Question
QUESTION: Hello,
Thank you for reading my following question...

My son is 10-years-old.  He suffers from cluster tension headaches and does see a chiropractor about once every 2-3 months.  We have recently changed insurances and are having a difficult time getting a dr to refer him.  Recently, he's been complaning of pain localized mainly to the very top of his head were the fontonal is closed up.  I am a massage therapy student and lightly massage his head as it helps his headaches, but I can't figure out what could be causing this pain.  It is so bad (even with the most gentle touch) that he's almost screaming in pain.  He doesn't show any signs of illness and is VERY active and healthy.  I do not feel anything out of the ordinary on his head.  He does have very tight muscles in his neck and shoulders. There are no other areas that are sore to the touch.  I am wondering if this could be normal for someone that suffers from cluster tension headaches?  Thank you again for taking the time to read this.
April

ANSWER: Pain on scalp, Headache, Cluster Headache, Tension Headache, Muscular tightness,





Hello April,

I am sorry to hear of the pain your son is suffering.

"....He suffers from cluster tension headaches ....", I am a little confused here.  I am a DACBSP (specialist in sports injury) and not a
DACNB (chiropractic neurologist), you can see the various Chiropractic Specialties at: http://www.acatoday.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf

But, I am not familiar with 'cluster tension headache', (http://ezinearticles.com/?Headache---Tension,-Cluster,-and-Migraine&id=619102)  I may be incorrect, but usually the headache classification is cluster, OR tension, OR migraine.  Having one does not mean you cannot have the other, but usually there are different classifications.  What doctor made the diagnosis?  What testing has been done? What treatment has been successful/ unsuccessful thus far?

"....We have recently changed insurances and are having a difficult time getting a dr to refer him.....", Doctors of Chiropractic usually do not require a referral.  Your plan may require this, but this would be unusual.  There should be no problem in getting a referral to the Chiropractic Doctor from your Medical Doctor.  Years and years ago MDs did not refer to DCs, but that time is long past.  In my Staten Island Chiropractic office I routinely get MD referrals, and routinely refer to MDs.  Ask your PCP- primary care provider, he(she) should be quick to refer you to a chiropractic doctor they work with.

"....Recently, he's been complaning of pain localized mainly to the very top of his head were the fontonal is closed up. ....", the fontanel on the anterior skull usually closes at 18- 24 months.  Your son is ten years old?  Did this fontanel remain open until recently? Has your son had some health, particularly neurological problems in the past?
         The fontanel should be long closed.  If not, you should have seen, or be seeing, a Neurologist.  Absence of a fontanel in a 10y/o should not impact headache. (fontanelle:  http://en.wikipedia.org/wiki/Fontanelle )

".....It is so bad (even with the most gentle touch) that he's almost screaming in pain....."- with pain this bad, Neurological evaluation is necessary.  Whether a Chiropractic Neurologist or a Medical Neurologist-- evaluation as to the cause of this severe a pain is needed.  MRI of the brain/ skull (and- or CT scan, depending upon the Doctor and facility available), EEG activity of the brain, opthalmic examination, balance and coordination evaluation; all of these thing would be necessary to more fully evaluate the CAUSE of this intense pain.  The DC or MD neurologist would give a better handle on the correct diagnosis, which would then lead to the most appropriate treatment.


".....I do not feel anything out of the ordinary on his head...."- you do not feel anything out of the ordinary ON his head.  With this severe a pain, and I do not mean to alarm you, you must find out what is happening IN his head.  A first step is a 'simple' physical examination at the neurologist office, then PERHAPS referral for testing.

".....He does have very tight muscles in his neck and shoulders.......I am wondering if this could be normal for someone that suffers from cluster tension headaches...."- the headache and the muscle tightness are probably SYMPTOMS of the same CAUSE.  You want to get to the CAUSE of the problem by having an appropriate neurological examination- again either a DC or MD neurologist specialist could handle this exam.

If the CAUSE is determined to be a medical pathology, your DC would refer you to the appropriate MD specialist.  If the CAUSE is a chiropractic problem- such as vertebral subluxation ( a common cause of headaches AND muscle tension), then the DC could treat this condition (VSC= vertebral subluxation) and remiss the symptoms.

In my office I hand out explanatory information sheets- this may be helpful to you:




PAIN     

Pain  is a  憆ed light on the dashboard?
 
Pain is your body telling you that something is wrong.

That RED LIGHT on the dashboard of your car-
-- do you ignore it until the car breaks down,
or do you get it checked and correct the problem?  

Pain,
pain in your body-
-- do you ignore it until your body breaks down,
or do you get it checked and correct the problem?   

Pain,  
do you cover up the pain by taking a painkiller?  
Take a painkiller,
mask the pain,
and allow a problem to progress in your body?


    NOTICE  ON  PAIN  RELIEVERS:
 
Label changes ORDERED by FDA;  the FDA announced proposed label changes for OTC over-the-counter pain relievers to include the potential for stomach bleeding and liver damage (FDA news  206- 207;  12-9-06) ;

The  American Heart Association issued a scientific statement recommending medical doctors change the way they prescribe OTC pain relievers from a first choice to an alternate of recommending non-pharmacologic treatment (AHA statement  2-26-07).

NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ). Many times people take NSAIDS for the pain of Arthritis, not realizing these drugs may make the underlying condition worse.  These medications cover up the pain, and cause the problem to worsen.



Pain  can  often  be  the  result  of  the  Vertebral  Subluxation  Complex.


Vertebral  Subluxation          (  慥SC?,    憇ubluxation?  )
Vertebral Subluxation  is  actually  a  quite  common  condition.   Doctors of Chiropractic look for pathological conditions which may require referral to other specialties,   and also look for 慡ubluxation? Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system  (the master control system- ALL health disciplines learn this).  VSC- 慡ubluxation??can be the cause of many symptoms and conditions.



Only  a  Doctor of Chiropractic  will  evaluate  and  treat  for  VSC,   as  well  as  other  pathology.


The course of VSC is highly variable.   Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights.    Some patients immediately develop symptoms related to the VSC,  some patients take years to develop symptoms.  Some people suffer for only a few days with pain and symptoms, some people suffer for months.  Some people recover in days, some take months or years, depending upon severity of the condition.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.
       Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching,  yoga,  vitamins  or  physical  therapy  alone.       Subluxation- a neuro/skeletal/muscular-    mechanical-    problem  requires  a    mechanical correction-  -  -    a manipulation,         best  performed  with  the  chiropractic  adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine
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揌eadache?  

( Also Known As-  Cephalgia )  

Sometimes  we  experience Headache.   Head pain,  headache, can come from many causes;   perhaps we overindulged in food or alcohol,  headache can result; perhaps an allergy, our eyes, fatigue, tension,  or a multitude of causes can  cause our headache.  

Sometimes we take pill after pill with little good result....  Sometimes the cause of headache pain can be in our head/ neck/ spinal alignment, our posture, our movement patterns.    Perhaps your neck is giving you a headache!!  Often-  the true    c a u s e   of  the headache and pain;  is a misalignment,  a  慿ink?in the neck- more properly termed a Vertebral Subluxation.


         Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


This is a serious condition identified by its five parts:

    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.

    Myopathology:
         Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.

    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.

    Pathophysiology:
         The VSC contributes to OsteoArthritic degeneration. Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.



The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
         Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.  For good health- Treat the   Cause,  not just the symptoms.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine
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"..... Thank you again for taking the time to read this....."- no thanks necessary.
        THANK  YOU  for the question!  and if further information is needed,,, please do not hesitate to REcontact me here at AllExperts.com : -
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

I hope this helps.

Mostly I am asking you to get a more complete evaluation on your son. If your MD is reluctant--- remember the squeaky wheel gets the grease!
Call, ask, demand a proper evaluation for this pain!

Thanks,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com     (Email NewsLetter)  


---------- FOLLOW-UP ----------

QUESTION: Thank you for your answer.  That was very informative.  It was actually a pediactric neurologist that made the diagnosis of cluster/tension headaches a couple of years ago.  He did not think it was anything serious through his testing.  There were no x rays performed however.  Our insurance is an HMO and the PCP will not refer to a chiro and he states our son is too young for that type of care. We are seeking out another dr for him and last week paid cash at a chiro and he evaluated him and said he believes that it is due to muscle tightness, possibly restricted fascia (I believe that's how he put it) and adjusted him.  He is much better now.  There were not fontonal issues, I'm not sure if I worded it incorrectly.  The pain is just located where the fontonal used to be open.  The dr thought it was pain located near the sutures of that closure.  Again, I may be wording this wrong.  I really appreciate your answer, it was very informative.

Answer
Thank you for your followup comments.

It came across to me as a question, so I have to write an answer.

Good Luck.  It sounds like just a few adjustments may be able to help your son.

Most Doctors of Chiropractic have a patient base from just a few weeks old until the ninth decade or more!

Many DCs have worked with infants with colic- with great success.

Any human, at any age, as long as they have a spine- COULD benefit from Chiropractic, IF they have a vertebral subluxation (VSC), only examination by a DC can elicit that finding if appropriate.



Chiropractic and children:

http://www.chiroweb.com/mpacms/dc/article.php?id=40153

http://www.chiroweb.com/mpacms/dc/article.php?id=41406

http://www.chiroweb.com/mpacms/dc/article.php?id=42457

http://www.chiroweb.com/mpacms/dc/article.php?id=36406



And there are many more,,,,,,,

Good Luck,

and I wish you and your son- Good Health Naturally!




Dr. Victor Dolan, DC DACBSP
http://drvictordolan.chiroweb.com     (email newsletter)