Resolving Tension Headaches
Approximately 90 percent of headaches originate as tension headaches. Medical experts continue to debate over the causes of tension headaches.
In my opinion, 90% of tension headaches are either caused by mechanical factors or are perpetuated by them. In other words, most ongoing, chronic, tension headaches can be attributed to specific physical restrictions.
These are restrictions in muscles, ligaments, tendons, and connective tissues which cause nerve impingement syndromes, vascular changes, and the output of biochemical substances that affect pain centers.
Symptoms of Tension Headaches
Tension headaches usually last from half-an-hour to an hour but they can continue to return for weeks, and in chronic cases, last for years. People who suffer from tension headaches often describe their headache as a dull ache, or they may experience them as a band of tightness around the sides of their head. This band may even feel like a vice compressing their skull. In severe cases the pain may even feel like a hooded cape that drapes over and across the shoulders. Obviously in such severe cases more than just the head is involved in creating the pain syndrome.
The following is a list of some of the common symptoms of tension headaches:
- Band-like pressure around the head
- Difficulty concentrating
- Difficulty sleeping (insomnia)
- Fatigue and irritability
- Loss of appetite
- Neck, jaw/TMJ, or shoulder discomfort
- Severe pain behind the eyes
- Tenderness of the scalp
Nerve compression is a major factor in the initiation and perpetuation of tension headaches. If we look at the pathway of different peripheral nerves that transect, or pass under, musculoskeletal structures (muscles, ligaments, tendons, connective tissue) it is easy to see how nerve compression can create a tension headache.
- Superior obliques
- The Suboccipital nerve supplies input to the muscles of the suboccipital triangle. Compression of this nerve can occur at the superior oblique.
- A trigger point in the superior oblique muscle itself will also refer pain to various regions of the head.
- Semispinalis (capitis, cervicis)
- The greater occipital nerve is located directly under the semispinalis capitis. Compression of this nerve is one of the causes of cervicogenic headaches. The symptoms from these headaches are called occipital neuralgias.
- Occipital neuralgia is a medical condition characterized by chronic pain in the upper neck, back of the head and behind the eyes. This is sometimes known as C2 neuralgia or Arnold’s neuralgia.
Treatment of Tension Headaches
To resolve Tension Headaches it is essential that we remove all physical restrictions throughout the body’s Kinetic Chain. This would include restrictions in your shoulders, neck, jaw, skull, and perhaps other affected areas. In other words, wherever we find restrictions that may be initiating a physical cascade of events that will eventually cause physical or biochemical changes resulting in a headache. This will include:
- Soft tissue adhesions – These will be found in muscles, ligaments, tendons and connective tissue. Anywhere that a change in tissue texture, tension, movement or function is noted.
- Peripheral nerve entrapments – Besides the actual tension headache, nerve entrapment symptoms include: paresthesisas or abnormal neurological sensations which include: numbness, tingling, burning, prickling, hyperesthesia (increased sensitivity) and muscle atrophy.
It is extremely important to recognize that if we are only dealing with the headache on a pharmaceutical basis we have not addressed the chronic chain of events that perpetuates the headache.
There is a considerable amount of research in the literature to support this perspective. Even a change in posture can greatly affect the prevalence of a tension headache.
Our clinical experience has shown that the majority of chronic tension headaches can be completely resolved or substantially reduced by using soft tissue therapy (Active Release Techniques, Graston Technique, Massage therapy) in conjunction with the correct exercise program.
These treatments, in conjunction with appropriate exercise and life style management changes, can prevent headaches from returning. Occasionally short term pharmaceutical intervention may be necessary, but in most cases this can be avoided when dealing with tension headaches.
See Kinetic Health’s Shoulder Exercise Videos for a sample of some the exercises we prescribe to our patients suffering from headaches.