The statistics from the World Health Organisation state that headache disorders are among the most common disorders of the musculoskeletal and nervous system. With almost half the adult population having had a headache in the last year.
There are several different types of headaches which can be divided into two categories – vascular and cervical.
Vascular headaches include migraine and cluster headaches. They affect one fifth of the population at some time in their life. They usually present in the teenage years through to mid-life, tend to have a fast onset with throbbing pain in the front or side of the head and can be accompanied by nausea or visual disturbances. This type of headache usually begins early in the morning and is at its most intense within 2 hours and resolves within a few hours. They can recur daily or several times per week. They maybe more frequent in certain seasons i.e. spring. They tend to be triggered by stress, food, environmental factors and are treated by avoiding precipitating factors, medication and stress reduction. When suffering from these types of headaches it can be best to lie down in a dark room or even sleep can terminate the attack. A huge part of the management is to identify and avoid the precipitating factors. Your pharmacist or G.P. may recommend some simple pain relief in the more severe cases. However, this is not a first line of treatment as overuse of medication can lead to “analgesic rebound headache” which becomes a self-generating headache requiring increasing dosages of pain medication.
Cervical headaches are caused by abnormal tension or reduced movement in the joints or muscles of the neck that refer pain around the head region. Cervical headaches include tension and cervicogenic headaches. They usually present from in the early 20’s through to 60 years. The onset tends to be slow with a constant dull ache on the side or back of the head. It tends to be triggered by acute trauma i.e. motor vehicle accident or repetitive trauma i.e. work or sporting posture. The treatment options include manual therapy, posture correction, exercise therapy and stress reduction.
Cervicogenic and Tension headaches are regularly treated very effectively by Chartered Physiotherapists. Cervicogenic headaches can be caused when the muscles and joints in the neck region become tight and stiff. This type of headache is typically described as a steady dull ache usually with a gradual onset which maybe present for days up to months. There maybe a history of acute trauma (whiplash) or repetitive trauma (associated with work/sports). Tension headaches are generally a diffuse, mild to moderate pain in your head that’s often described as a feeling of a dull tightness around the head. In addition, there maybe tenderness on the scalp, neck and shoulder muscles.
Poor posture can be a contributory factor or a secondary consequence to both cervicogenic or tension headaches. The abnormal posture typically seen with cervical headache is rounded shoulders, head forward position and a protruding chin. This results in shortening and increased tension in the muscles on the back of the neck and weakness in the muscles in the front of the neck. Addressing any poor posture positions is the first line of treatment – check how you are sitting at work and in the car initially. Are your shoulders rounded, chin poking out and slouched in the chair? If so, try to sit more upright and supported, squeeze shoulder blades together. Just by making these two small changes the neck and head will move into a more neutral position taking the tension off the muscles therefore relieving the headache. Sometimes a more detailed assessment of ergonomics in the workplace or with daily activities is needed to figure out what maybe contributing to the symptoms.
If checking your posture doesn’t ease symptoms then having a full assessment and treatment from a Chartered Physiotherapist is most likely required. Treatment options would include soft tissue release to address any muscle tension in the neck and shoulder region. Sometimes the joints in the neck become stiff and they can contribute to the headache. A Chartered Physiotherapist can mobilise and if required manipulate the joints so that they move efficiently. A simple exercise program to address any muscle imbalance around the shoulder/neck region is beneficial to prevent recurrence of the