Q: Why do symptoms in my head and upper shoulders, or neck worsen as the day goes on, especially around 2:30PM?
A: Generally because the weight of your 8-pound head pushing down on the nerves and joints in your neck overloads them, making them progressively more irritated. This common sense explanation has saved many people from confusion about where their headaches and/or migraines are coming from. To help resolve this problem in your neck, here are helpful strategies:
- Increase downtime at night to 8 hours to unload your sensitive neck structures and nerves; avoid lying on your back to read or watch TV- try lying on your side with your head slightly down (see illustration above, right); you can also lie down for 15 minutes twice per day, especially when you get home from work
- Minimize long walks or car trips. They both have a cumulative jackhammer-like effect of your 8-pound head on your neck
- Minimize lifting, carrying, and cleaning/scrubbing. They all involve strong neck muscle contraction, which jam sensitive neck structures and nerves.
How long do you continue with these suggestions? Core neck healing occurs in the first 8 weeks, though symptom relief is much faster. A routine outcome, based on observation of thousands of patients over the past 10 years is an approximate 60% reduction at 3 weeks and 85% reduction at 6 weeks of frequency of headaches, migraines, and associated symptoms (nausea, lightheadedness). If arm numbness or tingling is present, it typically consistently clears after about one week. Our System addresses what is routinely the source of this tightness, in the lower neck. It is wise to have that problem fixed. However, in the interim, you can likely achieve rapid, significant short-term change in your headache intensity by following this advice, along with the postural ideas available HERE. This advice may or may not be helpful to you, but it’s often a useful precursor to your engagement in our System. This System targets the discs in your lower neck, as well as the joints with our meticulous evaluation and treatment algorithms.
Q: I’ve noticed that my child gets headaches and migraines, just like I do. What’s the connection?
A: We would suspect that your child inherited your neck anatomy. This can apparently include both neck disorders, as well as an extra-touchy hub of nerve activity in your brainstem called the trigeminocervical (or trigeminal-cervical) nucleus. It’s located deep in your neck just below the base of your skull. The black circles in the illustration (right) show where this structure is, serving as an area where 4 major nerve systems converge and can overflow into one another. There has been some very exciting research from great minds about this “master switch” for headaches, migraines, and associated symptoms and its communication with nerves in the neck (purple, dashed line). This research is published in numerous major peer-reviewed professional journals.
An easy way to help discern the source of your child’s symptoms is to look for a mechanical pattern that points to the neck, such as being consistently worse in the morning (change their sleeping position to advice given above on this FAQ page for a few nights, then reassess), or progressively worse as the day goes on (especially around 2PM, from overload of their 8-pound head on their neck structures). That implies a neck source because it’s unlikely that tumors, blood vessel problems, blood pressure problems, or other scary things have a pattern like that. If there’s no pattern, or if there’s any other concern, of course consult your doctor.
Q: Control of my triggers is the most common advice that I have heard, other than medications for my headaches and migraines. How do my triggers tie in with your evaluation and treatment system?
A: Picture a glass 4/5 full of water. Imagine that that’s your neck problem.
Then, add more water to the top, to overflowing. Imagine that those are your triggers that you just poured on the top.
We focus on emptying the water (fixing your neck problem) from the glass with our system.
Then, you can pour triggers into the glass, but they rarely, if ever overflow into headaches and migraines.
Q: How exactly do you fix a migraine problem like mine, using your system?
A: We use the Strategic Orthopedic Spine System, which is based on detailed algorithms that track symptom of response in real time to repeated movements and sustained positions of the spine. Once positive symptom change is identified during the initial evaluation, it is then possible to teach patients how to centralize and abolish their own head and face pain and associated symptoms consistently and immediately. Symptoms rapidly become less frequent, less intense, then commonly, absent altogether as the neck and associated structures heal. The Strategic Orthopedic Spine System offers potential freedom from ongoing doctor visits, emergency room visits, medications, therapies, tests, and specialist interventions. The reason is that the patient can treat themselves whenever they experience symptoms, with immediate results. This makes patients much less likely to medicate or go to an ER if they have immediate control over their symptoms.
Q: Why are my eyes so dry and itchy?
Close up, inside view of trigeminal (head/face) nerve connections to the eye
A: With headaches & migraines, it’s because your trigeminal nerve (your headache nerve) controls the tear ducts in your eyes. When it’s irritated, it’s common that it shuts off your tears (though some patients report excess tearing from this same nerve). Fixing the nerve irritation routinely restores normal hydration to patients’ eyes nearly instantly. Eye itchiness, eye pain, and eye pressure also quickly resolve as well in the overwhelming majority of cases.
Maxillary division of trigeminal nerve controls mucous production and sensation in the nose and sinuses
Q: How do I know if my sinus pressure and runny nose are a neck problem, or what I’ve always thought it’s been (allergies)?
A: If your sinus symptoms tend to be better around 9AM (once you’ve been up and moving an hour or so), then worsening as the day goes on, around 2PM, it would most likely be from overloaded nerves in your neck. These neck nerves converge with your sinus nerves (see blue nerves in image to the right) in your brain stem. The reason for the consistent worsening in these symptoms later in the day is that your 8-lb. head can irritate your neck so badly by 2PM from sustained pressure that symptoms overflow into this nerve system, causing a stuffy nose or sinus pressure. This system targets the neck structures that cascade into that (sinus) nerve system and calm it down so that it no longer spreads into that area. In fact, it’s the first symptom to be abolished with our approach, and reactivity to allergens typically ceases or is markedly less once this nerve system is calmed down through neck treatment targeting that (trigeminal) nerve system.
Q: What exactly is happening with my hormones around my cycle that causes me to get menstrual migraines?
A: A summary of how hormones work by epilepsy expert Mark Yerby M.D. may help to explain how nerve excitability is affected by the balance of estrogen and progesterone. This may apply as a parallel explanation for migraine:
“Estrogen is an “excitatory” hormone, which means that it makes brain cells give off more of an electrical discharge. Progesterone, on the other hand, is an “inhibitory” hormone, which means that it calms those cells down. When the body is making more estrogen than progesterone, it can make the nervous system “excitable.”
It seems plausible that irritability of the central nervous system from hormonal fluctuation (i.e., think premenstrual syndrome, or PMS) also sets off nerve irritability in the neck, causing tightness at the base of the skull. Theoretically, this nerve irritation then cascades into the head and face (trigeminal and greater occipital nerves) through nerve connections in the brain stem, and down into the gut, explaining commonly-associated nausea (vagus nerve). A routine observation clinically is that symptoms continue to respond in a predictable, immediate, mechanical (cause/effect) fashion with cervical (neck) work, even during a woman’s cycle. Changes are so fast and dramatic that it’s natural to question a vascular explanation (versus our contention, which is nerve irritability) Nerve irritability would seem to make better sense, as nerves are amenable to immediate change, unlike blood vessel dilation/constriction).
Q: What might my child be doing to flare up her headache symptoms?
A: Looking down while doing schoolwork or texting (don’t underestimate the frequent, sustained neck down position from the texting). Have her use a backpack on top of her desk with a clipboard to support papers so her work is angulated and closer to her face while in class. Otherwise, I’d suggest the “Jasmine Plus Book Stand”, available through Amazon. Both stands are separate, yet work together and fold completely flat to carry in a backpack. The smaller stand that can fit on top of the larger stand can be slipped off and set to the side to hold a book at an angle, while the other (larger) one serves as a writing surface. The lip at the bottom can be folded down flush so that its doesn’t press on her forearm while writing. And lastly, make sure she’s not sleeping on her stomach at night (twists her neck), or on her back (puts sustained pressure on the greater occipital nerves at the base of her skull). We teach kids (generally 12 years old, or older) how to clear the lower neck obstruction that’s routinely observed in this patient population. That neck obstruction is what’s responsible for the neck tightness and the nerve problems in the head and face that result from it.
Q: How long might it take to achieve relief using your system?
A: A common outcome is approximately 50% reduction at 3 weeks and 85% reduction at 6 weeks and 95% reduction at 10 weeks of frequency of headaches and migraines. Since you’re empowered to control your own symptoms around the clock (work, home, sleeping) with this system, symptoms then become less frequent, less intense, and in many cases, absent altogether. Hence our mantra, “Fast, Natural, and Lasting”.
Of course, individual results vary, depending on many factors such as medication use, level of engagement with this system (which stresses proactivity), and psychosocial issues (which can keep neck muscles tight from continual, background anxiety). The latter can delay healing, due to sustained compression of neck structures that cascade up into nerve systems in the head and face. We incorporate strategies to address this common issue.
Q: What are the best exercises for me, since I suffer from headaches and migraines?
Click here for a pdf that answers that question in detail.
A: Click here to understand what we consider the source of this mysterious diagnosis.
Q: I notice that my neck makes a crackling Rice Krispies sound when I turn it, and I wondered if it’s something I need to be concerned about.
A: That sound is generally from the joints between your first and second vertebrae in your upper neck. Chances are that you feel tightness there, especially in the afternoon as they get inflamed from overload. This occurs from continual tightness in the muscles along the base of your skull, called suboccipital muscles. In our experience, a lower neck nerve problem nearly always causes these muscles to get abnormally tight like that, and this system is tailored to resolving that problem. The joint sounds typically reduce or clear over a few months, once engaged in our System. The reason that the joint sounds are so obvious to you (but not others) is that the upper neck joints feed sound (“Rice Krispies”) directly into your auditory (ear) canals. That’s known as “bone conduction” of sound. Google Glass, for example, harnesses the bone conduction pathway to eliminate the need for earbuds. Click HERE to read about that. It’s really fascinating!
Q: Why do I have reflux with my headaches?
A: Researchers indicate that the vagus nerve, which controls your stomach and intestines, connects to the trigeminal nerve (a primary “headache nerve”) in your brain stem. In most cases, shutting off the irritation in your neck shuts off input into both of these nerve systems, which can be the answer to abolishing multiple symptom problems quickly and naturally- and hopefully, long-term.
Q: I notice that bright light really sets off my headaches and migraines. What’s the connection?
A: The trigeminal nerve that produces head and facial symptoms also supplies sensation to the white and clear parts of your eyes, as well as your tear ducts. It seems reasonable that bright light can heighten the irritation of this trigeminal nerve system to the point that it sets off your headache or migraine. Most all of us are familiar with a “brain freeze” when you hold ice cream or a snow cone on your front teeth. The apparent reason for that is because your teeth share the same nerve as your head and face (the trigeminal nerve).
This explanation of a stimulated trigeminal nerve would also likely apply when you feel that you need to sneeze, then you look at the sun to “make it happen”. Realize that the trigeminal nerve also controls your nose and sinuses, including sensation and mucus production. Your trigeminal nerve is activated when you feel that you need to sneeze (trigeminal nerve), then you flood that nerve system further with super-bright light (the sun). This kicks the nerve firing threshold over-the-top, so to speak, resul
ting in the full-blown sneeze that you’d like to get out!
So, in summary, you might think of bright light stimulation of headaches (and the thankful production of a sneeze) as simply super-stimulation of the trigeminal nerve system from a source at the nerve endings (eyes, teeth, ears), versus from your brain stem (trigeminocervical nucleus). Once you calm down the brain stem over-sensitivity, the less “spark” the trigeminal nerve system becomes. We call it “becoming bombproof”, with relation to triggers that so commonly set off the trigeminal nerve.
Q: Speaking of nerve excitability, do you think there’s promise for this system in helping those with epilepsy, since it helps with migraine?
A: We make no such claim, but we suspect that it might. Researchers have noted that migraine and epilepsy frequently occur together. Another associated paper points out the likely common hub of nerve excitability with both migraine and epilepsy. That hub is strongly suspected to be the trigeminocervical complex in the brainstem. Since our contention is that research indicates that we’re likely impacting that hub of nerve excitability in the brainstem through calming of nerves in the neck that feed into it, it’s at least a consideration. Dr. Turner would be very interested in participating in research with a team focused on this potentially-viable, conservative intervention.
Q: Why is it that when the weather changes a lot, I get a bad headache or a migraine?
A: Nearly all of the patients that we see with headache/migraine issues have sore joints in their neck. One of the telltale signs is that symptoms are better in the morning, progressively worsening around 2 in the afternoon. Common sense implies it’s because of overloading of sensitive joints and nerves in your neck.
That said, consider that barometric pressure fluctuations may irritate the joints in your neck, setting off your trigeminal nerve system through its connections in your trigeminal-cervical nucleus. (Click HERE to view how general neck (joint) irritation can feed into this convergence of nerves in your brainstem. That nerve irritation, in turn can cascade into head and facial symptoms.)
Now, think of that same phenomenon happening when low barometric pressure from weather change causes each fluid-filled joint in your neck to expand. Theoretically, this can pressurize sensitive joint capsules (which surround each joint up and down your neck), causing stiffness and pain. From our extensive clinical experience, we know that joints clearly refer symptoms up into the head and face, much like hitting your funny bone sends nerve symptoms into your hand and fingers. It’s routine to put pres
sure on a neck joint, producing clear cause/effect symptoms in the head and face. Our System incorporates extensive strategies to clear this joint irritation so that healing can occur, targeting lasting change without ongoing medications, therapies, or exercises.
Q: What’s the difference between what you do and spinal manipulation?
A: Manipulation (popping) of joints in your neck and upper back can provide temporary, though not lasting relief in chronic cases- at least in the case load that we see in this headache/migraine clinic. If you’ve had spine manipulation sessions, you know what I’m talking about. Manipulation commonly results in short-term symptom relief, but the source of the tightness in your neck isn’t resolved in our experience with a headache/migraine population. Think of it as a Band Aid, though many yearn for the brief symptom relief that it generally provides. However, addressing the source, typically in the lower neck breaks the cycle of neck muscle tightness that overloads your neck joints and makes them sore and stiff. This empowers you for a lasting resolution of pain and tightness, versus passive dependence on a practitioner to manipulate your spinal joints on an ongoing basis.
Relaxation Training resources:
NOTE: While lying down more to help clear inflammation in your neck, you may find these relaxation methods helpful:
Suggested relaxation aides, which you can combine with the increased lying down time that you spend. Since you’re lying there anyway, you might as well develop your natural relaxation skills at the same time!
- QUICK CHANGE: Tina Low Dog, MD, who is associate professor at University of Arizona’s Integrative Medicine program with renowned Harvard-trained celebrity MD, Dr. Andrew Weil wrote a health and wellness book. An excerpt of her instructions of a fast, helpful breathing technique are accessible HERE.
- TOOL FOR QUICK RELAXATION AND AS SLEEP AID: McMaster University in Canada has posted recordings for their students online, associated with student services and health. This particular may sound a bit goofy and repetitive. But once you learn the technique, it can produce major relaxation in a very short period of time. Click HERE to access that (First note this technical tip: Please be aware that MP3 files cannot be downloaded directly to mobile devices, such as iPhones, iPads or Android mobiles. You should always download first to a desktop/laptop and then sync to your mobile device.): http://wellness.mcmaster.ca/images/stories/audio/naturalhigh-track3-autogenic_training.mp3
- FOR MORE LONG-TERM CHANGE: The App/website HEADSPACE is my favorite for retraining the mind for what’s popularly known as “Mindfulness Meditation”. It’s not really a spiritual practice, per se. Rather, it’s working briefly (and daily) with retraining your mind to stay more present-focused in a way that’s not, well, striving. It has a delightful interface, endearing programs, and we think very highly of its techniques. The idea is that the mind, without such gentle, consistent training can be rather random, somewhat “like a drunk monkey”. Generalized anxiety can result from that, so it’s worth at least giving it a free trial, if you’re open to the idea.
- FOR CLINICAL HYPNOTHERAPY ATTEMPTS: Max Kirsten, a clinical hypnotherapist in England produced a couple of Apps worth checking out. He combines both verbal cues to help you focus on relaxation, as well as embedded binaural beats, known as “encoded (Alpha, Theta, Delta) Brainwave Entrainment Frequencies”. The binaural beats are a fairly new, popular method to help slow your brain waves to deep relaxation more rapidly. A 15-minute sample is available HERE– First note this technical tip associated with this link: Please be aware that MP3 files cannot be downloaded directly to mobile devices, such as iPhones, iPads or Android mobiles. You should always download first to a desktop/laptop and then sync to your mobile device. His “Relax Now” and “The ABC of Better Sleep” are two of his more popular Apps. They can both be used when in bed at night and when unloading (lying down at other times) to calm your central nervous system.
Q: Where did this system originate and who else uses it?
The approach used by physical therapist, Jeff Turner, DPT is analogous to the well-researched McKenzie Method evaluation and treatment system for spinal disorders. However, as used at this clinic, it is a highly specialized and unique application for head and neck disorders and in this sense is not part of the McKenzie Method. Our system is based on the Strategic Orthopedic Spine System, (SOSS) which was developed by Angelo Dimaggio, PT, Dip. MDT (Michigan, USA). He spearheaded a unique and comprehensive system that circumspectly addresses not only general spinal problems, but also head and neck disorders and the many associated symptoms, along with a comprehensive, 10-point coaching system. Mr. Dimaggio is President of the American Headache Institute in Rochester Hills, Michigan. Dr. Turner modified the approach a bit for his practice setting and from countless patient encounters. That said, he gives full credit to Mr. Dimaggio for his amazing work and insight that resulted in the foundation of all that we do with evaluation and treatment with this clinical system.
Our system incorporates detailed, logical algorithms that meticulously track symptom response in real time to repeated movements and sustained positions of the spine. Positive symptom change (decrease or abolishment of key symptoms) is identified during the initial evaluation and subsequent re-evaluations. Armed with this crucial knowledge, patients can then abolish their own symptoms consistently and immediately. Pain and symptom problems then rapidly become less frequent, less intense, less spread out, and in many cases absent altogether. Routine outcomes are freedom from ongoing doctor visits, emergency room visits, ongoing medication use, conventional and alternative therapies, tests (e.g., MRI/CT imaging studies, EMG for associated arm symptoms), bloodwork, and specialist interventions (e.g., pain management injections such as occipital nerve blocks, radiofrequency ablation, and lower cervical epidural steroid injections). That said, however, there are a subset of patients with either partial or no response to this system, and some of these other interventions or investigations may be necessary. However, such issues are quickly identified within only a few sessions.