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  • Q&A with Australian Health Practitioners

    What can I do to treat my ongoing headaches?

    I have had daily headaches (lasts all day from 1/2 - 1 hr from waking till falling asleep) for the last four months. The pain doesn't fit neatly into the common headache categories as it is throbbing but the pain moves over my forehead and face (mostly forehead and cheek bones). I have associated nausea (occasional vomiting) and dizziness.

    I have had a head ct which showed nothing out of the ordinary, also have been to see an optomerist, dentist, physiotherapist, and ENT. None could diagnose these headaches or find any problems.

    I have tried numerous painkillers, triptans, anti-nausea medication, and blood pressure medication (have normal blood pressure) with no effect, the only thing that brings some relief is aspirin, however I don't take this every day, only approx twice a week so my doctor doesn't think that medication overuse is an issue.

    I have a neurologist appointment but it is not for another 5 months, so is there anything i can be doing in the meantime?
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    Dr. Danny Diab

    Chiropractor

    Dr Danny Diab is situated at Proactive Spine & Sports Medicine in Narellan NSW. His clinical interests extend far beyond the traditional neck and back … View Profile

    Daily headaches can be very worrying and also frustrating when you cannot find a diagnosis.
    As a chiropractor, I have seen numerous patients who suffer from very similar symptoms to yours. Luckily the majority respond very well to chiropractic treatment.

    Headaches can have various causes, and it is great that the CT scan didn’t show anything serious. It is also good that you have ruled out any involvement of the eyes, ears, or teeth.
     
    However another trigger of headaches can be dysfunction of the upper cervical spine (neck).  The nerves from the upper neck communicate with the nerves in the head, and so any irritation or dysfunction of these joints can contribute to headaches.  A dysfunction of these joints may also contribute to your dizziness, a condition called cervicogenic dizziness (as the name suggests dizziness from the neck).

    There are a number of other factors, such as your ages, stress levels, occupation, sleep posture and habits, any recent or previous accidents or traumas etc that need to be determined as they may contribute to the headaches.
    My suggestion would be to consult a local chiropractor who would perform a thorough history taking and physical examination to determine the exact cause of your headaches.

    If the neck is found to be contributing to the headaches, the aim of treatment would be to improve function and stability of the neck and correcting any muscle imbalances. Very effective treatment options include spinal manipulation, muscle release techniques, dry needling, and corrective spinal and postural exercises.
    Nutrition may also play a part, eg. Studies have found that reduced levels of Vitamin D can also contribute to headaches. Getting your vitamin D levels checked and supplementing accordingly may be appropriate.

    Danny Diab
    Chiropractor Mt Annan

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    Dr Carlo Rinaudo (Chiropractor and PhD candidate) is the clinic director of Brain Hub, a clinic in Sydney focussed on helping people with dizziness and … View Profile

    From the description, you may be suffering a common, yet only recently recognized form of migraine called migraine-associated vertigo without aura. Migraines are thought to be caused by areas of the brain being more ‘excitable and sensitive’, whereby normal senses, like noise, light, smells and motion, are perceived as being unpleasant and painful. In approximately 1/3 of people who suffer migraines, will also experience dizziness and vertigo symptoms.
    As I’m unaware of the exact testing you have had performed, typically a workup will include a detailed history of lifestyle, familial and past medical factors. Careful attention to other associated complaints including tinnitus, hearing loss and photophobia/phonophobia. Examination can often include hearing tests, caloric testing, and VNG, although typically negative results are seen. Migraine-associated vertigo is often confused with Meniere’s, and can differentiated by the above history and examination findings.
    Treatment for migraine-associated vertigo will firstly involve identifying and managing the potential triggers. Keeping a diary of discerning triggers is best to see correlation with symptoms. Apart from the pharmaceutical avenues typically explored by medical practitioners, I have had success using vestibular rehabilitation as a method of reducing and managing this type of migraine. This form of therapy often involves ‘resetting the motion detectors of movement’, namely coordinating movement between the body, head and eyes. Typically I would use a combination of computerized balance plate exercises, specific joint therapy, gait retraining, eye exercises, and procedures to assist the inner ear function.

    Carlo Rinaudo
    Chiropractor ~ Functional Neurology
    www.liveactiveclinic.com.au

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