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Dynamic Chiropractic – March 23, 1998, Vol. 16, Issue 07

Headaches: Many Causes -- Some New, Some Old!

From Individual Durability to a New Dural Connection

By Louis Sportelli, DC
From the Congressional Roll Call to the Encyclopedia Britannica

After receiving the February 9th issue of Dynamic Chiropractic, I got a headache.

The front page shouted "Chiropractic's Triple Threat!" and there were photos of Peter Ferguson (D-Ohio), Paul Phillips (R-Washington), and Meredith Bakke (R-Wisconsin). Great news, but when I reviewed my column in the same issue, I noted that there was no mention of Meredith Bakke. With a headache building, I called Dr. Bakke and apologized for what was a colossal oversight and error on my part for not mentioning her in my article. She laughed and said, "Don't worry, I am announcing my candidacy today!" DC scooped the announcement; Dr. Bakke was not upset; my tension headache was easing; and it afforded me an opportunity to take a few moments and repeat the challenges and opportunities which face these three candidates as they enter the primary races.

What a wonderful statement of having arrived! Three doctors of chiropractic who feel confident enough to throw their hats into the highest-profile political arena in the world: the Congress of the United States. Each of the candidates has great confidence, ability and determination. What they need is money, manpower, a majority of votes in the primary, and, to paraphrase a song, "a little help from their friends."

How exciting to think of the statement that the election of three chiropractors to the U.S. Congress will make to the country. No longer will health care be decided entirely by non-health care professionals. No longer will the medical model be the only model the Congress of the United States will consider in its deliberations. No longer will "alternative," "unconventional," "complementary" or whatever term du jour is applied to non-allopathic care be viewed with disdain or as a nonessential health care service without, at least, congressional discussion. The deliberations in Congress will serve the needs of the people by providing the opportunity of choice, free from monopolistic attitudes and obstacles to access.

It takes so few votes to make the difference between victory and defeat. If every DC in these congressional districts puts aside personal and professional disagreements and convinces every patient that Dr. (Bakke, Ferguson, Phillips) was the right candidate in their congressional election to help change the way health care is delivered, each of these candidates would be a certain winner. Time will tell if the chiropractic profession is willing to do what it takes to finally step into the big leagues and be a player at the table, rather than a spectator seeking admission. Enter the Encyclopedia Britannica -- and the Dura "Headache" Connection

As exhilarating as the congressional races may be, the new discovery of a muscle-dura connection has created excitement in the world of research. With publication in the November supplement to the Encyclopedia Britannica, Dr. Gary Hack, assistant professor in the department of restorative dentistry at Baltimore College of Dental Surgery Dental School, University of Maryland at Baltimore; Gwendolyn Dunn, DDS, private practice orthodontist; and Mi Young Toh, MS, MA, biomedical imaging researcher, announced the discovery of a physical connection between the muscular system and the central nervous system that had never before been described in the literature. The article in the 1998 Medical and Health Annual by Encyclopedia Britannica, Inc., was titled "The Anatomist's New Tools."

In a compelling article, reading like a good mystery novel, the authors described the discovery in colorful language, reflective of the emotional drama experienced by the researchers after they knew they had discovered something very significant. New visual technologies from the U.S. National Library of Medicine's Visible Human Project (VHP) aided the researchers in validating their discovery.

The discovery of this new muscle-dura connection was important, but the practical application and consequences could far and away overshadow the discovery. A new segment in the "headache puzzle" had been found. To any chiropractor, the connection between muscle tension headaches and the phenomenal results achieved with headache patients using chiropractic adjustments was commonplace. Empirical evidence for 100 years was now affirmed with a new scientific discovery. The article goes on to explain how the investigators postulated the connection of the inward folding of the dura with cervical extension or flexion, possibly compromising the flow of cerebrospinal fluid. Further investigation described the muscle-dura connection transmitting forces from neck muscles to the pain-sensitive dura.

The article then goes on to state: "While the notion that headaches may arise from cervical (neck) structures may be new to some medical practitioners, it is a concept that is widely accepted by chiropractors, osteopaths, and other professionals who regularly perform manipulative procedures involving the cervical spine. Moreover, a number of clinical trials have suggested that treatments such as massage, spinal manipulation, and biofeedback directed at the neck are valuable for managing muscle-contraction headaches. Spinal manipulation as a treatment for tension headaches is predicated upon the assumption that dysfunction in the neck muscles contributes to the head pain; in the U.S., more that 90% of such procedures are performed by chiropractors. Such treatment, as performed by a chiropractor, would decrease muscle tension and thereby reduce or eliminate pain by reducing the potential forces exerted on the dura via the muscle-dura connection."

The article is well-worth reading and sharing with everyone involved with headaches, both patients and professionals. This paper is the lead entry in a volume which contains work by such eminent physicians as Heimlich and DeBakey.

NCMIC and FCER were instrumental in providing assistance to Dr. Hack in his publication. This is another example of the potential which can result from providing support for research endeavors such as this new anatomical discovery. NCMIC and FCER will continue to work with Dr. Hack on future research projects.

By the time the next issue of Dynamic Chiropractic is published, I hope there will be some positive news on the elections of Drs. Bakke, Ferguson and Phillips. Maybe the dural connection will extend to Washington and provide some welcome relief from the headaches now experienced by Congress on how to deal with health care reform. Who knows, with three DCs in Washington, D.C., an adjusting room for legislators might be in order, as well as for adjusting legislative initiatives.

This Medical and Health Annual article should be in the hands of every neurologist, family physician and dentist as a way of expanding the potential which can result from chiropractic intervention into one of the world's most common complaints.

Louis Sportelli, DC
Palmerton, Pennsylvania

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