What can you do about your headaches?
Every time I hear this question in my consult room I feel like giving my client a big hug. Thankfully for them I withhold this urge due to something called ‘professional boundaries’. The reason I feel this urge is because it is not uncommon for headache sufferers to bounce around between various clinicians of various disciplines, often struggling to get any answers, and even rarer, get any relief. Even worse than this – the person never seeks any help at all, because for some unknown reason, people tend to think that there is little, if any help available for headache sufferers.
Now I’m not going to pretend to have all the answers. After all, headaches have plagued the medical community for centuries. Part of the reason for this inherent cluelessness (compared to advancements in other areas of medicine) is that headaches can be caused by a variety of sources; dehydration, neurological deficits, too much sensory input (think bright days + lots of squinting), tight muscles, stiff neck joints and ‘we don’t have a clue’ headaches (we call these migraines) to name a few.
But there are some very common headaches which can be helped quickly. The two main types of H/A’s which physiotherapists assist with are ‘Tension’ and ‘Cervicogenic’ headaches. Tension H/A’s are usually caused by postural deficits that lead to overworked muscles in the neck and shoulders. These muscles have been shown to refer pain to the head themselves, however they also pull on the fascia, which is the tissue that makes up the majority of our scalp. These are the headaches classically that office workers & truck drivers get after hours seated in the same position. The H/A is usually proceeded by significant stiffness in the neck and between the shoulder blades which isn’t relieved by movement & stretches. The usual pattern is that postural deficits and certain muscle imbalances need to be addressed for this person to receive long-term relief.
Cervicogenic H/A’s literally means ‘headaches that come from the neck’. These can be diagnosed very quickly. If your physiotherapist (or other health professional) can poke a certain spot in your neck and it reproduces your headache, and then begins to reduce within 30 seconds, you’re on the right track. These are caused because the top 3 vertebrae in your neck share the same nerve pathways as your face and scalp (through the trigemino-cervico-nucleus for the Googler’s amongst you).
The take home message is this; get checked out. Don’t suffer unnecessarily. Your headache may be easier to treat than you imagined.
HEADACHE TIP: headache sufferers have been shown to have lower levels of riboflavin than non-sufferers. Riboflavin down-regulates the trigemino-cervico-nucleus which = less pain. If you suffer regular headaches of any sort try drinking a glass of cranberry juice daily – it’s worth a shot!
Scott Cook (APAM)
POGO Master Physio