Dr. Adam W. Roussel: New Study shows how Chiropractic can Help with Tension Headaches

Forward Head Posture, Cervicogenic Headache, and Anatomical Connection Found Between the Rectus Capitis Posterior Major and the Dura Mater

by Dr. Stephanie Maj

A new study, just published in Spine Journal, reports on an investigation of the muscles of the suboccipital triangle and their relationship to cervicogenic headaches (headaches that are caused by subluxations in the neck.)

This got me thinking of a problem I see in over 75% of patients that come to my office: Forward head posture. This position (see picture) puts the neck in an extended position which puts pressure on the nerves that go to the muscles in the back of neck, right under the skull (the rectus capitus muscle group).

This study reports that those muscles connect to the dura mater. The dura mater is the outermost, toughest, and most fibrous of the three membranes, or meninges, covering the brain and spinal cord.

During the anatomic study of thirteen cadaver specimens, it was discovered that eleven of the 13 specimens had a connection between the rectus capitis posterior major muscle (at C2) and the spinal dura mater. [1] A previous report by Hack (Spine 1995) [2] discussed a connection found between the rectus capitis posterior minor and the dura mater and its relationship to cervicogenic headache.

What is most interesting in this new study is that manual traction of the rectus capitis posterior major resulted in gross movement of the dural sheath from the spinal root level at C2, all the way down to the T1 nerve root. Hack previously suggested that:

“It has been speculated that the function of the muscle dural bridge may be to prevent folding of the dura mater during hyperextension of the neck. Also, clinical evidence suggests that the muscle dural bridge may play an important role the pathogenesis of the cervicogenic headaches.”

The authors of the current study concluded that “various clinical manifestations may be linked to this anatomical relationship.” This is where Chiropractic comes in and the stress put on these upper neck structures from forward head posture becomes an important thing to evaluate.

According to Kapandji (Physiology of the Joints, Volume III), for every inch your head moves forwards, it gains 10 pounds in weight, as far as the muscles in your upper back and neck are concerned. That’s because because they have to work that much harder to keep the head (chin) from crashing onto your chest. This abnormal positioning also forces the suboccipital muscles (the ones that raise the chin) to remain in constant contraction, putting pressure on the 3 suboccipital nerves.

This nerve compression may cause headaches at the base of the skull. Pressure on the suboccipital nerves can also mimic sinus (frontal) headaches. It is these nerves and muscles that have the relationship with the dura mater and therefore the brain and headaches.

If you are suffering from headaches of any kind, take a look at how far your head is in front of your shoulders (they should line up ear over top of shoulder.) Chiropractic has great success correcting this postural abnormality and when corrected, can lead to less pressure on upper neck and significant reduction of headaches.

REFERENCES:

1. Anatomical Connection Between the Rectus Capitis Posterior Major and the Dura Mater
Spine (Phila Pa 1976). 2011 (Jan 27)
2. Anatomic Relation Between the Rectus Capitis Posterior Minor Muscle and the Dura Mater

Spine 1995 (Dec); 20 (23): 2484-2486

Dr. Stephanie Maj has a thriving family practice in the heart of Chicago. Her clinic is located at 1442 W. Belmont Ave., 1E, Chicago, IL 60657. 773.528.8485. www.communitychiropractic.net