Where’s My Headache Coming From?

Ryan LaCorte Craig Michaels, Publications

Although there are many culprits of headaches, did you know that one specific kind can be treated with Physical Therapy? There are many factors that can contribute to that nagging pain; such as stress and tension, allergies, posture, medication and even migraines. Although chronic headaches often tend to have more than one causative factor, this article will specifically look at the link between the musculoskeletal system and headaches. Many patients walk into All-Care Physical Therapy with complaints of occasional headaches, and the reason for this could be their posture.

How are headaches caused by the Musculoskeletal system?

Research has found that irritated or inflamed nerves or muscles in the neck can refer pain over the scalp, and into the face and forehead, causing headaches. Common neck problems that can cause or contribute to these irritated nerves/muscles are trauma, whiplash, or normal wear and tear such as arthritis. Whiplash is often present in Motor Vehicle Accidents when the head and neck “whips” backward and forward quickly, commonly experienced in rear-ended collisions. The muscles and ligaments in the front and the back of the neck are strained. Secondly, trauma, such as a fall or sporting accident can result in ligaments or bones being affected. Lastly, and most commonly, normal wear and tear of the vertebrae in the neck due to the ageing process can lead to a progressive degeneration of the cervical spine (neck), which can in turn affect the muscles. This is often exacerbated by forward head posture, in which the head crosses too far forward from the midline. This often puts strain and tightens certain muscles of the neck, leading to what is known as a postural related headache.

What are postural related headaches?

The skeleton and muscles of the neck and upper back must work together to allow movement. If there is a disconnect between this movement, such as forward head posture, a problem can occur. This can contribute to headaches. For example, a tension headache is almost always caused by excessive muscle tension in the neck, face, shoulders and upper back. Our muscles are made up of muscle fibers that are bundled closely together. When the muscle fibers contract together, a muscle is shortened. When we are under stress, we commonly tense and shorten the muscles of the shoulders, upper back, face, and neck which can lead to a tension headache. This can be further exacerbated by the buildup of chemicals that flood the area in response to irritation, causing what is known as a “trigger point.” These trigger points can refer pain along nerves of a nearby area, or into the head. These types of headaches tend to improve once the underlying problem is addressed.

Why does our posture change?

There are several culprits that can lead to changes in our posture over time. We typically spend a majority of our day slouching forward, spending too much time sitting down, or even looking down at our phones or computers. Over time, this can alter our posture and put added strain on the neck. This can specifically lead to tightness of the suboccipital muscles, which sit at the base of your skull. When these muscles tighten, pain can be referred deep in the head from the occiput (skull) to the eyes.

How can we help the headaches?

By the time headaches are being experienced by the patient, there are already significant postural changes that are causing inflammation and spasms in the neck musculature. Your therapist will perform a detailed Initial Examination to ensure your headaches are coming from a musculoskeletal origin. This includes extensive postural analysis, range of motion and flexibility. In addition, the therapist will feel around the numerous neck muscles and locate spasms or inflammation. This will allow for your therapist to pinpoint the specific cause related to your headache. Once this is performed, it is important to calm down this inflammation and relax the muscles using a variety of modalities we offer at All-Care Physical Therapy. This includes moist heat, ice, electric-stimulation, Ultrasound, or Phonphoresis (Ultrasound with hydrocortisone cream). Your therapist will determine the most appropriate modality for your symptoms. In addition, your therapist will “release” muscles in your neck that have become inflamed or in spasm over time. This can be performed through a treatment known as a suboccipital release, in which the muscles at the base of the skull are released to offer headache reduction. Another treatment is known as trigger point release, to soften and align spasms in muscles of the neck. Your therapist will also guide you in exercises to correct postural changes that have occurred over time. You can often notice a reduction of symptoms within 1 visit, however changes in posture and muscular control can take several weeks. Therefore, it is important to follow the specific exercises your therapist has created for you.

At All-Care Physical Therapy, we have the knowledgeable staff and tools to reduce musculoskeletal headaches and improve your quality of life. We will develop treatment programs for your individual symptoms and help to prevent the repeat of those nagging headaches in the future.

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