas vertebra will alter the weight bearing capability of the cervical spine. This resultant change in the centre of gravity can cause postural asymmetry, which represents a mechanical and physiological imbalance of the spine. Injury to ligaments attached to the atlas and skull can result in a complete shift of the skull on the atlas. According to White and Panjabi1 page 283, "the anatomic structures which provide stability for the articulation of the occipital-atlanto-axial articulations are the anterior and posterior atlantooccipital membranes, tectorial membrane, alar ligaments and apical ligaments." I think we can also add some of the sub-occipital ligaments like the rectus capitis posterior minor (RCPMI) and major, obliquus capitis superior and inferior. The RCMPI attaches to the posterior arch of the atlas, to the occiput and via the Myodural Bridge to the dura mater. Form comments from other authors White and Panjabi note that these authors "believe that the occipital-atlantal joint is relatively unstable, at least in children." What I notice most about sick children I have seen is their inability to hold their head up vertical and their tendency to hold their heads in forward posture. I also notice that some young children have very large heads, almost the size of adults (which weight about 4 to 5kg) yet their necks seem so frail as to seem incapable of holding the head upright on the neck. Are these necks unstable as defined in the literature?

Intractable Migraine Headaches During Pregnancy Under Chiropractic Care

Complementary Therapies in Clinical Practice 2009 (Nov);   15 (4):   192–7
             The absence of hormone fluctuations and/or the analgesic effects of increased beta-endorphins are thought to confer improvements in headache symptoms during pregnancy. However, for a number of pregnant patients, they continue to suffer or have worsening headache symptoms. The use of pharmacotherapy for palliative care is a concern for both the mother and the developing fetus and alternative/complementary care options are sought. We present a 24-year-old gravid female with chronic migraine headaches since age 12years. Previous unsuccessful care included osteopathy, physical therapy, massage and medication. Non-steroidal anti-inflammatory medication with codeine provided minor and temporary relief. Chiropractic care involving spinal manipulative therapy (SMT) and adjunctive therapies resulted in symptom improvement and independence from medication. This document provides supporting evidence on the safety and possible effectiveness of chiropractic care for patients with headaches during pregnancy.