Monday, April 6, 2009

Tension Headaches


Do you get headaches? Have you ever asked why you get headaches?

Headaches can be caused by a number of things. Listed among these is stress/tension, inflammation of the sinuses, cervical (neck) joint irritation, and arterial dilation. Dehydration, hunger, and straining of the eyes can also cause headaches. Though most headaches are not life threatening, there are some that have a more serious and life threatening nature. These life threatening forms would be caused by encephalitis, brain cancer/tumor, and cerebral aneurysms. I don’t want to focus on the life threatening forms of headaches. Instead I would like to list a few things to look out for. If you notice any of the following symptoms associated with you headache seek medical assistance:

• Stiff neck
• Seizures
• Confusion/disorientation
• Sudden fever
• Nausea/Vomiting
• Bulging of the Fontanels (soft spots of the head) in infants
• Behavioral/Emotional changes
• Paralysis on one side of the body
• Memory loss
• Impaired sense of smell or sight
• Impaired motor activity (speech, ability to write, walking, etc)
• Sudden change in weight
• Drooping eyelid
• Enlarged pupil in one eye
• Dizziness
• Ringing in the ears
• Increased/aggravated pain while chewing


I would like to focus on the most common form of headaches—Tension headaches. Tension headaches are often felt on both sides of the head. The pain may begin at the base of the head/neck and spread up and forward. The pain may be dull and feel like a vice squeezing around your head. Tension headaches are due to tightness of musculature of the head/scalp, shoulders, jaw, and/or neck, which may be pain directly where the muscle is or referred to areas of the head. Some common muscles to cause tension headaches include the Suboccipital muscle group, Trapezius, Levator Scapulae, and muscles surrounding the jaw. The muscle contraction/tightness may be related to stress, poor posture, cold temperatures, sustained abnormal positions, overexertion, or clenching or grinding your teeth. Tight muscles may be found to hold Myofascial Trigger Points (MFTP), or “knots”. These tight muscles and MFTP can cause pain not only to the neck, but the pain may radiate to the head.

For those who may have helped someone move (whether it be yourself or someone else), you know that it is easier to carry a box held closely to your body. When the box is held away from the body it appears to be heavier. The same applies to our posture. When we work at a desk we, generally, tend to lean forward. Our head is no longer directly above our shoulders, but placed in front of them. We have moved our head’s center of gravity in front of the pedestal it rests on. The muscles of our posterior neck, or back of our neck, have to work harder to hold our head upright. The result is tighter muscles and, possibly, MFTPs. Stress can also cause muscles to tighten, with or without MFTPs. From my experience, many people appear to “carry” their stress in the upper back, shoulders, and neck. If we do not have an appropriate outlet for stress its energy has to go somewhere. A common place is the muscles. We may also create a tightness of the muscles. For example, a boy who is having trouble breathing, maybe from asthma, may struggle to inhale and exhale. His body may respond by raising his shoulders to help expand the lungs. The boy is often unaware of the fact that his body is trying to help him breath in this way. If this continues the muscles raising the shoulders will hold the some of the tension, or contracted state, they used to help open his airway. This also happens when you sleep in an abnormal position for an extended period. The muscle is in a shortened position for that extended period of time and remains in that shortened state. When you wake up you may not be able to turn your head without pain.

To rid yourself of the pain of tension headaches you can do a number of things. The obvious suggestions would include talking to your doctor (if this is a medical doctor he/she will likely recommend taking an over-the-counter pain medication such as Ibuprofen or Tylenol). You may have already tried taking the pain medications, but noticed that you still get headaches. If you want to reduce the amount of headaches, and possibly get rid of them, you will need to take a more active role. This may include seeing a chiropractor and/or a massage therapist. Since I am a chiropractor, I will focus on what a chiropractor can do to help. A chiropractor will likely adjust the joints of your spine, including your neck. By improving the mobility of the spine your body can heal more efficiently. By allowing the nerves to properly transmit information, the body will be able to send the healing nutrients to the injured areas. He/she may also perform some trigger point therapy by applying pressure to the MFTP. The chiropractor will also likely give you stretches and exercises to do at home. Since the muscles are tightened and shortened, they need to be elongated to a more correct length. Electrotherapies may also help, with the assistance of heat. Electric stimulation, such as interferrential current (IFC), and heat will increase the blood flow to the affected area. This promotes healing by allowing the nutrients necessary for healing to be delivered by the blood and removing any inflammation that may be present. IFC can also perform a temporary “pain block”, achieved in one of two ways—1) stimulating local nerve cells and blocking the transmission of pain stimuli, or 2) stimulating the release of endorphins.

If you suffer from headaches, or know someone that does, refer them to a chiropractor. We at Evergreen Chiropractic are always ready, and willing, to help.