Pain in the region of the head and neck is considered a headache. Headaches occur in both men and women and are very common. They can be a throb, ache, pain or pressure that may be dull or very, very sharp. Headaches are irritating, make it hard to concentrate, reduce one’s humour & tolerance and can negatively impact work and exercise.
Headaches can be exacerbated by many contributing factors like busyness with no down time, for women in the pre-menstrual days, heavy lifting and stress to name a few.
Headaches are commonly caused by pain originating from dysfunction in the musculoskeletal system…..that’s where Physiotherapy comes into it!
Migraines are severe headaches often associated by visual disturbances, nausea, vomiting, the need to be in a dark room and are treated by prompt use of migraine medication. Physiotherapy cannot treat a migraine itself, however, Physiotherapy for headache treatment as described below is often very successful in reducing the severity and frequency of migraines.
How Physiotherapy Can Be Used As Headache Treatment
The neck, or cervical spine, is made up of 7 vertebrae that interlock.
The interlocking point forms a facet joint which is named by the vertebrae that connect them i.e. C4/5 joint.
The neck can move about 90º rotation, flexion and extension with about 45º into side bend. Stiffness in facet joints can cause a headache.
Physiotherapy can mobilise the stiff joints to restore movement and this can ease the headache.
Muscles themselves can be sources of pain. Muscles can get knots or ‘trigger points’ and by palpating the muscle trigger point, the headache can be felt.
In the diagram X is the muscle trigger point and the red is the location that the pain is felt (which is remote to the trigger point site). This is how tight neck and shoulder muscles can cause a headache.
Physiotherapy can treat muscle trigger point pain by massage or dry needling.
Dry needling is the use of an acupuncture needle inserted into the identified trigger point. Sometimes the needle can generate a strong ‘muscle twitch’.
Once movement is restored and muscles have relaxed, the cause for the headaches need to be examined. Commonly sitting posture is related to headaches as a habitual position will significantly affect the head and shoulders.
Physiotherapy can correct posture. Sitting too slouched may hurt the joints. Sitting too straight may overload the muscles
Physiotherapy can retrain muscles so they don’t become painful trigger points causing a headache.
Co-ordinated muscles = reduced headaches
It is imperative to finish rehabilitation so that you progress from muscle retraining to muscle strengthening.
Stronger arms and shoulders = reduced headaches
In addition to physical joint stiffness and muscle tightness, headaches can also be influenced and amplified by emotions, stress or feels of negativity. It is important the influence of these factors are explained to patients, as this understanding is vital in the longer term self-maintenance of headaches.
In Summary
It is important to acknowledge that headaches can be caused by a myriad of reasons; including ice cream (excessive nerve stimulation), concussion in sport, nerve pain after shingles, sinusitis, tooth infection, eye straining and the list goes on. Importantly a sudden, severe headache should always be promptly medically examined.
