Our Clinical Experience With Cluster Headaches
Our Clinical Experience With Cluster Headaches At Soft Touch Chiropractic, my approach to cluster headache is not based on chiropractic manipulation alone. During approximately 25 years of clinical practice, I have observed excellent results in patients with cluster-headache symptoms when using a comprehensive approach to the cervical spine, upper neck, head, and surrounding soft tissues. In my clinical experience, nearly every cluster-headache patient I have treated has reported meaningful improvement, although this does not necessarily mean that the headaches disappear completely. Many patients report that their episodes become less frequent, less intense, or easier to manage. This has been particularly noticeable in many of the women I have treated. My approach may include treatment of the suboccipital muscles, cervical muscles, temporalis and other appropriate craniofacial soft tissues, along with joint mobilization, gentle chiropractic techniques, CFRT (Contrastrain Facilitation Release Technique), Graston Technique, stretching, therapeutic exercise, and other therapies when clinically appropriate. Why Might the Neck and Head Matter?Cluster headache is classified as a trigeminal autonomic cephalalgia. Research shows involvement of the trigeminal pain system and trigeminal-cervical pathways, as well as important involvement of the hypothalamus and autonomic nervous system. This is particularly interesting clinically because sensory information from the upper cervical region and trigeminal system interacts within the trigeminocervical complex. For this reason, when a patient with cluster headaches also has significant cervical restriction, suboccipital tightness, temporalis tenderness, muscle tension, or other musculoskeletal findings, I believe those findings deserve evaluation rather than focusing only on the painful area around the eye. There is also early research supporting further investigation of this approach. A published case series involving manual therapy and exercise for cluster headache found improvement in headache impact in 6 of 7 patients, although changes in headache frequency were more modest and the study was very small. The authors concluded that manual therapy and exercise may have potential as a complementary approach and that additional research is needed. Clinical Experience vs. Scientific Evidence My results represent clinical observations from my own practice, not the results of a controlled clinical trial. More research is needed to determine exactly which manual and chiropractic therapies may benefit people with cluster headache and why. However, after approximately 25 years of treating headache patients, my clinical experience has encouraged me to use a comprehensive approach rather than manipulation alone—evaluating the cervical spine, upper cervical region, suboccipital and craniofacial muscles, movement restrictions, and other musculoskeletal factors that may accompany the patient's headache pattern. Cluster headache still requires appropriate medical diagnosis and management. Chiropractic and manual therapy should be considered complementary care rather than a replacement for established medical treatment. |
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rel=”author”>Masoud Shamaeizadeh
