026- Tension Headaches and Chiropractic Care

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Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. Today we have a great episode. It's been a great week for the Evidence Based Chiropractor and I have a few things to talk about off the top. Number one is that the research we're going to dive into today focuses on tension type headaches and chiropractic adjustments for the relief of them. So a very interesting topic. We do a lot of lumbar spine, but it's nice when we get a cervical spine and specifically a headache piece. So I'm excited to dive into that. Number two is if you've gotten your recent edition of Chiropractic Economics in the mail or if you looked online, you probably saw that the first article from myself has been published in Chiropractic Economics. I'm extremely grateful to Daniel and everybody at Chiropractic Economics for really picking up on what we've been doing at the Evidence Based Chiropractor and giving the opportunity. So you're going to see a lot more articles in Chiropractic Economics about marketing, about research, really a variety of topics to help you better build your practice and increase the utilization of chiropractic, which is our goal here at the Evidence Based Chiropractor. Before we get started, I'll say a few words about Rocktape. As I do every week. Rocktape is proud to be a sponsor of the Evidence Based Chiropractor. Rocktape offers the world's best kinesiology, tape, pain relief, topicals, mobility tools and functional fitness accessories. New from Rock Tape is Rocksauce Chill, a powerfully cool pain relief topical and a convenient roll on with 6% menthol. Stronger than the freeze competition. They are more than a tape company, they are a movement company. Learn more and get access to your medical discount by visiting rocktape.com I know in a couple weeks they're also having their summit there. I believe it's taking place on the west coast there at their headquarters and it is the second or first weekend, I should say in June is the Rock Tape Summit. I would love to be there. I'm actually going to be in Oklahoma City for continuing education at that point. So I'm bummed out that I won't have the opportunity to be there. But I know Stefano, Dr. Capo and everybody at Rock Tape is gonna put together a fantastic program and we're actually gonna have the opportunity also to have Dr. Capo back on to talk about Rock Blades, their new product. So that's another exciting piece to come. But today we are going to talk about a piece of literature from the Journal of Chiropractic Medicine. It was released in 2014 and it is titled Efficacy of Manual and Manipulative Therapy in the Perception of Pain and Cervical Motion in Pat Type Headache A Randomized Controlled Clinical Trial. So I love these RCTs. It is the highest form, the top tier of research or randomized controlled clinical trial. And again, you will find direct citation of this in our show notes, but I'll repeat the title again. It is Efficacy of Manual and Manipulative Therapy in the Perception of Pain and Cervical Motion in Patients with Tension Type Headache A Randomized Controlled Clinical trial. Journal of chiropractic medicine in 2014. So as we know, the prevalence of chronic tension headaches and their socioeconomic impact have continued to rise as our population develops a sedentary lifestyle, we see it each and every day. Postural effects, the ability or disability to really get up and moving throughout the day. If you're sitting at a computer all day, we see these patients every single day. In practice, these headaches are often accompanied by a limited cervical range of motion due to hypotonicity of the suboccipital and paraspinal muscles. Again, we see that as we go through our chiropractic exam up front, we're gonna find tension whether it's in the scm, the traps, the rhomboids, et cetera. And it's gonna limit then the cervical range of motion. Concurrent headaches, all these things fall together. In practice. Patients with chronic tension headaches typically have occupations which involve the promotion of kind of an upper cross syndrome. So again, it just gets back to the same old thing. Sitting at a computer all day, largely sedentary lifestyle has really resulted in a proliferation or an increased prevalence in terms of tension based headach stem from postural related components and muscle hypertonicity. So this study from the Journal of Chiropractic Medicine found that a combination of manual therapy and manipulation yields the best outcomes for patients suffering with tension headaches. It's important to note that patient history, exam and eval will determine whether manual therapy or manipulation is the best treatment option. But irregardless, the patients should also undergo an active at home program, of course, to strengthen their posture and, and make the proper ergonomic changes to break the cycle of the chronic tension headaches. So as chiropractors, this is really, we're uniquely poised, as you can imagine, to address the vast array of these concerns. As far as the muscle tension is concerned, we're able to address that with our soft tissue work. As far as the mobility or the biomechanics, of course, the wheelhouse of what we do, the chiropractic adjustment paramount in terms of making sure that there's adequate segmental motion and then as far as ergonomic changes and strengthening posture, we're also experts in terms of the active care and certainly can give solid recommendations, probably better than anybody else regarding ergonomics in the workplace. So for patients that have this sort of chronic tension based headaches, I think it's a really good opportunity for us as chiropractors to get out. And this is a great piece of research in the evidence based chiropractor. We put this out as our October 2014 research brief. So if you're a member, you can find this and pick this up in the members of all. But if you're not, you're missing out because this research article, again, it came out in 2014 and we published it as a research brief just like that. We actually put it out in October 2014. So it's still new research, but it was really top of mind. And it's important to get this research out to other providers. Many providers aren't able to piece these things together. They don't know what we do in practice. So research such as this really emphasizes the fact of the breadth and depth of what we do. Let's take a look at a few quotes from this piece of research as well. The researchers found, quote, regarding pain perception, manipulative treatment, manual therapy and combined treatment have shown efficacy in reducing pain in all of the dimensions assessed. Although the group with manipulative treatment stood out from the others. So great opportunity there. Of course, manipulation, chiropractic adjustment is typical wheelhouse of what we do as chiropractors. Number two, they found with regard to the weekly register on frequency and intensity of pain, these parameters showed significant improvement in the groups with manipulation and combined treatment. So combined treatment, manual therapy and manipulation or manipulation alone, manipulation being the key part of both of those equations. They found with the weekly registers that the patients were taking that the frequency and intensity of pain showed significant improvement in those groups. So very powerful piece right there. Number three, they found the manipulative treatment on its own or combined with manual therapy was more effective for reducing pain intensity. So just supporting the same things we've already learned essentially in this study, these researchers took patients again with chronic tension type headaches and they measured perception of pain and cervical range of motion and ultimately those that manipulation, AKA a chiropractic adjustment, whether on its own or combined with manual therapy, showed significantly greater improvement than the control group or those who received manual therapy alone. And really, to frame the power of this research, think about how many people, literally millions of people each and every day that are dealing with chronic tension type headaches. A vast majority of these individuals, literally millions of people, are taking over the counter meds every single day to avoid these tension type headaches which are stemming from what they are doing every single day, whether ergonomics or sitting at their workspace. Tension type headaches related to the cervical spine, secondarily to that. Then think about second place, the millions of people that are then going to their primary care doctors, literally millions of people and complaining of the tension type headaches to their doctors. Quite frankly, many of these primary care, we know this to be true. Many of these primary care doctors, they don't have the time, experience, skills or tools to dive into ergonomics to address the biomechanical changes or anything of that nature. So generally what they're doing at that point is writing the prescription again, maybe not for an over the counter, but for a regulated drug or medication. And again, what occurs? Well of course, the same thing we would expect to occur. The patient takes the medication, they might see a slight decrease in symptomatosis, of course, their body sensitizes to it and the tension headaches come back. That is they never left, but were just hidden by the medication. And then the patient's continuing the same cycle which got them into that position to begin with. And then they're going up or down, depending upon which way you look at it, the cascade of medications. So, and I firmly believe that many primary care doctors aren't really looking to do that with patients because these patients are coming back into their offices and then complaining that they're not getting well. So that's not something that a primary care doctor loves either. It doesn't exactly bode well for them when their treatment choices aren't working in the best manner possible. So this is where again, I can't say it enough, but here at the evidence based chiropractor, it's really about positioning your practice, positioning chiropractic in your community. Not only I know there's many resources out there for direct to consumer marketing materials and kind of getting out there in the your community. It's extremely important. Important, it's essential. But second to that, don't forget about reaching out to the other care providers in your community. I've talked to too many chiropractors who say I've tried, it didn't work in the past. They just didn't have a proper ABC plan, which is exactly what we do at the Evidence based Chiropractor. And taking research such as this, this is new research, top tier research, and showcasing it to these providers each and every month goes a heck of a long way. And then you can supplement that with case notes which provide social proof of patients improving in your practice as well as MD meetings as well as getting with some of these docs and meeting them and using again. I'm the biggest fan in the world of the Socratic method to determine ultimately how you can best serve their patients. It's not about going in there and hammering them with chiropractic, but it's about showcasing the challenges they might be having in their currently top tier choice and then showcasing where your practice can make life easier for them and their patients. That's the magic and that is absolutely the sweet spot. And that's why a lot of people have tuned into the Evidence based Chiropractor and myself and why I'm grateful that they have in order to really build those bridges, break down those boundaries and make sure everybody's reaching out in the most effective way possible. So this is a great research study. I would encourage you again please take a peek at the show notes. You will find the direct research linked from there. If you are not a member of the Evidence Based Chiropractor already, it is time you are primed and I would be happy to take a few moments. You can email me jeffthevidencebasedchiropractor.com and I'm happy to chat about things with you for a few minutes. Also, if you haven't explored our free tools, we have a variety of reports and guides that are available for free. Just as this podcast is on our website, the evidencebasedchiropractor.com and finally, if you've been listening to this podcast and you like it, I would love feedback. It helps us out tremendously. If you can go onto itunes and leave us some stars, leave us some favorites, feedback and a few comments. Until then, have a great week in practice Doc.

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