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Headaches: Migraine, Cluster & Tension


Headache categories include:

  • Tension Headache - pain or discomfort in the head, scalp, or neck, usually associated with muscle tightness in these areas; 
  • Migraine Headache - moderate to severe pain that is often described as throbbing or pounding and is associated with sensitivity to light, noise, or odors; nausea or vomiting; loss of appetite; stomach upset or abdominal pain; and upper neck pain;
  • Cluster Headache - severe pain in or around the eye that comes in attacks - known as cluster periods - and is also associated with drooping eye lid, tearing, and stuffy nose;
  • Chronic Headache or Chronic Daily Headache (CDH) - classified as experiencing fifteen or more days with a headache per month;
  • Cervicogenic Headache - headache with associated neck pain and muscle spasms.

How Upper Cervical Care Relates to Headaches: Migraine, Cluster & Tension

While medical science has not determined the exact cause of headaches, recent research is pointing towards a trauma-induced origin for many types of headaches.1-20 Evidence supports that trauma (in particular mild concussive injury to the head, neck or upper back) increases the risk of headache onset.1-20 Researchers have labeled some headaches as being "cervicogenic" in origin (they are triggered by neck dysfunction).21-32 Following the trauma, headaches can be triggered immediately or they can take months or years to develop.

The purpose of upper cervical care is to reverse the trauma-induced upper neck injury; thereby reducing irritation to the nerves and blood vessels that trigger headaches. While many headache sufferers recall specific traumas such as head injuries, auto accidents or falls, some do not. An evaluation is necessary in each individual's case to assess whether an upper cervical injury is present and whether benefit from upper cervical care can be achieved.

Research Summary

By 2019, Dr. Elster has cared for approximately 300 patients with chronic headaches including migraine, cluster, tension, etc. All patients showed evidence of trauma-induced upper cervical injuries during examination (upper cervical radiographs and digital infrared imaging). Many patients recalled specific incidences of trauma (auto accidents, falls, concussions, whiplashes, sports injuries) that could have caused their upper cervical injuries while some did not.

Case Studies

View Case Studies related to Headaches: Migraine, Cluster & Tension

Research Articles and Publications
  1. Solomon S. Posttraumatic migraine. Headache 1998 Nov-Dec; 38(10): 772-8.
  2. Margulies S. The postconcussion syndrome after mild head trauma part II: migraine underdiagnosed? J Clin Neurosci 2000 Nov; 7(6): 495-9.
  3. Lane JC. Migraine in the athlete. Semin Neurol 2000; 20(2): 195-200.
  4. Bettucci D, Aguggia M, Bolamperti L. Chronic post-traumatic headache associated with minor cranial trauma: a description of cephalalgic patterns. Ital J Neurol Sci 1998 Feb; 19(1):20-4.
  5. Lemka M. Headache as the consequence of brain concussion and contusion with closed head injuries in children. Neurol Neurochir Pol 1999; 33 Suppl 5:37-48.
  6. De Souza JA, Moriera Filho PF, Jevoux CD. Chronic post-traumatic headache after mild head injuries. Arq Neuropsiquiatr 1999 Jun; 57(2A): 243-8.
  7. Packard RC. Epidemiology and pathogenensis of posttraumatic headache. J Head Trauma Rehabil Feb; 14(1): 9-21.
  8. Obelieniene D, Bovim G, Schrader H. Headache after whiplash: a historical cohort study outside the medico-legal context. Cephalgia 1998 Oct; 18(8): 559-64.
  9. Keidel M, Diener HC. Post-traumatic headache. Nervenarzt 1997 Oct; 68(10): 769-77.
  10. Gilkey SJ, Ramadan NM, Aurora TK. Cerebral blood flow in chronic posttraumatic headache. Headache 1997 Oct; 37(9): 583-7.
  11. Packard RC, Ham LP. Pathogenesis of posttraumatic headache and migraine: a common headache pathway? Headache 1997 Mar; 37(3): 142-52.
  12. Haas DC. Chronic post-traumatic headaches classified and compared with natural headaches. Cephalalgia 1996 Nov; 16(7): 486-93.
  13. Plager DA, Purvin V. Migraine precipitated by head trauma in athletes. Am J Ophthalmol 1996 Aug; 122(2): 277-8.
  14. Foletti G, Regli F. Characteristics of chronic headaches after whiplash injury. Presse Med 1995 Jul 1-8; 24(24): 1121-3.
  15. Friedrichs ES. Migraine and childhood head trauma. Headache 1995 Mar; 35(3): 169.
  16. Spierings EL, Foo DK, Young RR. Headaches in patients with traumatic lesions of the cervical spinal cord. Headache 1992 Jan; 32(1): 45-9.
  17. Kennedy MP. Trauma-precipitated migrainous hemiparesis. Ann Emerg Med 1991 Sep; 20(9): 1023-4.
  18. Sallis RE, Jones K. Prevalence of headaches in football players. Med Sci Sports Exerc 2000 Nov; 32(11): 1820-4.
  19. McBeath JG, Nanda A. Roller coaster migraine: an underreported injury? Headache 2000 Oct; 40(9): 745-7.
  20. Ferrari R. Whiplash-associated headache. Cephalalgia 1998 Oct; 18(8): 585-6.
  21. Biondi DM. Cervicogenic headache: mechanisms, evaluation, and treatment strategies. J Am Osteopath Assoc 2000 Sep; 100(9 Suppl): S7-14.
  22. Martelletti P. Proinflammtory pathways in cervicogenic headache. Clin Exp Theumatol 2000 Mar-Apr; 18(2 Suppl 19): S33-8.
  23. Bono G, Antonaci F, Dario A. Unilateral headaches and their relationship with cervicogenic headache. Clin Exp Rheumatol 2000 Mar-Apr; 18 (2 Suppl 19): S11-5.
  24. Sjaastad O, Fredriksen TA. Cervicogenic headache: criteria, classification and epidemiology. Clin Exp Rheumatol 2000 Mar0Apr; 18 (2 Suppl 19): S3-6.
  25. Vincent MB, Luna RA. Cervicogenic headache: a comparison with migraine and tension type headaches. Cephalalgia 1999 Dec; 19 Suppl 25: 11-6.
  26. Zwart JA. Neck mobility in different headache disorders. Headache 1997 Jan; 37(1): 6-11.
  27. Nilsson N. The prevalence of cervicogenic headache in a random population sample of 20-59 year olds. Spine 1995 Sep 1; 20(17): 1884-8.
  28. Vernon H, Steiman I, Hagino C. Cervicogenic dysfunction in muscle contraction headache and migraine: a descriptive study. J Manipulative Physiol Ther 1993 Jul-Aug; 16(6): 428-31.
  29. Edmeads J. Headache of cervical origin. Rev Prat 1990 Feb 11; 40(5): 399-402.
  30. Fredriksen TA, Hovdal H, Sjaastad O. Cervicogenic headache: clinical manifestation. Cephalalgia 1987 Jun; 7(2): 147-60.
  31. Leone M, D'Amico D, Grazzi L. Cervicogenic headache: a critical review of the current diagnostic criteria. Pain 1998 Oct; 78(1): 1-5.
  32. Dvorak J, Walchli B. Headache in cervical syndrome. Ther Umsch 1997 Feb; 54(2): 94-7

The content and materials provided in this web site are for informational and educational purposes only and are not intended to supplement or comprise a medical diagnosis or other professional opinion, or to be used in lieu of a consultation with a physician or competent health care professional for medical diagnosis and/or treatment. All content and materials including research papers, case studies and testimonials summarizing patients' responses to care are intended for educational purposes only and do not imply a guarantee of benefit. Individual results may vary, depending upon several factors including age of the patient, severity of the condition, severity of the spinal injury, and duration of time the condition has been present.