How often have you had a headache at the workplace and reached for a dose of paracetamol? its a very usual habit. We take the pill, it gets better. It must be the reason why. After all, it 'specifically targets pain and inflammation in our system, achieving lasting and complete relief so you can get on with your day'.
Headache pain and migraines are influenced by many factors and the mere band-aid effect of paracetamol covers the topical pain relief but does little for the ongoing maintaining and treatment of such a condition. There are so many causes for headache and migraine pain and it covers a broad and varying degree of conditions, from a mild unpleasant and irritable throbbing, to blackouts, vomiting and loss of bladder control. Sensitivity to light also features prominently in migraines themselves so the degree to which people suffer as well as the causative effects are large, varying and numerous.
There are three main types of headache pains:-
Tension - often cited to be caused by emotional stress or tension in the head/neck
Cluster - frequent headaches usually to one side that spread. Causes are unkown but blood flow is a major factor
Migraine - a more severe category that can take the form of vomiting, bladder control, fainting and light sensitivity.
But often when dealing with clients who complain of headache conditions, there is a general perception that it is caused from stress or tension. This is true but to delve deeper into the particulars is to find some interesting consistencies in cases that I have seen.
The cervical vertebrae has a very 'minute' amount of space in which to operate. Flexion, extension and rotation of the cervical vertebrae has a major influence on the nerve pathways that exit through the forminae (holes) in the spaces between the vertebrae. There are so many neck muscles that attach to the transverse process' (side bony extensions of the vertebrae) and the Spinous Process (tail of each individual vertebrae) that tension here can result in narrowed pathways which can lead to impact upon nerves thus resulting in pain sensations throughout the neck, head, shoulder and arms. The two main muscles of concern at a superficial level are the Sternocleidomastoid *(SCM) in the front and the Levator Scapulae at the back. These two broad and superficial muscles can directly be attributed to tension in the cranium (head). Temporal pain (around the sides of the head) is attributed to the Levator Scapulae whilst pain that 'hooks' into the eye is attributed to the SCM. Often a lot of headache pain can be helped by simply releasing these broad muscles along with attention to the deeper scalene muscles that lie deep in the anterior portion of the neck. These muscles directly connect to the process' of the cervical spine and run anteriorly to the front aspect of the throat and mastoid process. Work here via a particular technique that involves delving deep to the throat (sometimes not very pleasant) can assist with reduced instances of headache pain.
Perhaps an often overlooked factor of minor headache pain is the shoulder girdle. As I have mentioned before in a previous article on wry neck, the head sits atop the triangle of the clavicle and scapula bone. Ensuring that postural alignment is correct in these areas can have many benefits to those experiencing headaches. The SCM attaches the to the clavicle and the sternum in front and the Levator Scapulae attaches to the Scapula in the back. So you can see the connection. Ensuring a good pectoral alignment influences the alignment of the clavicle. The same rings true for the rhomboids and Trapezius at the back as it influences the alignment of the scapula. So ensuring the broader muscles that act on these bones makes sense to ensure good postural alignment and reduce effect on the neck muscles. Balancing the head on top as opposed to the muscles having to 'hold' it in place.
The sensation of 'pressure' is often associated with the more serious migraine. This more debilitating form of headache, can be influenced by postural and muscular factors. Though often it is combined with other bone and nerve factors, work on the soft tissue can assist with ensuring that the arteries are not compromised or being impinged and ensuring effective blood flow to the cranium. Whilst blood pressure does not have a major effect on headache symptoms, blood flow does. Headaches brought about by blood pressure are small in number but if headaches are concurrent with hypertension symptoms such as palpitations or eye pain, then this is more concerning and you should seek medical assistance immediately. Thankfully this type of 'hypertension headache' only consists in 1% of headache conditions.
Whilst migraines are related to electrical impulses and chemical imbalances in the brain, blood flow has a major role to play in the onset of conditions. Spasms in the nerve rich arteries at the base of the brain can constrict arteries, reducing blood flow. This causes other reactions but also the dilation of arteries within the brain to meet the energy needs of brain activity and Doctors believe this causes the onset of migraine pain. Hence ideal postural alignment can make alarming differences to people who do suffer from migraines. A rather hypermobile (and I mean seriously hyperflexible here) friend and fellow dancer always suffered from migraines and oddly enough, yoga was a huge causative factor. He tried several classes of different teachers and always had massive issues with headaches, during and after the practice. The hypermobility of his spine (combined with a hefty dose of Ankylosing Spondolysthesis) meant that any inversions were terribly difficult to control and rotations in the lower spine had direct effects on how his head sat atop his spine. He did find a teacher in the UK who was able to address his concerns, combining a graduated introduction and addressing issues from the foot and lower leg, along with the pelvis, before tackling the upper body.
As I've explained to clients, think of the spine as being the pond into which you drop a pebble. The ripples are small at the epicentre but the wave effect makes larger ripples on the outer edge. Think of the pelvis as the epicentre and the neck as the outer edges of this analogy and you might begin to understand how difficult it can be control a hypermobile spine and not feel issues in the neck. Often gentle palpation at the occiput can influence blood flow to the brain and thus can influence the chemical and electrical activity in the cranium. Feldenkrais and the Alexander Technique have a lot of success in this area, both being gentle in application but they do achieve postural change in the highly sensitive occipital area which can have big advantages to headache sufferers.
Other factors that can be treated are ensuring the facial connections that form the ligamentum nuchae (rats tail that runs from the base of the brain to the 7th Vertebrae) is as open and free as possible. Myofascial treatment here can be alarming effective in reducing the onset and the symptoms of migraines. This structure acts as a connective tissue for the broad trapezius and other smaller superficial muscles such as the rhomboids. So you can see how muscular tension can effect these all important structures and elements that act on migraine related pain.
Whilst debilitating migraine issues are not directly attributed to muscular or soft tissue tension, the effects of managing the vertebral space, the connective tissues and the all important alignment of the bony structures easily relates to managing the blood flow to the brain. A person who suffers from migraines can be helped by addressing muscular and postural concerns further down the 'chain' in the body to assist with ideal alignment and maintaining that all important occipital space. Of course, headaches take varying forms and multiple and composite causes affect the sufferer. But good assessment with investigative process and gradual unlocking of the layers, combined with all approaches can bring about amazing results for sufferers.
