August 2023 – Dr. John Filo

A common misdiagnosis I’m seeing more in practice – particularly in teenagers – is the confusion between a Tension headache and a Migraine. In my opinion, the “Migraine” word gets thrown around way too loosely these days and has become ubiquitous with a pounding headache in the back of the neck, temples or over the eyes. 

In reality, migraines are very rare and are usually associated with a chronic neurological condition and hormonal imbalance. Often times, migraines are accompanied with vision disturbances, dizziness or nausea. True migraines appear once every few months, usually come with an aura type sensation before it starts, and are often triggered by environmental factors or stress. Common triggers being coffee, alcohol and sugary foods – which impact the neurological system.

If you’re child or teenager is experiencing repeated headaches, either once a week or more, its highly likely he/she is experiencing a tension headache. 

Tension headaches, unlike migraines, stem from a muscle and joint condition typically triggered by postural stress in the neck and mid back region. This is becoming much more prevalent in young teens and adolescents for ONE obvious reason; increased usage time on devices accompanied by flexion of the neck and rounding of the shoulders. Too much static posture is also a major factor.

Rebecca’s case:

Last month, I had a mom bring her 16 year old daughter Rebecca to the clinic complaining of chronic weekly headaches that she’s been suffering from since she was 14.  Yes, a 16 year old with 2 years of weekly headaches, countless visits to doctors and specialists who’ve run her through a gamut of tests like CT’s, X-rays, bloodwork – all perfectly clear – only to label her with a Migraine diagnosis.   

When I examined her, it was clear her neck and mid back were the trigger.  Joint mobility was severely limited and a misalignment of the atlas (C1 vertebrae) was causing the muscles of her spine to spasm setting off repeated headaches at the base of the head and over the temples.

It took the better part of 3 visits (one week) of chiropractic care and she’s been headache free for over 3 weeks.  The first time she’s felt normalcy in 2 years not to mention the amount of Tylenol she’s had to take for relief over that last 2 years! Rebecca’s case inspired me to write this newsletter, thinking about how many more teens like her are out there suffering needlessly.  Its not just the physical pain but the mental health impact this has on a child and the parents thinking their child has a serious neurological condition and the energy spent visiting doctor after doctor. 

As for real migraine headaches caused by a hormone imbalance – estrogen and progesterone being the primary candidates – or a neurological condition, Acupuncture has been shown to provide the greatest therapeutic benefit. Using the body’s own neuro based meridian channels as access points to stabilize and tune the autonomic nervous system into a balanced state. A natural and holistic self tuning process. 

In more complex cases, when childhood head trauma due to falls or accidents are a play, then cranial alignment is neccessary.  These conditions also lead to severe headaches but also accompanied with mouth breathing, TMJ dysfunction, facial pain and cognitive issues such as brain fog and poor concentration. This requires cranial work with an endonasal balloon technique to realease internal adhesions and restore mobility to the cranial and facial plates. More about this in the next blog. 

Whether its a tension headache, migraine or post concussion syndrome, our job is to correctly diagnose each case thoroughly and provide the appropriate treatment best suited for correcting the cause.

Let’s all work to keep advocating the importance of spinal awareness in our youth and make an effort to get your kids checked once or twice a year at the very least as a preventative measure to maintain a healthy and vibrant spine!

To your health,
Dr. John Filo
Dr. John Filo has been offering family and pediatric chiropractic care to families for over 20 years in Toronto, Ontario.  Trained in various chiropractic techniques including diversified, gonstead, cranial-sacral and endonasal balloon technique for the treatment of head trauma and concussions. Learn more about this procedure at