Headaches can’t be ignored. They affect everything and prevent you from being you. Finding a good medication can do wonders, but many times that falls short. Why? What else could be at play here?
What many people don’t know is that the majority of headaches (at least 80% according to some) have a significant muscular component to them. That is, the pain in the head is related to an actual tension in the musculoskeletal system. Whether it’s a tension headache, or the less common migraine or cluster headache, it’s important to consider physical and mechanical drivers of your pain. For many, in reality the headache is simply another type of muscle or joint pain, and we as PTs need to find the cause and address it just like anything else. Today we will highlight the major mechanical culprits for headaches.
TMJ/Bite Problems
If you clench or grind your teeth, or have pain in your temporomandibular joint (TMJ), you probably have an abnormal bite, which puts pressure into your skull each time you chew or clench. Quite literally, the “temporo” half of the “TMJ” joint is the temporal bone of the skull. If there’s excessive joint pressure or tension through this joint, doesn’t it stand to reason that your head might hurt too?
Your Neck
When the neck (or upper back) is dysfunctional or stiff, neck muscles get tense. This can happen in response to overuse, or just poor sitting posture. The problem is that these muscles can refer pain into the head and mimic a headache (the same way the low back can refer pain into your leg; you know where the pain is, but the cause is somewhere else). Some of these neck muscles do in fact connect to the bones of the skull, and impart an abnormal or asymmetrical tension across your scalp and skull, causing pain. So in addition to referred pain from a dysfunctional neck, there can also be an actual head ache that is muscular in origin. The cervical spine must be screened and treated if necessary in the presence of headaches.
Bad Habits
In addition to abnormal tensions on the head, as we just described above, we can get headaches from sustained, prolonged compressive forces on our heads. This makes sense, right? If you wore a hat, glasses, or a helmet that was too tight, I doubt you would be surprised to have a headache afterward.
A forwardly tipped head, especially with pressure on the back of it, can cause headaches for many people. Lying with the back of the head pressing on a surface -even a pillow – for a long time can be trouble (think watching TV in bed, reading a book, looking at your phone). The head isn’t meant to be nodded forward like this. Video: The Best Sleep Positioning for Headaches and Neck Aches.
This doesn’t mean that we can do the opposite though, and crane our necks like turtles. If you’re leaning into your computer (can you read your screen clearly??), or have poor sitting posture, this is also bad. You want a good, neutral neck and head. See our Ergonomics Videos for Sitting Posture Tips.
Finally, pressure on the ear or face can add up. Sleeping with your cheek bone on your hand, or holding a phone to your ear (firmly with your shoulder shrugging) can be trouble as well. Modifying these habits can really help, especially with one-sided pains and visual disturbances that we associate with migraines.
A History of Trauma
Trauma is never really forgotten by the tissues of your body. Just ask someone who broke a bone 40 years ago. I’ll bet that on a rainy, cold day that person feels still can feel something there. Fortunately, the human spirit is stronger than we know. We move on, compensate, and our brains suppress or forget the bumps we’ve encountered on our journey.
However, the trauma remains to some extent. There are still subtle tensions in the tissues of your body that, on a bad day, can cross the threshold of being symptomatic. A history of head injuries (concussions, hard “thumps”, and others) is important to consider as part of the headache puzzle.
What to do?
Try to be good to your neck. Work on the habits described above and be mindful of clenching your teeth if you can. Get your vision checked if you’re leaning and squinting a lot. If you’re still having trouble, you may want to see a craniosacral PT who specializes in headaches and TMJ dysfunction. Remember, as long as there’s a breath in the body, there’s potential to heal!
Related Posts
Who Can Benefit From Craniosacral Therapy?
There are many benefits from Craniosacral Therapy (CST), which is a gentle, non-invasive form of Osteopathic Manual Therapy that I use every day in my practice. It’s great for people who find conventional approaches (such as medications, exercises or...