There are many different classifications and subgroups of headaches. Migraines, Tension-Type Headaches (TTH), Medication-Overuse Headaches, Cluster Headaches, Cervicogenic Headaches, and Chronic Daily Headaches are only a few types among dozens. Each classification has a specific diagnostic criteria based on a variety of factors.
Headaches are a major condition across the globe that affect productivity and mood. They are one of the top reasons for disability and are a massive financial burden. The problem is so bad that 47% of people have recurrent headaches! Can you believe that? Over 10% of the population at any given time suffers from a migraine and 40% suffers from a TTH, which is the most common type.
Migraines are considered more severe because they may come with “auras” or visual disturbances like flashing images and blind spots. This is the type of headache, most common for female adults, where you might need to wear a pair of shades indoors. Interestingly, migraines are least common in the Far East of the globe.
Why does this happen?
When it is a life-threatening situation, it is important to get immediate medical attention. If someone experiences drop attacks (falling unconscious all of a sudden), dizziness/lightheadedness when they move their neck (often confused with headache), difficulty with speech, and double vision, then they are likely to be experiencing issues with their blood supply to the brain. Headaches can also be a sign of instability in the ligaments of the upper neck area. If this is the case, then someone might experience headaches or numbness at the back of the skull and limitations in their neck movements. Both of these cases are considered emergencies.
While some headaches are life-threatening, some are due to hormonal changes, which is why women can be subject to more frequent headaches. Migraines are traced to inflammation to the nerves and arteries in the head. Some headaches, especially TTH, are due to stress or posture. For these headaches, people often complain about a band of pain/pressure/tightness across the head that spreads from or towards the neck. Cervicogenic Headaches are distinguished by pain that starts at the neck and moves to one side of the forehead and eye area that is triggered by movement or pressure at the neck. This pain can often spread to the same-side shoulder or arm.
The reason why neck pain and headaches are closely related is because several muscles, ligaments, and nerves cross the neck to the base of the skull. When this is the case and the headache is coming from musculoskeletal origin, physical therapy can come to the rescue.
What can I do about it?
If you have neck pain that leads to a headache and your headache worsens when you move or press your neck, then check out some of these strategies to reduce your headache.
1. Improve your posture on a day-to-day basis.
If you are slumping most of the day and your head is not aligned with your neck, you are forcing your neck muscles to work overtime! Your head weighs about 10 pounds. Now imagine you are holding a 10lb bag of groceries with one arm stretched out in front of you, shoulder height. Imagine you are doing that for hours. Your shoulder is going to hurt! Similarly, it’s a lot to ask of the small muscles around your neck to hold up that heavy, intelligent, gorgeous brain of yours. So get it in check! Line up your earlobe to the tip of your shoulder. Sit up straight and don’t slump your head forward. It’ll feel weird to do this at first, but it always gets better with practice.
2. Strengthen and stretch your neck and shoulder muscles
To strengthen the deep neck muscles, do chin tucks, and to strengthen around the shoulder blades, do shoulder squeezes. See instructions below!
Sit or stand up nice and tall. With your eyes looking straight ahead, draw your head back to give yourself a “double chin.” Don’t nod your head down or up, but bring it straight back. Hold this for 3 seconds and release. Do not hold your breath. Repeat 3 sets of 10, 2x/day.
Sit or stand up nice and tall. Press your shoulders down and back. Don’t arch your lower back. Think about pinching your shoulder blades together. If your headache worsens when you do this, then you are probably lifting your shoulder up instead of down so try this in front of a mirror. Hold this for 3 seconds and release. Do not hold your breath. Repeat 3 sets of 10, 2x/day.
3. See a PT.
Physical therapists treat headaches with manual therapy when serious pathology is ruled out. Evidence suggests that joint mobilization and manipulation at the cervical and thoracic spine can reduce the length and intensity of headaches. PTs can also do soft tissue release to decrease muscular pain, give you a personalized stretching and strengthening home exercise program, perform ergonomic assessments of your work space, and offer postural advice.
4. Reduce Stress.
A lot of my patients have huge reductions in headaches when they start a personal home meditation and breathing exercise program. Thinking calming thoughts and take big belly breaths helps reduce an overactive nervous system and the hormones that might create tension in your muscles.
There is a lot you can do about your headache if it is a problem for you. It can be a huge emotional and financial burden if it is recurrent and intense. Generally speaking, there is not a lot of awareness of headache disorders because people don’t take it seriously and doctors might brush it off. A lot of people don’t reach out to their health care provider, end up self-diagnosing, and take over-the-counter medications for their headaches. While this might be a quick fix, this doesn’t solve the underlying problem. Reach out to your primary care doctor or a physical therapist to get your headache treated today!
I hope you are able to gain some good advice on reducing your headaches. Next up in our 4-Part Series: “Head, Shoulder, Knees, and Toes” is SHOULDER IMPINGEMENT.