Research and statistics indicate that headaches cause the loss of over 25 billion dollars each year in United States since frequent and episodic headaches are one of the most common causes of absence from work and low productivity. There are various types of headaches and the management of each type varies according to the patho-physiological factors. Although mild and infrequent headaches (one episode a month or less that responds to over the counter pain relievers) are considered normal; however if your headache episodes are unprovoked and are occurring at frequent intervals (two or more per week), they are not responsive to over the counter analgesics and rest and they are not associated with other features like dizziness, fatigue and lightheadedness, you may benefit from chiropractic therapy.

The prevalence of tension headaches is very high (approximately 78% of all the headaches are tension type) that are characterized by a constricting type of pain that starts from the back of head and involves neck and scalp. Researchers and investigators have been working for years to ascertain the exact cause of tension headaches. Extensive research indicates that they could be due to changes in the biochemical environment of brain due to alterations in the secretion of some neurotransmitters, improper posture and wear and tear changes in the bones affect muscular activity (tightening or contraction of muscles affect the blood supply to brain and/or teeth clenching which increases the pressure on the tempo-mandibular joint leading to irritation and damage to joint. TMJ irritation is another leading cause of tension headaches and is reported frequently in individuals with sleep disorders.

Women are at higher risk of developing tension headaches when compared to men. Advancing age and sudden/ abrupt changes in the biochemical environment of the body also increases the risk of tension headaches. Changes in the concentration of estrogen (just before menstruation or during peri- menopausal years) the risk of tension headaches increase tremendously. Also, chronic and excessive stress, sleep disorders and drug abuse are also strong risk factors that are associated with tension headaches.

In order to manage episodic headaches (especially cervicogenic headaches and tension type headaches) chiropractic therapy is often helpful. Research suggests that cervical misalignment or subluxation can also lead to headaches and with spinal adjustments performed by chiropractors to restore neuronal connectivity. A number of studies conducted on patients with chronic tension type headaches indicated that the overall efficacy of chiropractic therapy is far more superior to other pharmacological remedies, with very little risk of side effects.

Biofeedback training is helpful in controlling the strength of muscles and preventing the buildup of excessive tension in the cervical muscles, ligaments and joints. Chiropractors also introduce relaxation exercises and posture management strategies that aims at correcting and preventing any muscular and nervous abnormality; thereby minimizing the risk of recurrence. Oftentimes, the posture while working or sitting in front of computer for long hours affects the delivery of nutrients to neck muscles and joints; thereby leading to early destruction of joint spaces due to weakness and excessive wear and tear changes. Chiropractors help in correction of abnormal posture to prevent joint irritation.

According to a report published by Endres, acupuncture therapy is also helpful in alleviating the episodes of tension headaches. He reported more than 50% reduction in the frequency, severity and recurrence of tension type headaches in 409 patients with 10 sessions of acupuncture therapy in a period of 6 weeks (30 minute each).

Kassak published a report in the Journal of Manipulative Physiology Therapeutics according to which chiropractic spinal manipulation is reported to be much superior to amitriptyline in the management of chronic tension headaches. He suggested that long term therapy was not associated with any complications as opposed to amitriptyline therapy. The report concluded that "Spinal manipulative therapy showed a reduction of 32% in headache intensity, 42% in headache frequency, 30% in over-the-counter medication usage and 16% in functional health status".

Another study conducted by Biondi also suggested that chiropractor’s spinal manipulation is superior to other pharmacological therapies available for the management of recurrent tension type headaches. Chiropractors also introduce nutritional guidelines to promote bone and joint strength and stability.

If you have any of the following condition, you should seek other remedies for the management of tension headaches. If you are pregnant or breast feeding, you should speak to your primary care physician for the management of tension headaches, if the episodes of headache are followed by moderate to severe head injury or with associated symptoms like stiff neck, fever, vomiting, rigidity and seizure activity or if you are experiencing signs of motor or sensory abnormalities, visual impairment, discrepancies in the memory and other symptoms, you must seek the advice of expert neurologist.

Besides chiropractic care, a number of lifestyle modifications may play a preventive role in decreasing the intensity and frequency of headaches. If you have a sedentary lifestyle or your job responsibilities require long hours of computer work, you can take frequent breaks from work (at least once in 30 minutes for 2 to 3 minutes) you can stretch your neck muscles, walk around and stretch our upper limbs in air to prevent stiffness of neck muscles and resulting impaired blood supply to head region. Adopt yoga, meditation and other stress relieving exercises to manage the symptoms of pain and discomfort. Breathing exercises and hypnotherapy are long known as the ideally recommended stress management strategies. Massage is also helpful in alleviating an episode of headache by increasing the release of soothing brain neurotransmitters that abort an episode of severe headache.

Tension headaches are not a sign of any serious problem or long term complication, besides alteration in the day to day activities. You can easily manage the disturbing and disabling episodes of tension headaches by lifestyle modification, regular chiropractic therapy, relaxation and traditional strategies.