Osteopathic Medicine for Headaches

the human brain and spine as a jigsaw puzzle

Chronic headache is a common and often debilitating type of condition that affects many people around the world. Causes may include migraine, cervicogenic headache, post traumatic headache and cluster headache. When severe, headache can interfere with focus and function. While some individuals may be able to manage their headache with over-the-counter medications, others may require more specialized care from headache or migraine specialists. These healthcare professionals are doctors who have received additional training and expertise in the diagnosis and treatment of headache.

Craniosacral manipulation is a very gentle manipulative technique that restores movement at the bone sutures and relieves seismic tension. This has the potential to eliminate the headaches and the need for medication dependence. – Dr. Robert Minkowsky

Headache: Seismic Tension in the Skull’s Plates

Chronic headache, whether tension, migraine, cluster or other, afflicts many individuals and can interfere with focus and the ability to function. Although symptoms are localized to the head, factors outside of the skull and brain are often responsible for headache or are major contributors to intractability and frequency.

Unfortunately, traditional allopathic medicine usually uses a band aid approach to headache, consisting solely of prescribing a wide variety of drug combinations to control pain. If you don’t have a brain tumor, stroke or infection doctors usually have no understanding of the multiple issues that help to create chronic headache.

Headache specialists frequently are neurologists, doctors who specialize in disorders of the brain and nervous system. These specialists often limit treatment options to a pharmacological approach using a combination of medications. In recent years, injections of botox have been added to the mix.

The Osteopathic Approach

The osteopathic approach to headache is to put the symptom in the context of the entire body. In particular there are important muscular connections between the neck, shoulder and midback that tie into the skull.

Fascia, a membrane – like structure, connects the chest with the head. The dura, a membrane that surrounds the brain and spinal cord extends all the way from the skull to the low back and sacrum. Thinking of all of these connections as well as careful examination of these areas can be very helpful in the evaluation and treatment of chronic headache.

How The Solution Works

The skull and face are composed of 22 bones. The bones articulate together at sutures which resemble the fault lines in the earth’s crust separating tectonic plates. They are very convoluted and intricate, similar to a jigsaw puzzle. Osteopathic teaching, unlike traditional medicine, believes that there is a small amount of movement in the sutures. The craniosacral rhythm which is an alternating expanding and contractile movement in the nervous system depends on movement in the sutures. This rhythm can easily be felt in the skull as well as elsewhere in the body. Any locking in the sutures disrupts this rhythm and can build up pressure in the head similar to pressure build up in the earth’s crust along fault lines before an earthquake.

Clinically, this manifests as chronic headache or facial pain. Vertigo and tinnitus are also symptoms seen often. Head trauma, even many years ago, is often responsible for this persistent locking. Osteopaths perform craniosacral manipulation which is a very gentle manipulative technique to restore movement at the bone sutures, relieve the tension and help restore better cranial balance.

Thus, thoughtful examination of an individual with chronic headache through evaluation of the myriad number of connections that link the skull and brain to other areas of the body as well as direct treatment of the skull and craniosacral rhythm may eliminate headache and the need for medication dependence.

Our Headache & Migraine Specialists

Drs. Irène and Robert Minkowsky are medical doctors trained in Physical Medicine and Rehabilitation and performing a detailed neurologic evaluation is a part of their medical specialty. The Minkowskys are also trained in osteopathy, a branch of medicine that looks at the body holistically. One of the key advantages of seeing a headache specialist at the Physicians’ Back Institute is their unique approach to provide a non-pharmacological treatment plan based on the individual’s symptoms in the context of their entire body. After a thorough history, they conduct a detailed evaluation to determine the underlying causes of the headaches. These causes often lie outside of the head, as for instance arthritis of the cervical spine (neck) is frequently a factor in creating chronic tension headache. If all factors, including old forgotten trauma, are not properly addressed, headache persists despite medication.

The Minkowskys success results from a comprehensive approach and an emphasis on the nonpharmacologic treatment for migraine headaches. Emphasis is placed on relieving the symptoms and restoring the balance and equilibrium that is lost with any chronic musculoskeletal condition or symptoms.

Chronic headache, whether tension (which accounts for 80% of headaches), migraine, cluster or other, afflicts many individuals of all ages and backgrounds and can include symptoms which may interfere with focus and the ability to function. Although symptoms are localized to the head, factors outside of the skull and brain are often responsible for headaches or are major contributors to intractability and frequency.

Unfortunately, traditional allopathic medicine usually uses only a band-aid approach to headache, consisting solely of prescribing a wide variety of drug combinations to control pain. If you don’t have a brain tumor, stroke or infection, doctors usually have no understanding of the multiple issues that are responsible for chronic headaches.

More than 50 percent of people worldwide have headache disorders

What Are the Causes of Headache & Migraines?

The Tectonic Plates of the Skull

a human skull painted and divided up like a puzzle

The skull and face are composed of 22 bones. The bones articulate together at sutures which resemble the fault lines in the earth’s crust separating tectonic plates. They are very convoluted and intricate, similar to a jigsaw puzzle. Osteopaths, unlike traditional physicians, believe that there is a small amount of movement in the sutures.

As migraine specialists and headache experts, the Minkowskys utilize this concept in their treatment protocol for migraines. The craniosacral rhythm which is an alternating expanding and contractile movement in the nervous system depends on movement in the sutures. With training, this rhythm can be felt on the skull as well as elsewhere on the body.

If the movement becomes restricted or asymmetric, tensions build up and pressures increase in the cranium. This process is similar to pressure build-up in the earth’s crust along fault lines before an earthquake. The diameter of blood vessels changes, affecting blood flow and oxygenation of the surrounding tissues, chemicals are released and headache and pain result. A vicious cycle starts.

Clinically, this manifests as chronic migraine headaches or facial pain. Vertigo and tinnitus are also symptoms often seen. Head trauma, even many years earlier, is often responsible for this persistent locking of sutures. Osteopaths perform craniosacral manipulation which is a very gentle manipulative technique to restore movement at the bone sutures, relieve the tension and help restore better cranial balance.

Headache of Cervical Origin

Neck issues with increased tension in the cervical region often cause pain symptoms radiating to the head. There are important nerve connections between the upper cervical spine and skull. Chronic postural stresses resulting from long hours spent in front of a computer monitor or looking down at a laptop or cell phone are frequently responsible for this increased tension.

a woman's spine glows through her body

Other Causes of Headache

Other causes of chronic daily headaches may include

  1. Inflammation or other problems with the blood vessels in and around the brain, including stroke.
  2. Infections (meningitis).
  3. Intracranial pressure that’s either too high (brain tumor) or too low.
  4. Traumatic brain injury.
  5. Rebound headache; this occurs if you are taking pain medications, even over-the-counter, more than two days a week (or nine days a month).

The Osteopathic Approach to Treatment of Symptoms

The osteopathic approach to a migraine headache is to address the symptoms in the context of the entire body. In particular, there are important muscular connections between the neck, shoulder and mid back that tie into the skull and contribute majorly to headaches.

Treatment includes gentle osteopathic manipulation to balance the structures in the head including the bones, the brain and the dura (spinal membrane) as well as the interaction of the head with the spine and other surrounding structures. As part of treatment, our headache specialists instruct their patients in ways to improve posture of the neck and upper body through stretching exercises as these often are major contributors to the origin of headache.

Fascia, a membrane-like structure, connects the chest with the head. The dura, a membrane that surrounds the brain and spinal cord extends all the way from the skull to the low back and sacrum.

A fall on the sacrum can trigger a serious headache. Thinking of all of these connections as well as a careful examination of these areas can be very helpful in the evaluation and treatment of migraine headache.

General Treatment for Migraine Headache

  1. Maintain steady estrogen levels
  2. Get enough sleep
  3. Reduce stress (yoga, tai-chi, meditation)
  4. Reduce caffeine, cheese and alcohol

Seeing a headache specialist can be an important step in effectively managing this condition and improving quality of life. The medical specialists at the Physicians’ Back Institute have the knowledge and expertise to provide specialized care and support for individuals with headache and help them find relief from their symptoms.

As headache and migraine specialists here in San Francisco, Doctors Irène and Robert Minkowsky work to thoroughly examine individuals with chronic headache, evaluating the myriad number of connections that link the skull and brain to other areas of the body as well as direct treatment of the skull and craniosacral rhythm.

This approach provides a comprehensive new treatment approach for migraine, often eliminating the symptoms and the need for medication or therapy dependence.