How do I get rid of my headaches?

How do I get rid of my headaches?

Headaches are not fun.  Migraines are even less so.  Unfortunately, most of us experience one or the other, or even both.  In fact, 47% of you reading this article will have at least one headache this year.  While talking with my sister in law the other day, she pointed out that some people do not consider headaches and migraines to be treatable or preventable.  I’m here to tell you that they can and I am living breathing headache-busting proof.

Let’s take one step back.  I used to experience quite intense and sometimes debilitating headaches that felt like an ice pick was being driven into the back of my skull, straight into my eyeball.  Not fun and definitely not conducive to work.  Even as a doctor, it took me close to a decade to a get rid of mine.  So what took me so long to “cure” my headaches, considering the multitudes of treatments I have tried in the past? Well, the fact is all the care I received did help, but only temporarily, until I found the key to my long-term success, which is to say I finally identified and corrected the underlying causes of my headaches.

My goal is to guide you past your symptom, the headache, and start understanding potential physical causes of the problem, step by step.  This is how I help my headache patients and this how I helped UCSF’s migraine patients.  Ready? Let’s begin.

First Step: Identify the Trigger

Studies show that there are many different causes for the symptom called a headache: nutritional, psychological, neurological, and/or musculoskeletal.   We will be focusing on the latter two.

To begin, first ask yourself: What brings them on?

Here are a few examples of headache types and what differentiates them from other headaches:

Answer: “I did not drink enough water yesterday, today, or in general.”
Cause: Dehydration

Please drink 64-80 oz water per day.  You are 70% water, so your body will give you all sorts of grief if you do not replenish its main component.  Remember 64 oz is the MINIMUM you need to maintain basic hydration.

Answer: “It hurts when I turn my head quickly from side to side”
Cause: Sinus

You may have a problem in your sinuses, not a neuromusculoskeletal issue.  Being able to differentiate between a neuromusculoskeletal and a non-NMS issue is important.  For sinus issues, I like to start with a saline wash concept, such as a neti-pod, but you should have to consult an allergist or EENT for more major issues: unresponsive infection, deviated septum, or chronic reoccurrence.

Answer: “When I am stressed.”
Cause: Nerve Hypersensitivity

Your body is programmable and learns new habits constantly.  Your nerves “learn” through a process called neuroplasticity or the programming of new neural pathways.  Current research suggests that if you have chronically tight soft tissue in your shoulders, neck, or scalp this can both cause headaches and program a headache pathway into your neurophysiology.  So even if you find and address the soft tissue cause, stress and tension can still trigger the hypersensitive nerves.  Once triggered, the programmed pathway will create the perception of a headache without major soft tissue involvement.

Stress headaches of a musculoskeletal and neurological type will require a two-step process to correct.

    • Identify and work with the injured musculoskeletal structure – I.E. Basic chiropractic, massage, or manual therapy
    • Work with a technique that can re-train your neurological responses – I.E. Neurological reeducation such as Chiropractic Biophysics or Chiropractic Neurology
Answer: “When I’m working at the computer.” [Or similar prolonged downward focused activities.]
Cause: Repetitive Stress Syndrome due to Poor Posture

Poor posture is one of those simple, yet complex concepts.  Think repetitive stress syndrome for your entire neck and upper back.

When sitting at a computer or working a desk job, most people’s heads jut out in front of their shoulders and/or they tilt their heads downwards for hours at a time.   Now imagine your head is like a bowling ball on a large spring, your neck.  If the ball is directly over the top of the spring, the structure retains its shape and balances the ball.  Alternatively, if the bowling ball is pushed forward, the spring collapses forward.  Picture the spring collapsed for the equivalent time you spend on a computer or looking down at your Iphone/pad/android each day and think about the shape of the spring once you try to bring the ball back to a vertical balance.  It will no longer remain a nice unbent spring and neither will your neck if your posture is poor.

Having poor posture is a very easy way to repetitively damage your musculoskeletal system and train your nervous system into hypersensitivity.

    • Proper ergonomics will help to slow this process
    • Postural correction through exercise, stretching, neuromuscular reeducations, and lifestyle modifications will aid non-traumatic postural imbalance
    • Structural correction may be necessary if there is a history of significant neck trauma, such as a car accident

Next time you have a headache, make a mental note or log of what you were doing at the onset.  You may find that your triggers are one or more of the aforementioned examples.

Next Step: Where do you feel your headaches?

You may ask yourself, “Ok, I know when I get them, but how do I know if my headaches are from my muscle(s), my joints, my posture, or nerves?”

Here’s the breakdown of headaches that once identified, can be treated through a hands on approach:

Pain from the shoulders to the skull:

Hypertonic muscles or “knots” can refer pain along the length of the muscle, at their attachment point, and/or insertion points.  This phenomenon is called a trigger point.  While this condition can occur in many parts of the body, trigger points in the shoulders and neck will refer specific and re-creatable pain patterns up the neck to the skull and mimic headaches.  A skilled body worker will be able to help out you here.  You describe where you feel it and they may be able to literally put their finger on the offending muscle and have you say, “That’s my headache!”

General area or diffuse achy pain on the base, back or sides of your  skull: 

Joint inflammation, also known as arthritis, can cause the perception of pain in areas removed from the joint dysfunction and is termed sclerotogenous pain referral.  In relation to headaches, joints in the mid to upper neck can refer “achy” pain into the base and along sides of the skull.  This is easily diagnosed through your description and neck compression testing.   See the Pain Referral Patterns chart to see if your headaches match up with what our scientist found when studying joint inflammation.

Temples, forehead, and around the eyes:

Headaches here may be due to nerve irritation, more specifically your trigeminal nerve.  The trigeminal nerve controls the skin sensation over your eye, forehead, cheekbones, and jaw.  The proposed mechanism behind these headaches is that nerves become irritated due to mechanical tension.

In other words, the nerves, which are supposed to be protected by the structures of your neck, instead have direct pressure applied to them due to muscular imbalance, joint dysfunction, and/or postural deviation.  Once inflamed, these nerves refer a pain signal or “headache” to the areas they control – the temples, forehead, and around the eyes.   The main muscles that are supposed to protect the trigeminal nerves are the suboccipital musculature.  One of the proposed mechanisms for trigeminal nerve headaches are the dysfunction of these suboccipital muscles.

If your headaches present in the trigeminal controlled area, here is a simple way to test the suboccipital muscles involvement.  In the video, Scott Schwartz, co-owner of San Francisco’s Psoas Bodywork and Massage, shows us an active isolated stretch of the suboccipital muscles.  If your headache reduces through the use of this stretch, there is a very good chance that you have just identified the area contributing your headaches.

Side Note: Chronic TMJ and jaw issues may also create headaches in this area, history of trauma to the neck versus trauma to the jaw will help to differentiate the potential reason.

Any and all of the pain areas listed above: 

 The underlying cause here may be poor posture. Remember postural imbalances damage entire regions of your body, which means that if left unchecked these bodily distortion will lead to muscle trigger points, joints related pain referral, and injury to the nerves.  The end result is multiple types of headaches from multiple sources in your neck.

This is why poor posture tends to muddle the ability a physician’s ability to diagnose the “main problem”.  A misdiagnosis or incomplete diagnosis can reduce both lasting relief from needed treatments and falsely discourage the headache sufferer from seeking treatment.

I believe this is why the notion that a headache of the neuromusculoskeletal source can be treated conservatively is not universally understood.

The Final Step:  A Multidisciplinary Approach

Now, you are armed with a basic understanding of when your headaches are triggered and what underlying structures maybe effected.

So what is the right combination of treatments for you?

The headaches mentioned in this article may respond favorably to one or more of the following:

    • Massage Therapy
    • Chiropractic
    • Acupuncture
    • Exercise
    • Ergonomic Assessment
    • Postural Correction
    • Structural Correction

Often, the solution requires a multidisciplinary approach to truly correct the underlying issues.  For me, I was able to cure my headaches through a combination of chiropractic to reduce arthritis, muscle work to break up the scar tissue in my neck, structural correction in my neck, exercise to retrain the neurology, and postural correction to prevent the process from repeating itself.   For some of my patients, it is as simple as few good adjustments and focused muscle work.   The difference is my issue stemmed from a neck trauma over 15 years ago and therefore needed a comprehensive approach.

If you work with me, you quickly realize that no two people are alike.  Your body is the sum of your experiences good or bad. Each of us has a different history, different job, and different obstacles in life.  That’s why I challenge you to put thought and careful consideration into the when, where, and what quality of your headaches and then bring this information to the appropriate health care provider.  If they are the right person for the job, they will ask you the very same questions.  You want a headache detective.

Start with conservative care, keep a log of what treatment relieved your headaches, and be patient.  The body can only repair itself so fast.  Typically, the right combination of treatments will begin to yield results in 2-3 weeks with more solid improvement in 6-8 weeks.

That means, with the right care, in 2-8 weeks you can feel better, function better, and live with a higher quality of life.

So I will leave you with one last question: What are headaches stopping you from doing?


For more information, you can contact me directly at or setup a consultation by calling 415-373-3897.

This article was written by Dr. Scott Levin.  A chiropractic physician and clinical director at PostureWorks – A health center for chiropractic postural and structural correction in San Francisco.

Link Between Vitamin D3 and Immune Function

Research Shows the Link Between Vitamin D3 and Immune Function

Why do we get sick more often during the winter months?

Research indicates that the increase in incidence of cold and flu during winter months is more likely due to drops in serum levels of vitamin D3 (a hormone which is extremely influential in immune function) rather than in drops in temperature. In fact, temperature change has little to no measureable effect on the immune function. The human body synthesizes vitamin D3 when our torso is exposed to sunlight. During winter months, the earth is shifted further from the sun causing a reduction of Vitamin D3 levels and a subsequent drop in immune function.

Studies have shown:

  • Vitamin D levels reduce by approximately 50% during winter months
  • Vitamin D deficiencies are linked to:
    • o Increased incidence of the cold and flu
    • o Autoimmune diseases
    • o Cancer
    • o Cardiovascular disease
    • o Osteoporosis
    • o Loss of cognitive function
    • o Multiple Sclerosis
    • o A 39% increase in annual health care costs:
  • Vitamin D supplementation has already been proven to
    • o Reduce incidence of cold and flu by as much as 66%
    • o Up-regulate immune function through increase white blood cell production capability
  • Studies are currently underway to determine Vitamin D supplementation effect on dozens of other disease processes

Research indicates that vitamin D3 supplementation is most beneficial at 4000 – 6000 iu’s per day in adults and 1200 – 2000 iu’s per day in children.

At PostureWorks and NutraWorks, we only recommend and offer supplements of the highest quality. For Vitamin D3, we believe that the supplement with the most value is Nutri-West’s prescription grade Complete Hi D3 (5000 iu’s per tablet).  At only $16 for a 2 months supply this is likely one of the most valuable supplements one can take!

Inactivity and Shorter Life Expectancy

Diagnosis: Sitting Disease Studies Show Correlation between Inactivity and Shorter Life Expectancy

Our bodies may be paying the ultimate price for the comfort and convenience of our relatively sedentary lifestyles. Sure it feels good now, to get through an average day with minimal physical strain but, according to an article in USA Today quoting a recent study in the British Medical Journal (BMJ), the current amount of sitting that the majority of the U.S. population engages in could be hindering the nation’s overall life expectancy. Though the correlation between inactivity and poor health has long been recognized, new research suggests the possible prevention of chronic diseases like breast cancer, colon cancer, heart disease and diabetes simply by getting up and moving more. This doesn’t mean that an active person has no risk but, the study suggests that their risk for developing such conditions could be up to 30 percent less than those with sedentary lifestyles.

In addition to diseases like cancer and diabetes, the accumulation of unhealthy practices over an extended period of time such as prolonged sitting also causes structural distortions in the body which can lead to a vast number of health conditions including high blood pressure, thyroid imbalances, chronic fatigue, headaches, dizziness, bladder problems, and asthma. PostureWorks, a premier spinal health and wellness center located in downtown San Francisco is dedicated to the prevention and correction of these debilitating conditions through our specially tailored corrective care techniques and top-of-the-line equipment and technology. Our highly trained doctors and staff not only treat your conditions, but teach you how to maintain your results and optimize your health for the rest of your life! Our goal is provide all of our patients with the tools and the knowledge to positively influence their future state of health.

To learn more about the resources that PostureWorks can provide for you, visit our website or call us directly at (415) 373-3897.

To learn more about the associations between activity level and overall health, visit the following links:

Out with the Old and In with the NutraWorks and PostureWorks – San Francisco’s Top Wellness Facility Welcomes New-Age Technology.

Our goal at NutraWorks and PostureWorks is to provide the highest quality service to truly optimize the health and vitality of our patients and in order to do so, we invest in nothing but the BEST. The doctors, coaches and staff of San Francisco’s top health and wellness centers are proud to introduce the latest and most advanced technology to support and regenerate our patients’ strength, flexibility and bone mass!

Power Plate Technology

Power Plate technology was originally created by the Russian space program in the 1960s to aid cosmonauts in re-building muscle mass and bone density depleted from extended time spent in space. It incorporates whole-body vibrations that induce rapid involuntary muscle contractions at a rate of thousands per second! Also known as “acceleration technology” for its ability to increase muscle strength and bone density at an accelerated rate, Power Plate technology has been implemented as a training and rehabilitation tool for Olympic athletes mainly for its un-matched efficiency and safety.  Countless medical studies have shown a number of health benefits that acceleration technology can produce including:

  • Time & workout efficiency:15 minutes on the Power Plate = 60 minutes of gym training
  • Increased strength and flexibility up to 10 times faster than traditional training methods
  • Increased human growth hormone by as much as 350%
  • Reduced pain in muscle, joints and tendons
  • Reduced cellulite by 25%, cortisol by up to 150%
  • Improved balance and coordination
  • Overall less risk and more benefit!

At NutraWorks and PostureWorks, we believe that every person deserves the same quality of care and available resources as the pros therefore, we’re bringing this new-age technology, once only available to elite and professional athletes, to you! For more information about the services we can provide to optimize your health, visit our web sites at and or call us at (415) 373-3897.

San Francisco’s PostureWorks at the US Open

The United States Golf Association 2012 U.S. Open swings back into the bay area June 11th to 17th at San Francisco’s Olympic Club hosting some of the world’s finest professional golfers and some 245,000 spectators. Dr. Scott Levin, co-founder and clinical director of San Francisco’s state-of-the-art spinal rehabilitation and wellness center, PostureWorks, is one of the few health care providers selected to be a part of the PGA’s “Wellness Team” created specifically to work on the golfers and caddies. A Titleist Performance Institute (TPI) certified health care provider, Dr. Levin will work side by side with the doctors and physical therapists of the Oakland Raiders, Oakland A’s, San Francisco 49ers and Sacramento Kings to provide optimal care and induce top performance for all those on the green.

Beyond the world of professional athletes, Dr. Levin believes that every person deserves the highest quality treatment. At PostureWorks, we are constantly pushing the forefront of true health care by bringing the latest and most advanced health technology off the green and into your daily life!

In honor of our love for golf PostureWorks presents you with this limited-time offer: During the month of June, Dr. Levin is offering a FREE HEALTH CONSULTATION. Availability is limited so call soon! Just mention “US Open” when calling to schedule your appointment. For more information, visit our web site at

Call us: (415) 373-3897 today!

Common Pain Disorders Cost Big Money

Research shows that one of the largest contributors towards corporate medical expenditure and lost productivity time (LPT) is common pain disorders.

According to the American Medical Association1, the American Productivity Audit shows:

  • Within a two-week period, 13% of the workforce experience LPT due to common pain conditions.
  • The average LPT due to musculoskeletal pain is 4.6 hours per week per employee:
    • Back pain 5.28
    • Headache 3.51
    • Arthritis 5.19
    • Other MS issue 5.70
  • Costs American employers an estimated $61.2 billion dollars per year.

Further research published by the European Journal of Pain demonstrates the links between chronic pain, reduced worker effectiveness, and the hidden costs faced by employers.

  • The average pain sufferer lost the equivalent of 30 workdays per year due absence and lost productivity time.
  • A worker with chronic pain earning $36,000 per year will cost their company $3,700 annually.
  • As the salary paid to a pain sufferer increases, there is a significant increase in cost of their LPT.

Finally, studies agree that the use of a chiropractor as a primary care provider, vs a medical doctor, is more cost effective. When instituting this practice, AMI Insurance Company’s costs ranged from 57.1% to 88.1% below their predicted budgets for four consecutive years.

Bad Posture Saps Your Energy

Nobel prize winner, Roger Sperry, taught us that:

” The more mechanically distorted a person’s body is, the less energy is available for thinking, metabolism and healing.”

Most people do not realize that inside of them, over 640 named muscles act in harmony with thousands of tendons and ligaments to create a vast system of levers and pulleys.

This system moves the 206 bones of the adult human skeleton creating our movement, known as locomotion. This intricate network makes your body one of the most complex machines known to mankind.

Just as any complex machine benefits from regular maintenance, so does the human body.

By restoring proper balance and function to the musculoskeletal system, our care may have a number of effects beyond the resolution of pain and discomfort. Current areas of research into additional benefits of chiropractic care include:

  • Asthma
  • Allergies
  • Anxiety and Stress
  • Hypertension
  • Irritable Bowel Syndrome