Dr. Kestner: What kind of doctor should you see for headaches? on The Murfreesboro Post

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Dr. Kestner: What kind of doctor should you see for headaches?

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By: DR. MARK KESTNER, Post Columnist

Posted: Sunday, January 18, 2009 6:31 am

What kind of headaches do you have? If you answered, “None,” consider yourself blessed. Most people will experience headaches of some description at various times in their lives. The severity can range from barely perceptible to being so painful that extreme cases can cause patients to even consider suicide.

Chronic headaches are generally classified into one of several types: common migraine, classic migraine, sinus pressure, muscle tension, cluster, medication-induced (rebound) or mixed. Although many people equate a severe headache to a migraine, this is not accurate. Migraines are the result of a specific physiological process that affects cranial blood vessels and can cause pain that is severe or mild. In some cases, patients will experience a migraine-type reaction, complete with an aura, and never actually feel head pain. Just because a headache hurts a great deal does not make it a migraine.

In Middle Tennessee, sinus pressure headaches are extremely common. Because our climate combined with abundant pollen varieties causes many people to experience allergic sinus congestion, this inevitably leads to sinus headaches.

The above descriptions refer to common chronic headaches. In other words, you have had this type of headache before, and you have probably already been diagnosed by a doctor. Why is it important to be diagnosed for headaches? Because headaches can also be a warning that something is very wrong with your body.

If you haven’t been to a doctor yet, where should you go for help? If you have not already done so, you should consider seeing your primary care medical provider first. I say this even though I frequently see patients for headaches in my clinic. Your primary medical doctor can perform routine screenings, order any appropriate blood tests, imaging, or other work-up to make sure that the kind of headache you are experiencing is not a warning sign of a more ominous diagnosis.

The exception to this is if you experience a sudden onset of a headache that is different from anything you have ever experienced or is especially severe. In this event, you should go immediately to the emergency department of the nearest hospital or if necessary, call 911.

It may be necessary for you to consult a neurologist for head pain. Neurologists often are called on to diagnose headaches that don’t fit typical patterns or that don’t respond to normal medications. In some cases examinations of brain function, MRI’s or other tests will be appropriate.

For females with headaches that are hormonally related, a visit to the OB-GYN may be productive. Certain headaches are initiated by dramatic hormonal changes during menstrual cycles.

In some cases, imbalances in body chemistry such as blood sugar can be responsible for headaches and a consultation with an endocrinologist might be in order.

What about alternative treatments for headache? Chiropractic has a long history of being very helpful for many sufferers of chronic headaches. Many people are surprised to learn that not only tension headaches respond to chiropractic, but migraines and sinus related headaches do as well. Chiropractic care is generally safe and well tolerated, and results in improvement for the majority of patients that try it for headaches. Although chiropractic care is like orthodontics or allergy shots in that a series of visits over time are required for success, you should begin to see results after only a short trial of visits.

Acupuncture has been surprisingly effective for many people with various kinds of headaches, even those that are hormonally related. Exactly how acupuncture works is unclear. It is known that acupuncture affects the function of the central nervous system and may be effective as a result of altering the way the brain processes pain.

Although I see many patients with various forms of headache, I often recommend they also see their primary care medical doctor for an assessment. Because there can be so many reasons for head pain, and some can be complex or dangerous, I like to make sure that the patient has the benefit of being evaluated medically.

Dr. Mark Kestner
mkestner@DrKestner.com

Tagged under VOICES

Member Opinions:

By: momx5 on 1/21/09
Thank you for the inclusion of Chiropractic Care as a viable choice for headaches. We have seen many patients receive relief from chronic headaches in our Chiropractic Clinic in Shelbyville.

By: justdance on 1/23/09

Momx5, I for one am one of them. Finally, relief from my migraines! God bless my Chiropractor here in Murfreesboro.