Acupuncture for Cervicogenic Headaches
Acupuncture as a therapeutic intervention is being embraced by the medical community. This is in part because it is a non-pharmacological therapeutic intervention that is simple to carry out, economical, and has very few side effects. One area that is being explored is the use of acupuncture to decrease the individual’s headache frequency, intensity, duration and acute medication requirements.
A Biopsychosocial Model: Many clinicians explain the mechanism of action in neurophysiological terms.
Evidence based acupuncture is an approach grounded in neuroscience that is based upon a theory that is inline current scientific understanding of how the body works. Using occam's razor the insertion of an acupuncture needle is a form of novel stimuli, that functions by sending anti-nociceptive input to the neuroimmune system. Stimulating endogenous opioid release, purinergic signaling and modulation of the endocannabinoid system.
Preferential sites for acupuncture stimulation are associated with areas rich in specialized sensory receptors such as muscle spindles, Golgi tendon organs, ligament receptors, Paciniform and Ruffini’s receptors (joint capsules), deep pressure endings (within muscle belly), and free nerve endings (muscle and fascia).
Based off the biopsychosocial model, all of these areas are highly innervated and as a result there are a number of physiological responses that help modulate the experience of pain. An observed favorable outcome may be explained by a number of overlapping mechanism in the periphery, spinal cord, and brain including represented in the image below.
Structures to be Aware of When Treating Cervicogenic Headaches
My first recommendation for those who suffer from headaches is to work with a physician to develop strategies to manage symptoms. Then a treatment plan can be implemented based on patient-specific assessment findings and patient tolerance.
Structures to keep in mind while assessing and treating patients suffering from migraine headaches may include neurovascular structures and investing fascia of:
• Upper Trapezius
• Splenius Cervicis
• Splenius Capitis)
• Levator Scapula
• Corrugator Supercilii
• Temporomandibular Joint
• Scalene Muscle Group
More to Explore
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Bendtsen, L., Ashina, S., Moore, A., Steiner, T.J. (2016). Muscles and their role in episodic tension-type headache: implications for treatment. Eur J Pain.
Coeytaux, R. R., & Befus, D. (2016). Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders. Headache.
Fernández-de-Las-Peñas, C., Courtney, C.A. (2014). Clinical reasoning for manual therapy management of tension type and cervicogenic headache. J Man Manip Ther. (OPEN ACCESS)
Fernández-de-Las-Peñas, C.. Myofascial Head Pain. (2015). Curr Pain Headache Rep.
Fernández-De-Las-Peñas, C., Arendt-Nielsen, L. (2017). Improving understanding of trigger points and widespread pressure pain sensitivity in tension-type headache patients: clinical implications. Expert Rev Neurother.
Ishiyama, S., Shibata, Y., ... Matsumura, A. (2018). Clinical Effect of C2 Peripheral Nerve Field Stimulation Using Electroacupuncture for Primary Headache. Neuromodulation.
Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Shin, B., . . . White, A. R. (2016). Acupuncture for the prevention of tension-type headache. Cochrane Database of Systematic Reviews.
Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Vertosick, E. A., . . . White, A. R. (2016). Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews.
Luedtke, K., Boissonnault, W., Caspersen, N., Castien, R., Chaibi, A., Falla, D., . . . May, A. (2016). International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study. Manual Therapy.
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MacPherson, H., Vickers, A., Bland, M., Torgerson, D., Corbett, M., Spackman, E., ..., Watt, I. (2017). Acupuncture for chronic pain and depression in primary care: a programme of research. Southampton (UK): NIHR Journals Library.
Millstine, D., Chen, C., Bauer, B. (2017). Complementary and integrative medicine in the management of headache. BMJ.
Murakami, M., Fox, L., Dijkers, M.P. (2017). Ear Acupuncture for Immediate Pain Relief-A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain Med.
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Yang, Y., Que, Q., Ye, X., Zheng, G.h. (2016). Verum versus sham manual acupuncture for migraine: a systematic review of randomised controlled trials. Acupunct Med.
Zhao, L., Chen, J., ... Liang, F. (2017). The Long-term Effect of Acupuncture for Migraine Prophylaxis A Randomized Clinical Trial. JAMA Intern Med.