If you have a headache, you're not alone. Nine out of ten Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea.

What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? 

Research shows that spinal manipulation - the primary form of care provided by doctors of chiropractic - may be an effective treatment option for tension headaches and headaches that originate in the neck.

A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.

Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.

But to get to the bottom of the problem, you first need to find out what is causing your pain. Headaches have many causes, or "triggers." These may include foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.). About 5 percent of all headaches are warning signals caused by physical problems.

Ninety-five percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease. The headache itself is the primary concern.

• If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.
• Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.
• Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) - the two joints that connect your jaw to your skull - leading to TMJ irritation and a form of tension headaches.
• Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.
• In addition, the ACA and its Council on Nutrition suggest you avoid the following food "triggers":
• Avoid caffeine. Foods such as chocolate, coffee, sodas and cocoa contain high levels of the stimulant.
• Avoid foods with a high salt or sugar content. These foods may cause migraines, resulting in sensitivity to light, noise, or abrupt movements.
• Avoid drinking alcoholic beverages. These drinks can dehydrate you and cause headache pain.
• Other headache sufferers may want to avoid not only caffeine, but also high-protein foods, dairy products, red meat and salty foods.

Chiropractors may do one or more of the following if you suffer from a primary headache:

• Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.
• Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.
• Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

If your headache is symptomatic of a health problem that needs the care of another discipline, we will refer you to an appropriate specialist.

These are just a few of the bad habits that can lead to musculoskeletal problems-conditions that have an enormous impact not only your health, but also on society as a whole. In the United States alone, musculoskeletal conditions cost society an estimated $254 billion every year and one out of every seven Americans reports a musculoskeletal impairment.

Doctors of chiropractic, in particular, have long emphasized the importance of spinal health, posture and other lifestyle factors in the body's ability to function optimally. Poor spinal health, for instance, can cause a negative chain reaction throughout the body. It can cause stress on joints, which, especially if the muscles are weak, can cause wear and permanent damage. The ACA and your local doctor of chiropractic offer the following advice to help improve and maintain your musculoskeletal health.

At the Office
Make sure your chair fits correctly. There should be 2 inches between the front edge of the seat and the back of your legs. Sit with your feet flat on the floor, with your knees at a 90-degree angle. If you can't sit that way, use an angled or elevated footrest.

Take periodic stretch breaks. Clench your hands in a fist and move your hands like this: 10 circles in, then 10 circles out. Put your hands in a praying position and squeeze together for 10 seconds and then "pray" with the backs of your hands together, fingers pointed downward for 10 seconds. Spread your fingers apart and then bring them together one by one.

Hold the telephone with your hand or use the speakerphone. Don't cradle the phone between your ear and shoulder. This can lock up the spinal joints in the neck and upper back, and eventually cause pain.

Take breaks and alternate tasks that use different muscle groups.

Arrange your desk so that everything is handy - phone, mouse, reference materials, reports - to minimize awkward stretching and reaching.

Position your computer monitor so that the middle of your chin is aligned with the middle of your monitor. This will allow for good neck posture.

At Home
When you wash the dishes, open the cabinet beneath the sink, bend one knee, and put your foot on the shelf under the sink. Lean against the counter so some of your weight is supported in front.

When resting or watching TV, don't use the sofa arm as a pillow. The angle is much too sharp for the neck.

Don't bend from the waist when you lift a child. Squat with your back straight. Keep the child close to you and use your legs and arms to lift.

In the Yard
If you shovel snow, push the snow straight ahead. Don't try to throw it and walk it to the snowbank. Avoid twisting and turning motions. Bend your knees to lift when shoveling. Let your legs and arms do the work, not your back. Take frequent rest breaks to take the strain off your muscles. Try to stand as erect as possible.

When raking leaves, use a scissors stance: right foot forward and left foot back for a few minutes; then reverse, putting your left foot forward and your right foot back. Bend at the knees, not the waist, as you pick up leaves. Make piles small to decrease the possibility of back strain.

For mowing, use your weight to push the mower. Whenever possible, use ergonomically correct tools for the job.

Playing Sports
Warm up slowly before a game. Do calisthenics, flexibility exercises, or light running to increase your heart rate.

When sweat beads form, your body is at the proper temperature to stretch the tendons and muscles.

While Traveling
When driving, adjust your car seat so you can sit firmly against the seat back without having to lean forward or stretch. Buckle your seatbelt and shoulder harness, and adjust the headrest so that it supports the center of the back of the head.

Invest in a wheeled suitcase that has a sturdy handle.

Don't always carry the weight on one side - take frequent breaks and transfer the weight to the other side.

Don't try to carry too much. Even wheeled suitcases can cause problems to the neck, shoulders and lower back when pulled from behind.

When traveling by air, check all bags heavier than 10 percent of your body weight. Overhead lifting of any significant amount of weight should be avoided to reduce the risk of pain in the lower back or neck. While lifting your bags, stand directly in front of the overhead compartment so the spine is not rotated. Do not lift your bags over your head, or turn or twist your head and neck in the process.

While seated in an airplane, vary your position occasionally to improve circulation and avoid leg cramps. Massage legs and calves. Bring your legs in, and move your knees up and down. Prop your legs up on a book or a bag under your seat.

For Children
Have a smaller table for them where they can do their homework, rather than force them to use a standard table and chair. If the child's feet don't touch the floor, place a footrest or box under the feet. Position the computer monitor so the top of the screen is at or below the child's eye level.

Make sure the straps of your child's backpack are padded and worn over both shoulders, not just one. Also, the contents of the backpack should not weigh more than 10 percent of your child's body weight.

If your child is involved in sports, make sure all equipment, including helmets, pads and shoes, fits your child properly. If your teenage child is involved in soccer, make sure they are taught how to "head" the ball properly. A young child should not use the heading technique at all, according to ACA experts.

Make sure your child has enough calcium included in his or her diet. ACA recommends 1 percent or skim milk for children over 2 years old, and whole milk for those younger than 2. The calcium in milk is essential for healthy bones and reduces the risk of joint and muscle-related injuries.

Make sure your child avoids sugar-loaded, caffeinated and carbonated drinks. Rather, encourage them to drink plenty of water. Caffeine can dehydrate your youngster, and the high levels of phosphorous in sodas and other carbonated beverages can interfere with calcium absorption - a problem that could lead to osteoporosis down the road.

While the ACA encourages you to follow these tips for better musculoskeletal health, remember that good spinal health is but one component in a healthy lifestyle. Exercising, getting a good night's sleep, drinking plenty of water and eating a nutritious diet contribute not only to health but also to the ability to heal after an injury.

We all know that Vitamin D is a critically important component in building strong bones and strong teeth. It turns out that Vitamin D has a vast number of additional functions.

For example, recent research shows that low Vitamin D levels is related to increased risk for diabetes as well as cardiovascular disease.1 Insufficient Vitamin D during pregnancy can lead to gestational diabetes as well as pre-eclampsia2 (pregnancy-induced hypertension), which may be life-threatening. Links between low Vitamin D levels and development of cancer have been studied for many years.3

Vitamin D insufficiency has been associated with mild depression, Alzheimer's disease, and stroke, as well as with peripheral neuropathy, lupus, and fibromyalgia. It seems that Vitamin D has a huge impact on almost every aspect of our physical health. It makes sense for everyone to ensure they are getting enough Vitamin D on a daily basis.

How to get enough Vitamin D? The best source of this powerful vitamin is sunlight. The sun's rays stimulate skin cells to produce the activated form of Vitamin D, cholecalciferol (Vitamin D3). Activated Vitamin D helps regulate levels of calcium and phosphate in the blood stream, helps maintain normal bone mineralization, and helps regulate nerve function, the immune response, and genes responsible for cell growth, differentation, and cell death. These genetic regulatory functions are associated with Vitamin D's role in cancer prevention.

Back in the day, people were outdoors much more than they are in the 21st century. There were no text messages, no multiplayer games, no social networking sites (people actually "networked" by meeting each other in physical space), and definitely no computers that occupied less than entire room's worth of square feet.

Our modern lifestyle causes us to stay indoors, far away from the healthful rays of the sun. Oh wait - the sun's rays aren't that healthful anymore because of pollution and radical degradation of the ozone layer by excessive accumulations of free radicals in the atmosphere. The resulting increased exposure to ultraviolet-B radiation from the sun can cause skin cancer in those who are susceptible and do not protect themselves with sunscreens.

To balance the daily requirement for Vitamin D with the opposing need to avoid undue exposure, most studies recommend getting 15 to 30 minutes of unprotected sunlight several times per week (two to four such expeditions each week are sufficient). Importantly, studies demonstrate that three out of four Americans have Vitamin D deficiency. Vitamin D deficiency affects more than one billion people worldwide.

Vitamin D supplementation may also be recommended, particularly for those who live in sun-deprived climates and for most people in winter. Two thousand IU of Vitamin D3 is typical daily dose.

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References

1Swales HH, Wang TJ: Vitamin D and cardiovascular disease risk: emerging evidence. Curr Opin Cardiol July 7, 2010 (Epub ahead of print)

2Lapillonne A: Vitamin D deficiency during pregnancy may impair maternal and fetal outcomes. Med Hypotheses 74(1):71-75, 2010

3Edlich R, et al: Scientific documentation of the relationship of vitamin D deficiency and the development of cancer. J Environ Pathol Toxicol Oncol 28(2):133-141, 2009