East Dallas Chiropractor Best Practices;

Research Commentary

Best Treatment for Headaches

A review of

Christopher E. Ramsden, Keturah R. Faurot, Daisy Zamora, Chirayath M. Suchindran, Beth A. MacIntosh, Susan Gaylord, Amit Ringel, Joseph R. Hibbeln, Ariel E. Feldstein, Trevor A. Mori, Anne Barden, Chanee Lynch, Rebecca Coble, Emilie Mas, Olafur Palsson, David A. Barrow, J. Douglas Mann, Targeted alteration of dietary n-3 and n-6 fatty acids for the treatment of chronic headaches: A randomized trial, PAIN®, Volume 154, Issue 11, 2013, Pages 2441-2451, ISSN 0304-3959, https://doi.org/10.1016/j.pain.2013.07.028

Reviewed by Dr. Justin Thompson

Best Treatment for Headaches


A Summarized Review of the Conclusion

In this randomized trial, the combination of increasing dietary n-3 fatty acids with concurrent reduction in n-6 LA (the H3-L6 intervention) produced statistically significant, clinically relevant improvements in headache hours per day, severe headache days, and headache-related quality of life compared to baseline, and compared to the n-6-lowering (L6) intervention.

Quotes from the Article

“Conventional treatment relies heavily on medications that often provide only partial or transient relief and can be associated with significant side effects and costs”

“Omega-6 (n-6) and omega-3 (n-3) fatty acids regulate multiple pain-related biochemical pathways. As major components of vascular, immune, myelin, glial, and neuronal cell membranes, n-6 and n-3 fatty acids can be converted to lipid mediators with pro- or antinociceptive properties”

“Clinical improvements in the H3-L6 group were not due to increased use of pain medications. In fact, these improvements were observed despite significant reductions in the use of vasoactive abortive, total acute, and adjunctive medications compared to baseline. Improved headache outcomes with concurrent reduction in medication use may be important given potential side effects of many headache medications”

“Targeted dietary manipulation of n-3 and n-6 fatty acids reduced pain and improved quality of life in this population with chronic headaches, and could represent a novel strategy for treating chronic pain in general.”

Introduction to the Research

Chronic daily headache (CDH), defined here as the presence of headaches lasting 4 hours or more for 15 or more days per month over at least 3 months, is a heterogeneous group of debilitating chronic pain syndromes affecting an estimated 10 million adults in the United States. Conventional treatment relies heavily on medications that often provide only partial or transient relief and can be associated with significant side effects and costs. We see patients with headaches in our clinics every single day. Not only is joint motion essential to resolve these, addressing dietary influences and intakes is so important. This study displays the benefits of Omega 3 fatty acids and how they can impact pain and headaches.

Research Methodology

This study was a randomized, single-blinded, parallel-group clinical trial to assess clinical and biochemical effects of targeted alteration in dietary n-3 and n-6 fatty acids for treatment of chronic headaches. After a 4-week pre-intervention phase, ambulatory patients with chronic daily headache undergoing usual care were randomized to 1 of 2 intensive, food-based 12-week dietary interventions: a high n-3 plus low n-6 (H3-L6) intervention, or a low n-6 (L6) intervention. Clinical outcomes included the Headache Impact Test (HIT-6, primary clinical outcome), Headache Days per month, and Headache Hours per day. Biochemical outcomes included the erythrocyte n-6 in highly unsaturated fatty acids (HUFA) score (primary biochemical outcome) and bioactive n-3 and n-6 derivatives. Fifty-six of 67 patients completed the intervention. Both groups achieved targeted intakes of n-3 and n-6 fatty acids.

Research Findings

In intention-to-treat analysis, the H3-L6 intervention produced significantly greater improvement in the HIT-6 score (−7.5 vs −2.1; P < 0.001) and the number of Headache Days per month (−8.8 vs −4.0; P = 0.02), compared to the L6 group. The H3-L6 intervention also produced significantly greater reductions in Headache Hours per day (−4.6 vs −1.2; P = 0.01) and the n-6 in HUFA score (−21.0 vs −4.0%; P < 0.001), and greater increases in antinociceptive n-3 pathway markers 18-hydroxy-eicosapentaenoic acid (+118.4 vs +61.1%; P < 0.001) and 17-hydroxy-docosahexaenoic acid (+170.2 vs +27.2; P < 0.001). A dietary intervention increasing n-3 and reducing n-6 fatty acids reduced headache pain, altered antinociceptive lipid mediators, and improved quality-of-life in this population.

Research References

As always with these reviews, these are my takeaways from the article and I encourage you to read the article in its entirety.  The references used in this article by the authors of this article are listed here.

Our Message

When you are looking for a Chiropractor near you that you can trust, choose one who will not only get rid of your back pain, neck pain, or headaches but who will also guide you to living a healthier lifestyle to keep you out of pain. Our East Dallas Doctors, located in Lakewood at the corner of Mockingbird Ln. and Abrams Rd., are here to teach you that taking care of your mental health and getting the proper nutrients are just as important as the chiropractic adjustment to stay healthy.