Headaches can be extremely painful, and effect most aspects of your daily life, from simple things like trying to fall asleep, working at your computer, and driving, to more stressful physical activity like exercising. There are many causes of headaches, but for the purposes of this article, weâll discuss the most common forms of headache, which are due to problems in the neck, how to diagnose these conditions, as well as your treatment options and how to get headache relief.
What Causes Headaches
There are so many causes of headaches that it would be impossible to list them all here. If you suspect that your headache is caused by a chronic disease, an infection or if you have a high temperature (fever), then you should consult your General Medical Practitioner or local hospital as soon as possibe to get to the root cause.
For someone who is otherwise healthy and has no current disease or infection, the most common cause of a headaches is a problem in the neck. This includes Tension Headaches caused by injured muscles or stress induced muscular knots, triggerponts or spasm, or the headache is due to irritation of the internal structures of your spine, like the spinal (facet) joints, intervertebral discs or nerves, in which case we call it a Cervicogenic Headache.
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By far the most common cause of headache visits to a Chiropractor is due to excessive neck stress from the following:
- Trauma: Whiplash from motor vehicle accidents and falls causes a violet flicking of your head, leading to an acceleration / deceleration injury which often bends your spine into an abnormal position. This spinal trauma creates spinal joint inflammation and muscle spasm, and sometimes intervertebral disc compression.
- Incorrect Pillow: Feather, buckweat, husks, or ordinary foam doesnât provide the correct neck support, leading to abnormal spinal positions for many hours during the night.
- Excessive use of technology / reading: Forward bending (flexion) of your neck for hours each day to look down at laptops, cell phones, tablets or books is literally bending your spine in the opposite direction to how the cervical (neck) portion of your spine is naturally bent. Over time, the spine can lose its natural curved shape, a condition know as Loss of the Cervical Lordosis (Curvature).
As a general rule of thumb, Tension Headaches from soft tissue problems in the neck cause short term pain, hours to days, and are gone when the stress subsides. When a headache due to a neck cause has been going on for weeks, months or years itâs generaly spinal in origin, a Cervicogenic Headache. Quite simply, muscles donât usually cause pain for prolonged periods of time, but spinal problems nearly always do. Muscular neck problems donât directly cause internal cervical spinal problems, but if you have a spinal problem you will almost certainly have an associalted muscle spasm, your bodyâs natural muscular response to the spinal condition.
When headaches have been around for weeks or longer, be sure to to shift your focus away from the muscles (Tension Headache) and get your spine assessed by a Chiropractor or Neurologist, the spinal and nerve focussed practitioners for a Cervicogenic Headache.
How To Diagnose Headaches
There are 4 pillars to making the correct Headache diagnosis from a neck problem:
- A Thorough Patient History: having an in depth discussion with a health care practitioner is the first step in understanding which neck tissues are involved in your problem. As mentioned in the âcausesâ section above, there are many potential tissues involved in headaches, but based on a simple conversation, your practitioner can already get an idea of the issue based on how the pain started, how long youâve had the pain, the type of pain sensation you are feeling, and any associated problems like Upper Back Pain, and Neurological symptoms down your arms.
- A Physical Examination: your neck is a moving structure and specific movement / orthopedic tests need to be performed in order to see how the different tissues function under movement stress. Discomfort during certain tests helps the practitioner understand which tissues are injured, either the soft tissues and/or the spinal structures. Muscle spasm / knots / triggerpoints can be felt with the practitioners hands, and joint stiffness and inflammation can be elicited through cervical facet (joint) tests.
- X-Ray Scan: when a patient history and physical examination does not help the practitioner to make an initial diagnosis, or if the results donât add up, especially when the spine is the cause of your problem, visualizing the tissues internally is required. The bony structure of the spine is investigated through an X-ray, which can help diagnose joint degeneration (Osteoarthritis), fractures, dislocations, vertebral instability, and structural abnormalities like vertebral misalignments and loss of the cervical curvature (lordosis).
- MRI Scan: when a X-ray of the bony neck structure fails to bring you closer to the diagnosis, an MRI is the best way to understand the health of your other spinal tissues, namely the intervertrebral discs and spinal nerves. Conditions like disc bulges (slipped disc), disc ruptures, and the extent of the pressure on your spinal nerves (pinched nerve) are well visualized on a MRI scan.
There are lots of different soft tissue (muscle) practitioners in health care, but not many spinal focused practitioners. If your muscular diagnosis of Tension Headaches is not responding well to soft tissue treatment, or if your diagnosis is uncertain and needs an X-ray or MRI scan to further understand your problem, make sure you get help from a Chiropractor and/or Neurologist, as this may be a Cervicogenic Headache.
Treatment for Headache Relief
The treatment you receive for your neck related Headache should be 100% dependant on the cervical (neck) diagnosis that was made. There are many treatments worldwide for this type of pain, but the procedures mentioned below are the most used, have the highest success rate, and are backed by the most science.
Tension Headaches from muscle pain responds well to the following soft tissue treatments:
- Massage: digging into and rubbing your hands over tight muscles is a great way to iron out the spasm and knots.
- Stretching: tight soft tissues are loosened when they are lengthened.
- Heat: increases blood flow to the area, and the warmth has a relaxing effect on tight muscles.
- Dry Needling: putting a needle into stubborn knots / triggerpoints helps break down the stubborn knot and loosen the muscle that other soft tissue teckniques failed to achieve.
- Electrotherapy (T.E.N.S / Interferential): blocks pain signals, therefore reducing your perception of the pain.
- Ultrasound: aids the healing of damaged / torn soft tissies, as well as reducing the swelling in the area.
- Exercise: strengthening the soft tissues around the problem area helps provide a layer of protection from future bouts of similar neck pain.
Cervicogenic Headaches from spinal pain responds well to the following treatments:
- Electrotherapy (T.E.N.S / Interferential): blocks pain signals, therefore reducing your perception of the pain.
- Heat: increases blood flow to the area, and the warmth has a relaxing effect on tight muscles and helps loosen stiff joints.
- Cervical Facet Joint Mobilization: gently moving your spinal joints through their natural range of motion, in order to restore the normal fuction and motion to the problematic joint.
- Cervical Traction: helps reduce pressure on any bulging intervertebral discs, which in turn reduces pressure on your nerves.
- Cervical Manipulation: most effective way to restore misaligned vertebral bones back to their normal position, and restores the movement back to a âseized upâ / tight / stiff joint that has lost its ability to move naturally. (see Manipulation video)
- Cervical Curvature Restoration: a specialized home based exercise and stretching protocol to reduce upper back and neck pain, correct bad posture and restore the normal spinal curvature (lordosis), see the Mobile App or eBook here: Â https://umhlangachiropractor.co.za/posture-correction-at-home/
As mentioned in the diagnosis section above, due to the nature of spinal conditions almost always causing soft tissue spasm around the problem area, spinal focussed practitioners will often perform one or more of the above mentioned soft tissue procedures in conjunction with the cervical spinal treatment. However, if the spinal problem is successfully treated, the body would have no need to hold those surrounding muscles in spasm, and the soft tissues will almost always settle down on their own, without any direct treatment.