Headaches. Dr Simon Pumfrey 1 BSc MSc DC

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1 Headaches Dr Simon Pumfrey 1 BSc MSc DC

2 Dr Simon Pumfrey BSc MSc DC 2

3 3 Sick Care vs. Health Care Dr Simon Pumfrey BSc MSc DC

4 Tension type Migraines Cervicogenic Cluster 4 Temporal arteritis Sinusitis Meningitis Trigeminal neuralgia TMJ dysfunction Haemorrages Dr Simon Pumfrey BSc MSc DC

5 Red Flags: 5 Sudden onset Severe or debilitating pain Fever Vomiting Disturbed consciousness Worse with bending/coughing Neurological signs/symptoms New headaches in 50+yr Dr Simon Pumfrey BSc MSc DC

6 Cervical Spine Anatomy Dr Simon Pumfrey 6 BSc MSc DC

7 Dr Simon Pumfrey BSc MSc DC 7

8 Dr Simon Pumfrey BSc MSc DC 8

9 Dr Simon Pumfrey BSc MSc DC 9

10 Referral zones from joints and muscles Dr Simon Pumfrey 10 BSc MSc DC

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15 Dr Simon Pumfrey BSc MSc DC 15

16 Dr Simon Pumfrey 16 BSc MSc DC Posture and Headaches

17 Dr Simon Pumfrey BSc MSc DC 17

18 Dr Simon Pumfrey BSc MSc DC 18

19 Dr Simon Pumfrey BSc MSc DC 19

20 Postural Correction 20 Movement requires the integration of several body segments Change in one area, refinement of posture will occur (Farah & Tanaka 1997) Pelvis, Lumbar, thoracic and cervical spine (Saito et al 2009) Flat feet increased masseter and temporalis activity (Valentino et al 2002) Changes in longitudinal plantar arch stimulates mechanoreceptor neurons and this readjusts head position Dr Simon Pumfrey BSc MSc DC

21 21 Possible causes of TMD Intestinal Parasitic Infections (Tehrani et al 2010 Dent Res J) Bruxism Stress levels and personality traits (Serra-Negra 2012 Pediatr Dent) ACL injury (Tecco et al 2007 Cranio) Increase temporalis, masseter, SCM activity Forward head posture Cervical spine positions (Ballenberger et al 2012 J Manipulative Physiol Therapy) Dr Simon Pumfrey BSc MSc DC

22 22 Dr Simon Pumfrey BSc MSc DC

23 Dr Simon Pumfrey BSc MSc DC 23 Treatment of Headaches What does the research tell us??

24 24 J Jpn Phys Ther Assoc. 2014;17(1):31-8. doi: /jjpta Effectiveness of Physical Therapy in Patients with Tension-type Headache: Literature Review. Victoria Espí-López G1, Arnal-Gómez A1, Arbós-Berenguer T2, González ÁA2, Vicente-Herrero T3 Studied myofascial release, stretching, heating, cervical and thoracic spinal adjustment/mobilisation, progressive active exercises of shoulder, lumbopelvic postural correction CONCLUSIONS: The findings from these studies showed evidence that treatment with adjustments/mobilisation, combined with cervical muscle stretching and massage are effective for TTH. No evidence was found of the effectiveness of the techniques applied separately Dr Simon Pumfrey BSc MSc DC

25 25 Eur J Phys Rehabil Med Dec;50(6): Epub 2014 Apr 30. Effect of manual therapy techniques on headache disability in patients with tension-type headache. Randomized controlled trial. Espí-López GV 1, Rodríguez-Blanco C, Oliva-Pascual-Vaca A, Benítez-Martínez JC, Lluch E, Falla D. When given individually, suboccipital soft tissue inhibition and occiput-atlas-axis manipulation resulted in changes in different parameters related to the disability caused by TTH. However, when the two treatments were combined, effectiveness was noted for all aspects of disability and other symptoms including photophobia, phonophobia and pericranial tenderness. Dr Simon Pumfrey BSc MSc DC

26 J Manipulative Physiol Ther Mar-Apr;18(3): Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial. 26 Boline PD 1, Kassak K, Bronfort G, Nelson C, Anderson AV. The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. Amitriptyline therapy was slightly more effective in reducing pain at the end of the treatment period but was associated with more side effects. Four weeks after the cessation of treatment, however, the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values Dr Simon Pumfrey BSc MSc DC

27 27 Spine (Phila Pa 1976) Sep 1;27(17): ; discussion A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Jull G 1, Trott P, Potter H, Zito G, Niere K, Shirley D, Emberson J, Marschner I, Richardson C. Manipulative therapy and exercise can reduce the symptoms of cervicogenic headache, and the effects are maintained. Dr Simon Pumfrey BSc MSc DC

28 28 Cranio Apr 17: Y Incidence of headaches related to occlusion and bite force imbalance: a case study. Sutter BA CONCLUSIONS: Once the patient's bite was balanced and the interferences removed, the headaches were greatly improved Dr Simon Pumfrey BSc MSc DC

29 What do you need to do Not follow the NZ Health Model Dr Simon Pumfrey BSc MSc DC 29

30 Dr Simon Pumfrey BSc MSc DC 30

31 Your Stress Buckets To listen to this audio section, please open the e-book using Acrobat Reader Having trouble listening to this video? Click here to listen online (You must be connected to the internet!) 31 to manage daily stress. For example, in my own life, I have Dr Simon Pumfrey BSc MSc DC a very busy daily schedule that has the potential to cause me

32 Three Phases to Stress Adaptation Alarm Phase a. Physiological response to a perceived stressor. b. Hormonal and neurological changes 2. Resistance Phase a. Body adapts and learns to tolerate the repeated stressor. b. If stressor repeated too often, without adequate recovery, the body enters stage 3 3. Exhaustion Dr Simon Pumfrey BSc MSc DC

33 Dr Simon Pumfrey BSc MSc DC 33

34 Dr Simon Pumfrey 34 BSc MSc DC Life is like a battery

35 35 Dr Simon Pumfrey BSc MSc DC

36 36 Back In Action Special 50% of Initial Consultation with Dr Simon Pumfrey promo code Headache Dr Simon Pumfrey BSc MSc DC

37 Thank you for attending 37 Dr Simon Pumfrey BSc MSc DC

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