Migraine: New Article in Cephalgia: Targeting pericranial nerve branches to treat migraine: Current approaches and perspectives.

This new article in Cephalgia (PubMed Abstract below) discusses evidence that interventions targeting peripheral Nerves are useful.

This is not new information to anyone who has experienced relief and elimination of Migraines from occipital Nerve Blocks or SphenoPalatine Ganglion Nerve Blocks.  Both of these nerve blocks can be safely and efficiently used to decrease, treat and eliminate migraines.

The Sphenopalatine ganglion block is easy for patients to self administer at home to prevent migraines.

Neuromuscular Dentistry has shown thousands and thousands of patients that correction of craniomandibular problems can decrease and eliminate migraines by changing the input into the Trigeminal Nervous System.  All headaches and migraines are mediated in part of fully by the Trigeminal Nerve and the TrigeminoVascular System.

There is a massive amount of input into the Trigeminal Nervous system from proprioception that passes thru the mesencephalic nucleus.  The mesencephalic nucleus is very specialbecause it does not contain chemical synapses.  The neurons are electrically coupled unlike other central nevous system (CNS) ganglia.  The mesencephalic nucleus is the only CNS Ganglia to contain cell bodies of a primary afferent nerve.  The Trigeminal Ganglion is the primary sensory nucleus of the Trigeminal Nerve.

Trigeminal Neuralgia is sometimes treated by destroying parts of the Trigeminal Ganglion with thermocoagulation or injection of glycerol.

Another well known procedure for preventing and treating migraines is osteopathic and chiropractic treatment.  Especially effective are upper cervical chiropractic techniques used by NUCCA and Atlas-Orthoganol Chiropracters.

A very dfferent type of perpheral stimulation of the Trigeminal Nerve can decrease migraine.  Humans smell Menthol with their Trigeminal Nerve. The use of topical menthol is an effective topical pain treatment but smelling of menthol and activation of the Trigeminal Nerve may account for much of this action.    Activation of the antitussive effects of menthol  "occur secondary to the activation of TRPM8+/TRPV1− nasal trigeminal afferent neurons."  (http://jap.physiology.org/content/115/2/268).
These effects were the reason cigarrette companies added menthol .

The trigeminal system is unique in its ability to smell and taste Menthol in a different manner than olfactory nerve (smell) , chord tympani of facial nerve (taste), posterior third of tongue tastefrom Glossopharyngeal nerve.
Smells and taste are frequently associate with migraines as percipitating factors, Auras and can be used in a preentive manner.

Cephalalgia. 2015 Mar 3. pii: 0333102415573511. [Epub ahead of print]

Targeting pericranial nerve branches to treat migraine: Current approaches and perspectives.

Ambrosini A1, D'Alessio C2, Magis D3, Schoenen J3.

Author information

Abstract

BACKGROUND: 

Migraine is a highly prevalent neurological disorders and a major individual and societal burden. Migraine is not curable at the present time, but it is amenable to acute symptomatic and preventive pharmacotherapies.

SUMMARY: 

Since the latter are frequently unsatisfactory, other treatment strategies have been used or are being explored. In particular, interventions targeting pericranial nerves are now part of the migraine armamentarium. We will critically review some of them, such as invasive and noninvasive neurostimulation, therapeutic blocks and surgical decompressions.

CONCLUSIONS: 

Although current knowledge on migraine pathophysiology suggests a central nervous system dysfunction, there is some evidence that interventions targeting peripheral nerves are able to modulate neuronal circuits involved in pain control and that they could be useful in some selected patients. Larger, well-designed and comparative trials are needed to appraise the respective advantages, disadvantages and indications of most interventions discussed here.

© International Headache Society 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Neuroscience. 2011 Aug 25;189:377-83. doi: 10.1016/j.neuroscience.2011.04.065. Epub 2011 May 7.

Perception of specific trigeminal chemosensory agonists.

Frasnelli J1, Albrecht J, Bryant B, Lundström JN.

Author information

Abstract

The intranasal trigeminal system is a third chemical sense in addition to olfaction and gustation. As opposed to smell and taste, we still lack knowledge on the relationship between receptor binding and perception for the trigeminal system. We therefore investigated the sensitivity of the intranasal trigeminal system towards agonists of the trigeminal receptors TRPM8 and TRPA1 by assessing subjects' ability to identify which nostril has been stimulated in a monorhinal stimulation design. We summed the number of correct identifications resulting in a lateralization score. Stimuli were menthol (activating TRPM8 receptors), eucalyptol (TRPM8), mustard oil (TRPA1) and two mixtures thereof (menthol/eucalyptol and menthol/mustard oil). In addition, we examined the relationship between intensity and lateralization scores and investigated whether intensity evaluation and lateralization scores of the mixtures show additive effects. All stimuli were correctly lateralized significantly above chance. Across subjects the lateralization scores for single compounds activating the same receptor showed a stronger correlation than stimuli activating different receptors. Although single compounds were isointense, the mixture of menthol and eucalyptol (activating only TRPM8) was perceived as weaker and was lateralized less accurately than the mixture of menthol and mustard oil (activating both TRPM8 and TRPA1) suggesting suppression effects in the former mixture. In conclusion, sensitivity of different subpopulations of trigeminal sensory neurons seems to be related, but only to a certain degree. The large coherence in sensitivity between various intranasal trigeminal stimuli suggests that measuring sensitivity to one single trigeminal chemical stimulus may be sufficient to generally assess the trigeminal system's chemosensitivity. Further, for stimuli activating the same receptor a mixture suppression effect appears to occur similar to that observed in the other chemosensory systems.

Copyright © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

Highland Park Dentist is New Chair of The American Alliance of TMD Organizations. New Highland Park Office Focuses on TMJ Disorders, Sleep Apnea, Snoring, Chronic Daily Headaches and Migraines

The Alliance of TMD Organizations' mission is to support and protect the rights and freedom of patients and their doctors. A grave new threat is now looming that may have very negative effects on patients and doctors.

The American Alliance of TMD held its annual meeting on February 26-27 at the Chicago Marriott. Long Time Highland Park resident Ira L Shapira became the new Chair of the TMD Alliance.

The Alliance (http://www.tmdalliance.org/index.html) is dedicated to protecting the rights of TMD patients to receive the care they need. According to Dr Shapira there is a grave new threat has arisen that may effect both the patients rights and ability to have their care reimbursed by insurance. The threat is from a new board claiming the right to grant specialty outside the auspices of the American Dental Association which is and always has represented the dental profession and public safety.

The American Dental Association is the voice of organized dentistry and Specialty recognition in the U.S. The American Dental Association has recognized several dental specialties including: American Board of Dental Public Health, American Board of Endodontics, American Board of Oral and Maxillofacial Pathology, American Board of Oral and Maxillofacial Radiology, American Board of Oral and Maxillofacial Surgery, American Board of Orthodontics, American Board of Pediatric Dentistry, and American Board of Periodontology.

A new group, the American Board of Dental Specialties (ABDS) is acting outside of organized dentistry to create and grant specialty status to groups that have either not met the ADA standards for specialty or had their application rejected by the Ameican Dental Association.

The following Dental Specialty Boards have been granted recognition by the ABDS:

American Board of Oral Implantology. Implant Dentistry; this so called specialty is already well represented by both The American Board of Oral and Maxillofacial Surgery & The American Board of Periodontology.

American Board of Orofacial Pain. This group has been repeatedly denied specialty by the American Dental Association for multiple reasons. There have been other groups who have also been denied specialty in the TMD field by the American Dental Association. All Diplomats of the ABOP will become instant (just add water) specialists. Many of these doctors have previously been involved in questionable groups that unfairly (and possibly fraudulently) deny patients legitimate insurance claims. Specialty Status, however dubious will embolden them to unfairly attempt to restrict medical benefits to patients. This group actually discounts the effect of dentistry and occlusion on oral facial pain. The promote utilizing drugs and psychotherapy to treat TMJ disorders.

Two additional boards seeking specialty are:
American Dental Board of Anesthesiology
American Board of Oral Medicine.

The TMD Alliance and it's individual members have multiple other concerns over any specialty designation in TMD or Oral Facial Pain.

Dr Shapira could not comment further on specifics of the problems associated with this group but the Alliance of TMD Organizations has long been opposed to specialty. Dr Shapira believes this specialty will hurt patients, TMD practitioners as well as the entire dental profession.

The so called specialties being created will need to be approved by each and every state dental board across the country. Dr Shapira urges the ADA and all of its constituents to do all it can to protect the American Public from this dangerous development. State Dental Boards across the country need to reject these questionable new specialties to protect the public until they have been properly vetted. The ADA should consider taking a strong stance in this issue before it is too late.

When the American Dental Association creates a new specialty it Grandfathers in doctors working within the specialty as specialists. The DANGER WITH SELF-DECLARED SPECIALTIES IS ONLY MEMBERS OF A SELECT GROUP ARE ADMITTED AND THEN THAT GROUP IS IN CHARGE OF WHO CAN LATER BECOME A SPECIALIST. The ABOP has been restrictive in the past in who could become members.

THIS IS A REAL DANGER TO THE AMERICAN PUBLIC AND SHOULD BE DISCUSSED IN AN OPEN FORUM.

The Alliance of TMD Organizations includes the following organizations:

American Academy of Craniofacial Pain
(Previously American Academy of Head, Neck and Facial Pain

American Equilibration Society
(The first organization dedicated to TMJ disorders)

International Association of Physiologic Aesthetics
(previously International Association of Comprehensive Esthetics)

International College of Cranio-Mandibular Orthopedics
(The original Neuromuscular dental group)

International Association for Orthodontics

Sacro Occipital Technique Organization-USA
(The only Chiropractic group in the Alliance)

Tennessee CRANIO

The following organizations have lapsed membership in the Alliance but Dr Shapira hopes to bring them back to full membership status:

American Academy of Pain Management
American College of Prosthodontics

Treatment of TMJ and Sleep Disorders has been a consuming passion for Dr Shapira for 35 years who is a Fellow of the International College of CranioMandibular Orthopedics as well as Secretary and the representative from ICCMO to the TMD Alliance along with Dr Barry Cooper, who is Past President of ICCMO, A Life Member of the AES and one of the founding members of the Alliance and past chair. Dr Cooper has an impressive history in the TMD field.
http://www.tmjtmd.com/curriculum-vitae2.html

As a Diplomat of the American Academy of Pain Management and a long time member of both the American Equilibration Society and the Academy of CranioFacial Pain, and a previous member of the IACA Dr Shapira is well versed in all of the pholosophies of each group. As a member Dr Shapira urges the ADA, the Illinois State Dental Society and the Chicago Dental Society to see these pseudo-specialties as a threat to the profession and the public.

Dr Shapira is a founding member of The American Academy of Dental Sleep Medicine (formerly the Sleep Disorder Dental Society), a Diplomate of the American Board of Dental Sleep Medicine and a founding and charter member of DOSA, The Dental Organization for Sleep Apnea. The AADSM should, in Dr Shapira's opinion, join the TMD Alliance this year.

Dr Shapira is the Dental Editor of Sleep and Health Journal.

Dr Shapira did research on the similarities in jaw position in sleep apnea and TMJ patients in the 1980's as a visiting assistant professor at Rush Medical School where he worked with Rosalind Cartwright PhD who is primarily responsible for the entire field of Dental Sleep Medicine. He also studied with Dr Barney Jankelson who created the initial concepts that neuromuscular dentistry still uses today and created a company Myotronics that is the leading manufacturer of instrumentation used by Neuromuscular Dentistry.
His research showed that TMJ and Sleep Apnea patients had very similar jaw postures.

Dr Shapira has maintained a general dental practice with a special emphasis on sleep and pain in Gurnee, Il and has recently started Chicagoland Dental Sleep Medicine Associates in Highland Park. More information on Sleep, TMJ and Headache Treatment can be found on his websites.

http://www.thinkbetterlife.com (Highland Park office)

http://www.delanydentalcare.com (Gurnee Office)

http://www.ihateheadaches.org

http://www.chicagoland.ihatecpap.com.

http://www.Sleepandhealth.com

Dr Ira L Shapira is an author and section editor of Sleep and Health Journal, President of I HATE CPAP LLC, President Dato-TECH, President of Sleep Well Illinois,
 Dr Shapira also holds several patents on methods and devices for the prophylactic minimally invasive early removal of wisdom teeth and collection of bone marrow and stem cells. He is currently working with Dr Tom Diekwisch at the University of Illinois and Baylor University to prove these stem cells can change peoples lives for the better. Dr Shapira is a licensed general dentist in Illinois and Wisconsin.
sin.

Parkinsons Disease, Strength and Neuromuscular Orthotics

A new article  "demonstrates that moderate intensity progressive resistance training, 2-3 times per week over 8-10 weeks can result in significant strength, balance and motor symptoms gains in people with early to moderate Parkinson's disease."
This is interesting because neuromuscular orthotics and oral orthotics designed to treat Dystonias can also increase strength and balance.  The PPM or Pure Power Mouthguard was shown to increase strength and balance in highly conditioned athletes.  I have personally had experience in treating people with Parkinson's who "instantly improved"  with an oral appliance..
Dr Brendan Stack has the most experience in the country.  Google "brendan stack video parkinsons" and you will find several videos on treatment of Parkinsons and other movement disorders.
Visit www.thinkbetterlife.com to learn more about treatment in my Highland Park office.

12.

Clin Rehabil. 2015 Feb 17. pii: 0269215515570381. [Epub ahead of print]

Effectiveness of resistance training on muscle strength and physical function in people with Parkinson's disease: A systematic review and meta-analysis.

Chung CL1, Thilarajah S2, Tan D3.

Author information

Abstract

OBJECTIVES:

To systematically review the evidence investigating the effectiveness of resistance training on strength and physical function in people with Parkinson's disease.

DATA SOURCES:

Seven electronic databases (COCHRANE, CINAHL, Medline ISI, Psycinfo, Scopus, Web of Science ISI and Embase) were systematically searched for full-text articles published in English between 1946 and November 2014 using relevant search terms.

REVIEW METHODS:

Only randomized controlled trials investigating the effects of resistance training on muscle strength and physical function in people with Parkinson's disease were considered. The PEDro scale was used to assess study quality. Studies with similar outcomes were pooled by calculating standardized mean differences (SMD) using fixed or random effects model, depending on study heterogeneity.

RESULTS:

Seven studies, comprising of 401 participants with early to advanced disease (Hoehn & Yahr stage 1 to 4), were included. The median quality score was 6/10. The meta-analyses demonstrated significant SMD in favour of resistance training compared to non-resistance training or no intervention controls for muscle strength (0.61; 95% CI, 0.35 to 0.87; P <0 .001="" 0.001="" 0.08="" 0.21="" 0.64="" 0.75="" 95="" abstracttext="" and="" balance="" but="" ci="" confidence="" for="" gait="" life.="" motor="" not="" of="" p="" parkinsonian="" quality="" symptoms="" to="">

CONCLUSION:

This review demonstrates that moderate intensity progressive resistance training, 2-3 times per week over 8-10 weeks can result in significant strength, balance and motor symptoms gains in people with early to moderate Parkinson's disease.

© The Author(s) 2015.

KEYWORDS:

Parkinson’s disease; Resistance training; meta-analysis; systematic review

Chicago / Highland Park Migraine Relief: Acupuncture: As Effective AS Drugs In Migraine Prevention

A new article in Headache describes Acupuncture as being "At least as effective as medication for migraine prevention".

Migraines and Chronic Headaches destroy our day to day quality of life.  My new office in Highland Park is dedicated to the relief of chronic pain, headaches and migraines and the treatment of sleep disorders.  Think Better Life is a division of Chicagoland Dental Sleep Medicine Associates. Visit my website www.thinkbetterlife.com

Acupuncture works on the same principles as trigger point injections and Neuromuscular orthotics, that is it treats Migraines as an Input /Output or I/O error where neuro information fed into the brain changes brain chemistry through the neurons and creates pain.
Trigger points in muscles have an 80% correlation to classical acupuncture points and are extremely effective in relieving all types of chronic pain. Experience has shown that eliminating myofascial trigger points not only relieves the referred muscle pain but also decreases or eliminates frequency and severity of migraines. When there is less nociceptive (painful) neurological input to the brain the Trigeminal-Vascular system does not produce migraines and other autonomic cephalgias such as cluster headaches .
The Neuromuscular Orthotic created utilizing Neuromuscular Dentistry is specifically designed to eliminate nociceptive input from the Trigeminal Nervous System which is the cause (partial of fully) of all headaches.
I frequently show patients easy acupuncture points that can be utilized with acupressure for treatment of their headaches and migraines.

All patients who are receiving acupuncture for headaches or migraines and are not receiving complete relief should consider trying a Diagnostic Neuromuscular Orthotic to eliminate nociception that causes headaches and migraines.

The PubMed Abstract is below:
Headache. 2015 Feb 16. doi: 10.1111/head.12525. [Epub ahead of print]
Acupuncture for Migraine Prevention.
Da Silva AN1.
Author information

Abstract
BACKGROUND:
Migraine is a complex and multifactorial brain disorder affecting approximately 18% of women and 5% of men in the United States, costing billions of dollars annually in direct and indirect healthcare costs and school and work absenteeism and presenteeism. Until this date, there have been no medications that were designed with the specific purpose to decrease the number of migraine attacks, which prompts a search for alternative interventions that could be valuable, such as acupuncture.
METHODS:
Acupuncture origins from ancient China and encompasses procedures that basically involve stimulation of anatomical points of the body.
RESULTS:
This manuscript reviews large and well-designed trials of acupuncture for migraine prevention and also the effectiveness of acupuncture when tried against proven migraine preventative medications.
CONCLUSION:
Acupuncture seems to be at least as effective as conventional drug preventative therapy for migraine and is safe, long lasting, and cost-effective. It is a complex intervention that may prompt lifestyle changes that could be valuable in patients' recovery.
© 2015 American Headache Society.
KEYWORDS:
acupuncture; alternative medicine; prevention

HEADACHE RELIEF with SPG Blocks Dr Shapira treats Wisconsin Patients for Migraine and Chronic Headache Patients

The SPG Block or Sphenopalatine Ganglion Block is a safe and effective treatment to for chronic tension headaches and migraine.  It is possible to prevent headaches entirely.   The Sphenopalatine Ganglion is a Parasympathetic Ganglion adjacent to the back of the nose that can be blocked with cotton tipped applicators and lidocaine.

Sphenopalatine Ganglion Blocks are also effective in treating TMJ Disorders.

Neuromuscular Dentistry combined with trigger point injections or spray and stretch techniques combined with SPG Blocks can give headache patients their lives back.

http://www.ihateheadaches.org/blogs/illinois/labels/migraine%20treatment%20SPG.html

http://www.24-7pressrelease.com/press-release/good-news-for-chicago-and-north-shore-headache-patients-i-hate-headachesorg-founder-opens-highland-park-lake-forest-office-to-serve-lake-county-northern-cook-county-and-chicago-headache-patients-398930.php

Treating and Preventing Migraines: Episodic vs Chronic New Article in Headache March 2015 Describes Barries to Optimal Treatment and Prevention

There is a new article "eadache. 2015 Mar;55 Suppl 2:103-22. doi: 10.1111/head.12505_2.

Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention." in Headache that describes the problems in finding optimal treatment.

In my experience the diagnosis of episodic or chronic migraine can actually harm the patient.  As headaches are classified it then limits the treatments that physicians offer.  I frequently find that wrong assumptions as to the cause of headaches is often the largest deterrent to successful treatment.  

The following video is a patient with severe headache that was relieved in just a few minutes time with Ttrigger Point Injections and muscle stretch.  The orgin was Myofascial Pain but the symptom was headache or migraine. When I saw this patient the first time she had been in constant excruciating pain for every minute of every day for 22 years.

Watch the video and then go www.thinkbetterlife.com testimonial page to see her first video. 

https://www.youtube.com/watch?v=-VA-amBnd8A

According to the article there are only five strategies for preventing episodic migraine and one  for preventing chronic migraine.  This fact is based on the idea that drug therapy is the method of preventing migraines.   " Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine. "

5.

Headache. 2015 Mar;55 Suppl 2:103-22. doi: 10.1111/head.12505_2.

Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention.

Lipton RB1, Silberstein SD.

Author information

Abstract

Migraine is a common disabling primary headache disorder that affects an estimated 36 million Americans. Migraine headaches often occur over many years or over an individual's lifetime. By definition, episodic migraine is characterized by headaches that occur on fewer than 15 days per month. According to the recent International Classification of Headache Disorders (third revision) beta diagnostic criteria, chronic migraine is defined as "headaches on at least 15 days per month for at least 3 months, with the features of migraine on at least 8 days per month." However, diagnostic criteria distinguishing episodic from chronic migraine continue to evolve. Persons with episodic migraine can remit, not change, or progress to high-frequency episodic or chronic migraine over time. Chronic migraine is associated with a substantially greater personal and societal burden, more frequent comorbidities, and possibly with persistent and progressive brain abnormalities. Many patients are poorly responsive to, or noncompliant with, conventional preventive therapies. The primary goals of migraine treatment include relieving pain, restoring function, and reducing headache frequency; an additional goal may be preventing progression to chronic migraine. Although all migraineurs require abortive treatment, and all patients with chronic migraine require preventive treatment, there are no definitive guidelines delineating which persons with episodic migraine would benefit from preventive therapy. Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine. 

© 2015 American Headache Society.

KEYWORDS: 

chronic migraine; diagnosis; episodic migraine; iontophoretic transdermal system; onabotulinumtoxinA injection; treatment

PMID:

 

25662743

 

[PubMed - in process]

LAKE FOREST: TENSION HEADACHES, CHRONIC DAILY HEADACHE, MIGRAINE, CLUSTER HEADACHE AND CHRONIC MIGRAIN

Diagnosis of a particular type of headache is often the worst event for a headache patient.  All headaches are multifactorial and there are many aspects to prevention and treatment.  Unfortunately once the headaches are labeled many patients experience their doctors wearing Blinders and all diagnosis and treatment decisions are outside of the blinders are never considered.  At my new office in Highland Park I take an open approach to chronic pain.  The labels do not help and often interfere with treatment. Visit www.thinkbetterlife.com the website for my HighlandPark office.

There is one common thread to almost 100% of all chronic headaches, the involvement of the Trigeminal Nerve. There is no universal agreement on the sequence or causes of headaches but there is agreement that there are various triggers to most headaches.

Effective Treatment to Prevent, Treat and Eliminate the spectrum of headaches should include a primary Trigeminal Component.

Our nervous system has a Somatic Division which is divided into Sensory and Motor Nerves and an Autonomic component which has a Smpathetic and Parasympathetic components.

Before discussing more common headaches and migraines lets consider a special group of headaches called the Trigeminal Autonomic Cephalgias that includes Cluster Headaches, Paroxysmal Hemicrania and the SUNCT / SUNA headaches or Short Unilateral Neuralgiaform Headache with Conjuctival Injection. All of these often present with severe sudden onsets and initially should be evaluated with either/or CAT Scans and MRI’s to rule out tumors and/or vascular bleeds. I will discuss these special autonomic headaches in more detail in a future post. These headaches frequently can be prevented and allieved in many cases by Neuromuscular Dentistry and by changing Trigeminal Input with a Diagostic Orthotic. More information can be found at www.ihateheadaches.org and http://www.neurology.org/content/74/11/e40.full

Another special type of headache or cranial pain disorder is Trigeminal Neuralgia or Tic Douloureux known for sudden stabbing pain usually unilaterally in the face. Tic Doulourex is considered one of the most severe types of pain a person can experience earning it the name “The Suicide Pain” because of patients taking their life. Trigeminal Neuralgia will also respond to initial treatment with a Neuromuscular Diagnostic Orthotic though radical (and dangerous) therapy may be required.

Tension headaches, muscle spasm headaches, chronic daily headaches, cervicalgia headaches, sinus headaches, TMJ headaches are some of the names given to pain coming primarily from muscles. I would characterize this group of headaches as MPD or Myofascial Pain and Dysfunction in nature. It is associated with taut muscle band and trigger points. The primary cause of all of these in the head and neck is repetitive strain injuries and are ideally treated with Neuromuscular Diagnostic Orthotics as The First Line of treatment. Correction of underlying orthopedic and functional conditions can lead to a lifetime of better health. This treatment is often called TMJ treatment but that is always an oversimplification.
The postural train goes from the jaws to the feet (or hips when sitting) and changes in one area affect all areas. The terms Cranial Sacral Therapy, Sacral Occipital Therapy, and the fields of Chiropractic Medicine, Osteopathic Medicine Physiatry, Physical Therapy, and Naprapathy are all about treating problems between the reset points. Correction of end points are necessary for long term results.

The three endpoints are the bite including the upper and lower jaws including the TMJoints, the feet when standing and the hips when sitting. It is incredibly important to stabilize end points.

The Jaw is the single most important end-point in regards to headaches. This is because it is home to the majority of Trigeminal Nerve input to the brain. The Trigeminal nerve accounts for over 50% of all input to the brain after amplification by the Reticular Activating System. If Nociceptive (painful) inputs are brought into the brain chronic headaches is a frequent outcome. In computer lingo “Garbage in….Garbage Out” where Garbage is pain. The Trigeminal nerve innervates the teeth, the periodontal ligaments, the jaw joints, the jaw muscles, the tongue, soft palate, uvula, the tensor of the ear drum, the muscle that opens and closes the eustachian tube, the lining of the sinuses and MOST IMPORTANT, the Trigeminal Nerve controls the blood flow to the anterior two thirds of the meninges of the brain. This is the connection to all vascular and neurogenic headaches including previously discussed Autonomic Trigeminal Cephalgias and Trigeminal Neuralgia.

All headaches are basically primary or secondary results of input-output errors of the information the Trigeminal Nerve brings into the brain. This input causes chemical changes in the brain through the synapses. This changes blood flow and muscle function, posture, breathing and more.

The NHLBI of the NIH published a report”The Cardiovascular and Sleep -Related Consequences of TemporoMandibular Disorders"  discussing the wide spread affects of TMJ disorders. www.nhlbi.nih.gov/files/docs/workshops/tmj_wksp.pdf
This should be read by all headache patients.

I n the past I have seen patients who have lived with chronic pain for most of their lives only to find out there was treatment that could relieve their pain.  One patient had continuous headaches for over fifty years in spite of being married to a physician.  After two visits she was out of pain but also very angry.  Why did she have to live with constant headache pain when treatment was so simple.  The reason is what I call circle of knowledge.  There are thousands of excellent, well educated physicians and specialists who love helping patients and stay abreast in their knowledge.  Unfortunately, even the best and brightest don't know what they don't know.  Often, they have seen a failure in one patient and assume it applies to all patients.

Each patient is unique as is the source and causes of their pain.  A good physician listens to their patients, hears what they express and believes what their patients tell them.  Many patients feel like their doctors don't believe them about the severity of their pain which is very frustrating.