Headaches affect 99% of people at some point in their life, and chronic, debilitating headaches affect 62% of people.  Therefore, headaches everyday are a common complaint in our clinic. In order to properly diagnose and treat a headache, it is obviously important to understand the mechanism of a headache.  

Essentially, the pain noted with a headache is due to swelling, expanding, or dilation of a blood vessel in the brain.  When the vessels expand, they irritate nerves surrounding the vessels, which are transmitted and interpreted by the brain as pain.  However, the cause of vessel expansion is the most important variable that must be discovered to treat a headache.  

First of all, there is one very important thing to remember.  The majority of headaches have at least two triggers, if not more.  Triggers that directly or indirectly lead to the dilation of the vessels in the brain.  The more common triggers include; allergic response, spinal tension, hormone fluctuation, nutrition, temperature, and blood flow and viscosity.  Like I stated earlier, the majority of headaches have at least two triggers.  For example, a female may be experiencing cervical spine tension, and not have a headache.  However, once her hormones begin the increase due to her monthly cycle, hormonal headaches are triggered.  Another example would be if a person is having an allergic response to pollen, but has no headache until they become dehydrated and the viscosity of the blood increases, causing an allergy headache.  

The most common contributing factor to headaches is spinal tension.  I am not saying that most people with spinal tension will have headaches.  I am just saying that the majority of people with headaches have spinal tension as a contributing factor.  I have noticed through my experience that by removing one or more of the contributing factors, the frequency and intensity of headaches can be drastically reduced.  Since most headaches have spinal tension as a contributing factor, if this spinal tension can be resolved, the headache symptoms will decrease, even if there is another contributing factor like hormones or allergic response.  

Therefore, to properly treat headache symptoms, the triggers or contributing factors must be determined, and at least one of them eliminated. Headaches everyday, whether they be hormonal headaches, an allergy headache, or a headache caused by any number of other reasons, require getting to the root of the cause, and treating it.        

Carpal tunnel is a common complaint of many people, especially those that consistently use their hands in a repetitive motion.  However, for being such a common complaint, carpal tunnel cause factors are misdiagnosed the majority of the time.  

What causes carpal tunnel, the syndrome, is from compression of the median nerve at the wrist of the affected hand.  This compression or entrapment of the median nerve can be caused by fluid (edema), trauma, degeneration, ligament thickening, inflammation (any –itis), etc.  

The symptoms are most commonly tingling, numbness, ache, or pain radiating into the hand.  The biggest misconception is that when someone experiences these symptoms, it is most commonly diagnosed as emanating from a carpal tunnel cause, and is therefore labeled carpal tunnel syndrome.  However, 65% of the time, the symptoms are not entirely, or even partially, due to entrapment of the median nerve at the wrist (carpal tunnel syndrome).  Why is this?  Because, the median nerve actually originates at the cervical spinal nerve roots.  It then travels through the brachial plexus that resides at the anterior shoulder compartment.  After leaving the brachial plexus, the nerve then travels down the arm, through the pronator teres muscle, and finally into the hand and wrist.  Carpal tunnel type symptoms are most commonly caused by entrapment of the nerve at any of those four areas (1. cervical spinal nerve roots, 2. brachial plexus, 3. pronator teres, 4. wrist) or a combination of two or more of these areas.  

So to treat carpal tunnel pain correctly it is necessary to evaluate the full track of the nerve line as it goes down cervical spine, brachial plexus in the shoulder, pronator teres muscle in the forearm, or the wrist.  For example, there could be 25% entrapment at the cervical spine, 40% entrapment at the brachial plexus, 15% at the pronator teres muscle, and 10% at the wrist.  All of these areas combined equal 90% entrapment.  However, if the condition was treated as carpal tunnel syndrome, then only 10% of the cause would be corrected. Only ten percent of carpal tunnel relief is no relief at all, and leads to a great deal of frustration.

Therefore, it is very important to have the condition properly examined to determine the correct diagnoses and proper treatment. Only then will the patient have complete carpal tunnel relief.        

The term “Sciatica” is a very well known word by most individuals.  I personally hear it daily.  However, “Sciatica” is very specific condition contrary to how it is commonly used as a general term for leg pain. 

Sciatica Symptoms
The sciatic nerve begins in the lumbar spine as nerve roots (L4-S3) branching off the spinal cord.  These nerve roots combine together to form the large and very complex sciatic nerve.  Once forming the sciatic nerve in close proximity to the spine, the sciatic nerve travels down the posterior gluteal muscles then underneath the piriformes muscle.  Once exiting from the piriformes muscle, the sciatic nerve then travels down the back of the leg, into the sole of the foot.  The sciatic nerve has many other nerves that branch off of it and innervate other areas of the leg.  One way to think of it is that, in relation to the leg, the sciatic nerve is the trunk of the tree that then branches into many other limbs (nerves).  When using the term “Sciatica”, it is important to know that sciatica symptoms and sciatic pain is strictly limited to the posterior thigh (hamstring area), lower leg (calf area), and sole of the foot. 

What Causes Sciatica
There are multiple causes of sciatic pain that must be understood in order to properly treat this condition.  What causes sciatica is considered a lower motor neuron condition.  Lower motor neuron sounds complex; however, it simply means that it is a condition that originates after the spinal cord.  The spinal cord and brain neuron networks are considered upper motor neurons, and the peripheral nerves (everything branching from the spinal cord) are considered lower motor neurons.  Since it is a lower motor neuron condition, the nerve can only be affected by structures or disease starting at the outer most part of the spinal cord.  Therefore, the possible causes of sciatica pain are limited to the spinal structures, and tissue following.

The primary cause of sciatica pain is irritation of one or more of the nerve roots (L4-S3) that form the sciatic nerve at the spinal level.  This can be due to a disc injury, spinal degeneration, disc degeneration, spinal facet joint inflammation, etc.  After ruling out spinal level conditions, the final primary cause of sciatica pain  is contracture of the piriformes muscle.  As stated above, the sciatic nerve travels underneath the piriformes muscle.  If this muscle becomes chronically restricted/contracted, the result will be compression of the sciatic nerve leading to sciatica pain. 

Obviously there are many causes of “Sciatica” which is why the condition must be properly examined.  Once the underlying cause of the sciatica pain condition is determined, then and only then can the sciatica symptoms and condition be treated correctly.