Tension Headaches and Migraines Many people will experience headaches and migraines over the course of their lives. When the condition becomes more frequent and interferes with the quality of life is when it is time for intervention. This article is here to identify the muscular causes of pain and the conditions which can exasperate the muscular condition and assumes that all other conditions The first thing we need to discuss is the definition of headache and migraine. Many people associate a migraine as being a really bad headache. This is a common misconception as a person may have what is called, “migraine without headache”, otherwise known as a silent migraine. In this case a person has all the other symptoms of a migraine, but without the headache. Migraines have four components or phases.1
 Prodrome - This is sometimes referred to as a “pre-headache”. The prodrome is a warning about 30 to 40 percent of migraine sufferers receive that let them know a migraine is eminent. This warning may be experienced hours or days before the onset of headache and can be beneficial as a person can use the warning to intervene and possibly prevent the progression into headache. Symptoms of the prodrome are:
Aura - This is the most popular term understood by the general public in reference to migraines. Aura is the next phase in migraine progression and usually lasts less than one hour. While many people associate aura to the visual disturbances associated, there may be other symptoms, such as:
Keep in mind as you read through these phases that not all migraineurs (those who experience migraines) will have all of the phases, or perhaps not notice them. Some experience migraines without headache, as mentioned above, referred to as “silent migraine”, “sans-migraine”, and “migraine equivalent”.
Headache - This is the most debilitating part of the migraine and may be felt in other parts of the body. This pain may be so severe that it is difficult for those who have never experienced it to understand. A migraine may occur at any time during the day, but the most common time is at 6 am and is not uncommon to be awakened by pain. The headache usually lasts between one and 72 hours. Other symptoms of the headache phase are as follows:
Postdrome - The migraine is not over after the headache. The following and last phase will many times make a person feel “hungover” or “like a zombie”, which may be partly due to the migraine and partly due to medications used to treat. Postdrome is associated with abnormal cerebral blood flow and EEG readings - and these readings have been recorded up to 24 hours after the end of the headache stage. The symptoms of the postdrome are:
It is important to learn to recognize the early symptoms before the headache phase as there are medications and therapies which may be utilized to prevent the headache. Also, an understanding of these phases may help explain what is going on and make it easier to cope with the symptoms. Now that you have a better understanding of what a migraine is, let’s talk about the common tension type headache. These headaches are believed to be from muscular origin, brain chemistry, or both. Many people will suffer this type of headache during some point in their lives. Tension type headaches are divided into two different categories. Episodic: Fewer than 15 headaches per month Symptoms of the tension type headaches are a “band-like” tightness around the head like that produced by a tight headband or vise. The muscles of the back of the neck and shoulders are usually very tight and tender to the touch. These headaches can last from an hour to a day and may vary in intensity during their duration. 2 Prevention of these headaches include stretching of the neck muscles along with moist heat. Massage, trigger point therapy, and chiropractic have been shown to be helpful therapies. It is also important to realize that dental problems can cause the patient to use their jaw abnormally thus placing undue strain on the muscles, thus causing headaches. Many times headaches and jaw pain run hand in hand. Notice how the trapezius muscle may refer pain to the back of the head, temple, and jaw! Now that you can see a difference in the 2 most common types of headaches (migraine and tension headache), you may better be able to decide how to approach treatment. We always advise attempting therapies before medications. In the experience of our practice, we find that many people respond favorably to a combination of massage, trigger point therapy and chiropractic care. If there is no response we look to other conditions or deficiencies which may weaken the muscles of the body. Another helpful thing to do, especially when treating migraines, is to look at food triggers. The big food triggers (or intolerances) are gluten, dairy, fructose, or yeast. Sometimes it is just the body’s response to these that trigger migraine. Also, there could be a reaction taking place from mold spores in the home or toxic fumes from new carpeting (glue) and painting. In these cases you may notice a correlation between a recent move or renovation and the onset of symptoms. We had a case a few years back where a female was getting headaches nearly every day. I wish I was the one who figured out the answer, but it was the patient who asked if we thought carbon monoxide (CO) could cause headaches. Of course CO gas can cause headaches, among other things, we said – then realized that she works as the repair manager in a local car dealership. Her workplace was in a closed office beside the garage that had very little ventilation. She took in a CO test kit, found the levels were dangerously high and changed offices as a result. The headaches slowly went away and she is now fine. Use the above example and think back on your life and see if there are any correlations between your headaches and your work and hobbies. Keep in mind that our bodies are all unique and what may cause many problems in one person might not do anything to another. Some suggestions if you wish to explore food triggers.
Despite the type of headache you have, you may still have some muscular components and it will be worth figuring out what, if any, strenuous situations you place on your body. Below this is a list of some of the most common factors which mechanically affect the muscles which refer pain into the head and neck and cause headaches.
What Causes Neck Pain and Headaches? Other than chemical imbalances in the brain, there are several other causes of headaches which relate directly to the musculoskeletal system. This system of the body relates to the bones of the skeleton and the muscles which move those bones. We can start with the joints of the spine. There are many people who believe they have a “pinched nerve”. In a person’s mind the nerve is being compressed in a manner similar to ringing water out of a washcloth. In reality, more pain is experienced from joint dysfunction between the individual spinal segments or vertebrae. The joints where the spine joins together are filled with sensitive nerve fibers and pain receptors, called nociceptors. When these joints, called facets, become dysfunctional they can cause a lot of pain in the head and neck depending on which vertebrae have become dysfunctional. Pain will also cause an inflammatory reaction which can further irritate the nerve root and surrounding muscles. Many times, the facets become injured in whiplash type injuries, most commonly induced by motor vehicle accidents. Facet joints refer pain, just as muscles and organs do. Before testing the joints, examine the chart below to determine if you have pain similar to the pain these joints may cause. The black areas are the overlapping pains between two pain patterns.
To determine if the facet joints are involved you can perform a couple simple tests. Facet joint loading test: This test should recreate the pain you are experiencing because it will Facet joint unloading test: This test should decrease, if not fully eliminate, the pain being caused by the facet joints. Turn your head 45° away from the pain, and take your chin towards your chest at that angle. You may use one or both hands behind the head to help stretch the neck. Note: do not pull forcibly with the hands, but use the weight of your hands to help stretch. Workstation Ergonomics: This is one of the biggest concerns in this day and age. Many people, doctors included, are just now beginning to realize the correlation between poor ergonomics and muscular conditions, including headaches. The muscles which most commonly cause headaches are the ones in the neck and upper shoulders. These muscles become strained and cramped when the keyboard and mouse are elevated in a position which is too high for the user. This is almost always the case when the keyboard and/or the mouse is on top of the desk and not on a keyboard tray and at a level that keeps the user from elevating the shoulders to operate the equipment. If this is the case for you, you may want to look into a solution, such as a keyboard drawer, to lower the keyboard and mouse. A couple other tips to help at the computer: sit all the way back in the chair with the back locked so it cannot lean. Push your buttocks all the way back and be sure your feet are supported either on the floor or, if you are of short stature, using a foot rest which helps to support the low back. Self Treatment and Stretching The best tool, in my professional opinion, to treat the upper back and neck is the Backnobber II by The Pressure Positive Company. The simple design makes it easy to locate and compress trigger points (Trigger points) located in muscle and its disassembly feature makes it convenient to use on the go. Once a Trigger point is located, pressure should be applied in a way which does not take the pain above a 4 or 5 on the person’s pain scale. The Trigger point should be compressed and held until the pain begins to subside – as little as 10-15 seconds and up to a few minutes. When the pain begins to subside, more pressure may be applied to take the pain back up to a 4/5 and held until it subsides again. Do this release 2 or 3 times over each trigger point and then gently stretch the muscle and then apply moist heat for 10 to 20 minutes. The best moist heating pack we have found is the Thermophore made by Battle Creek Equipment Company. 1. http://headaches.about.com/cs/headpain101/a/anatomy_mig.htm |
have been ruled out by a qualified medical professional.