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Showing posts with label cervicogenic headache. Show all posts
Showing posts with label cervicogenic headache. Show all posts

Sunday, February 22, 2015

Dangers of Forward Head Posture


 Neutral posture is observed when a plumb line passes through the center of the ear, shoulder, hip, knee and just in front of the ankle (Illustration - LEFT). Forward Head Posture [FHP] is present when the head at rest is positioned in front of the center of the shoulder. The movement of this much weight (About ten pounds) in front of the plumb line causes a shift in the body's Center of Mass, or balance point.

Forward Head Carriage

The good news is that the human body has an exquisite self-balancing system to compensate for shifts of the Center of Mass. The bad news is that these compensatory changes can be quite extreme (Illustration - RIGHT ) and cause severe structural stresses and even changes in organ systems.

There is a predictable pattern of compensation as the body realigns the Center of Mass. This is called the Trinity of Forward Head Posture [FHP].
  1. Head moves forward of the shoulders. This changes the body's center of mass and center of gravity, triggering a response in the body's balance system.
  2. To counter-balance the mid and upper back drifts backward, the shoulders rotate inward.
  3. In response to that movement, the pelvis tilts forward

Several major studies have concluded that FHP is a direct indicator of a person's overall health:
  • Spinal pain, headache, mood, blood pressure, pulse, and lung capacity are among the functions most easily influenced by posture; however, many symptoms, including pain, may be moderated or eliminated by improved posture.1
  • Hyperkyphotic (hi-per-kie-fah-tick) posture [excessive curvature of the thoracic spine, commonly referred to as hunchback] predicts increased mortality. Interventions specifically targeted at improving hyperkyphotic posture could result in reduced mortality rates.2
Hyperkyphosis video by Spine-Health
What is Kyphosis?
  • Researchers found that even mild forward head carriage is “detrimental” to a person’s “overall health”. They concluded that the farther the head/neck moved in front of the seventh (7th) cervical vertebrae “all measures of health status showed significantly poorer scores” and that this forward translation increased a person’s pain and decreased their ability to function!3
  • Researchers at the University of Leeds in the UK found a direct cellular connection between muscles in the neck and a part of the brainstem - called the nucleus tractus solitarius (NTS) - which plays a essential role in regulating heart rate and blood pressure. This finding quite possibly explains why an injury to the muscles of the neck (i.e. whiplash) can at times change a person’s blood pressure and heart rate. It stands to reason that repetitive use injury to these same muscles (i.e. slouched posture at your desk and/or computer, cell phone, tablet use) may very well adversely alter these vital signs too!
Poor Posture Alters Your Vital Signs

Major Effects of Forward Head Posture

- For every one inch the head sits forward of the shoulders, an additional 15-30 pounds of tension is placed on the muscles in the back of the neck.
The Physics of Forward Head Posture

It has been estimated that a person with Forward Head Posture uses 30% more body energy to keep the body erect.

As the body shifts, certain muscle groups get stretched and become weak, and other groups shorten, and become weak. This results in degenerative changes that twist and distort the spine and subsequently shorter stature.

 

There is nothing good about poor posture and regardless of the activity (work or play) posture affects your overall performance. At least 85% of the back/neck pain related issues that enter my office derive from improper posture. Poor bodily usage directly impacts the biological, psychological, and social aspects of our daily lives leaving us dysfunctional, exhausted, and in pain. Implementing proper body mechanics is simply a mindful adherence to good habits that must be practiced with moment to moment awareness.  

Even though poor posture is not self-correcting it can be reversed. A chiropractor near you utilizing manual therapy, therapeutic exercise, and lifestyle advice can help you overcome upper crossed syndrome [see image above] and return you to a neutral posture in no time



1 Lennon J, Shealy N, Cady, RK, Matta W et al. Postural and Respiratory Modulation of Autonomic Function, Pain, and Health. American Journal of Pain Management. 1994;4 (1):36-3

2 Journal of the American Geriatrics Society. Volume 52, Issue 10, pages 1662–1667, October 2004

3 Glassman SD, Bridwell K, Dimar JR, Horton W, Berven S, Schwab F. The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976) 2005 Sep 15;30(18):2024-9.

4 The Journal of Neuroscience, 1 August 2007, 27(31):8324-8333











Monday, March 17, 2014

Integrative Care for Headache Pain



Headache has been a bane of humankind for centuries and one of the most common conditions that affects the nervous system. The universally accepted premise is that pain sensitive components of the head and neck are what elicit headache.[1] It is estimated that 47% of adults will experience a headache at least once within the next year.[2]

In 1988, the International Headache Society (IHS) devised a uniform system for classifying headaches which has unequivocally aided headache research. However, the clinical application of this system is limited due to its length, intricate detail, contradictory elements, and lack of real-world observation and data.[3] In fact the World Health Organization admits that many people have their headaches inaccurately diagnosed by their health-care provider.[1] An understandable fact when primary care physicians (PCP) only receive an average of four hours of instruction on headache disorders while in medical school.[1]
This statistic in no way indicates incompetence, just inadequate training with regard to headache. A comprehensible fact given the other more fatal pathologies a PCP must learn about on an intricate level.

This does, however, lead one to theorize that the prescribed drug treatments utilized to combat headache pain may be improperly applied due to the many coinciding aspects of migraine and tension-type [4] headaches. Therefore these analgesics provide no lasting relief to the patient and out of their frustration to feel better easily leads to the development of a medication-overuse headache (MOH).[5]

An integrative approach to headache pain is the most logical way to manage this epidemic given the reasons and biologic elements that contribute to it. According to the research, especially in the case of migraine and tension-type headaches, this may be the most successful strategy to help patients overcome their headache pain.


Since the principal causative factor of headache is spine related, wouldn’t it make sense to have a physician who is specifically trained in spine related disorders be the hub of the diagnostic, management and treatment of headache pain. The doctors at Life in Motion Chiropractic and Wellness are trained Primary Spine Practitioners who can deferentially diagnosis, rule out serious pathology, and provide evidence-based management for the majority of headache patients while also integrating that care with their already established healthcare providers.




[1] Swenson, Rand and Grunnet-Nilsson, N. 2005. The Management of Headache. In: Haldeman, Scott, et        al, eds. Principles and Practice of Chiropractic. New York: McGraw-Hill, pp. 999-1011

[2] "Headache Disorders." WHO. Ed. WHO Media Center. World Health Organization,
         Oct. 2012. Web. 12 Mar. 2014.

[3] McKenzie, Robin, Stephen May. The Cervical & Thoracic Spine – Mechanical Diagnosis & Therapy.
            Raumati Beach: Spinal Publications New Zealand Ltd, 2006. Print.

[4] Most common type of primary headache. Its mechanism may be stress-related or associated with musculoskeletal problems in the neck. [World Health Organization]

[5] Most common type of secondary headache. [World Health Organization]