Headache is growing concern in the military, with recent research suggesting that more soldiers are suffering from chronic head pain as result of their service. In one study of 3,621 military personnel who were evaluated within three months of returning from Iraq, soldiers were four times more likely to have migraine than the general population.

This increased prevalence of headache in the military is one major consequence of rising concussion rates in soldiers. Compared to previous military conflicts, soldiers in the Iraq and Afghanistan wars are much more likely to be exposed to improvised explosive devices, putting them at an elevated risk of concussion. Indeed at least 20% of deployed US service members have suffered from a concussion caused by an explosive blast, and many of these soldiers will develop post-traumatic headache.

A recent study from Johns Hopkins School of Medicine adds to our understanding of headache in the military. Researchers analyzed the medical records of 985 military personnel who were medically evacuated from Iraq between 2004 and 2009. The researchers were curious to examine both the prevalence of headache types, and how likely a solider was to return to combat after being evacuated.

Post-concussive headaches and migraines were the most common types of head pain experienced by military personnel, affecting 34.1% and 30% of soldiers respectively.

Only 33.6% of soldiers returned to duty after being evacuated for headache. People with tension-type headache were the most likely to return to duty while soldiers with traumatic headache were the least likely. Traumatic headaches like post-concussive, occipital neuralgia, and cervicogenic headache were associated with the worst outcomes after evacuations. Other factors that predicted negative outcomes were traumatic brain injuries, migraine with aura, use of opioid drugs and beta-blockers, and co-existing psychopathology.

The fact that the majority of soldiers did not return to duty demonstrates the need for effective treatments for combat-related headache. Research shows that chiropractic care can relieve back and neck pain in soldiers, and studies suggest it can also be beneficial for headache.  In a 2010 study, people with cervicogenic headache who received chiropractic treatments reported a 50% reduction in headache symptoms. And in another study, chiropractic care reduced the frequency of migraine attacks by 90%. These findings suggest that chiropractic can could offer an effective solution for soldiers suffering from headache after war.

References

1. National Headache Foundation: War Veterans Health Resource Initiative. http://www.headaches.org/warveterans/index.html. Accessed May 1, 2013.
2. Cohen SP, et al. Headaches during war: analysis of presentation, treatment, and factors associated with outcome. Cephalalgia 2012; 32(2):94-108. doi: 10.1177/0333102411422382.
3. Haas M, Spegman A, Peterson D, Aickin M, Vavrek D. Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial. The Spine Journal 2010; 10: 117-128.
4. Tuchin P, Pollard H, Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of Manipulative and Physiological Therapeutics 2000; 23 (2)
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5. Theeler BJ. Posttraumatic headache in military personnel and veterans of the Iraq and Afghanistan conflicts. Current Treatment Options in Neurology 2012; (1):36-49. doi: 10.1007/s11940-011-0157-2.