Headaches
Headaches can range from mild & infrequent to severe and disabling in nature. The severely disabling type of headache can throw our sense of wellbeing and personal life into complete disarray.
What Causes Headaches?
The International headache society has categorised headaches into primary and secondary headaches.
Primary Headaches are relatively mild and usually recurrent. They are the commonest variety and include migraines, sinus headache, tension headaches and cluster headaches.
Secondary headaches occur due to underlying systemic causes like hypertension, meningitis, whiplash injury, tumours, vascular disorders, brain bleeds etc.
Another increasingly recognised cause of secondary headaches include problems in the cervical spine like facet joint dysfunction, trigger points in the neck & shoulder muscles and poor posture etc. These are called as the Cervicogenic headaches. Headaches due to TMJ joint dysfunction (jaw problems) are also a common occurrence that are frequently missed.
A glimpse into the headache types
Cervicogenic headaches
Cervicogenic headache (cervico meaning neck) are headaches manifested by pain referred to the head from the neck. Research has shown that pain from the joints at the upper part of the neck (C2-C3) and neck muscles can refer pain into the head when irritated.
This can manifest as restricted neck range of motion and headaches that are aggravated by movement or application of pressure to the neck. The after effect of whiplash can frequently give rise to this pattern.
How do I know if it’s a Tension headache?
Tension headaches are the most common variety of headache. They manifest as constant pain on both sides of the head and may occur daily. The sensation of a tight band around the head is frequently reported. The pain may last from 30 minutes to several hours only to be relieved in certain positions.
Women tend to suffer from headaches more frequently and they most commonly occur between the ages of 20-40 years of age. Patients complain of continuous pain in the forehead, temples, back of the head or neck and it may be episodic or chronic.
Tension headaches have been linked to bad posture, increased stress, irregular meals, dehydration etc. They have also been attributed to depression and psychological issues with women being affected more than men. Over the counter medications such as paracetamol or ibuprofen can help relieve the headaches as do certain lifestyle changes like practicing relaxation techniques, regularising mealtimes and consuming plenty of water.
What are Migraines?
Migraines are less common than tension headaches and are usually felt as a severe, throbbing pain at the front or side of the head in around 70% of people. Accompanying symptoms may include nausea, vomiting, and increased sensitivity to light or sound.
Migraines are believed to be associated with inflammation and swelling of the arteries in and outside of the brain
As migraines can be very debilitating and long lasting, some people end up bedridden or struggling to go to work. The frequency of these headaches can vary from two to four times per month to a couple of times per year.
Each episode may last for between four hours to several days. Many of the migraine patients also experience an aura a few minutes before the onset of the actual headache. The aura can include visual disturbances or hearing hallucinations.
A recent review compared the published literature on the effectiveness of spinal manipulation, acupuncture and medication in the treatment of tension type headache and migraine headaches. Manual therapy involving Physiotherapy and Chiropractic manipulation was found to be more effective than pharmacological treatments for patients with tension type headache and migraine headache
Can headaches be caused by jaw problems?
According to a recent study of TMJ (temporomandibular joint) disorders, the jaw may may be a common source of recurring tension headaches. TMJ headaches are commonly undiagnosed because its symptoms may resemble sinus headache, tension headaches or migraines.
TMJ headaches affect women more than men and are most common between the ages of 20 to 50.
TMJ pain shows up like migraine headache accompanied by neck pain, which occur at the back of the head often associated with stress. The pain often radiates down into one or both shoulders.
Headaches due to TMJ disorders can be relieved by TMJ mobilisation and upper cervical joint mobilisation. Massage to the neck and facial muscles, especially the masseter muscle, can help to alleviate headaches due to facial muscle tightness in TMJ disorders. Our physiotherapists and Chiropractors are highly trained in TMJ dysfunction related headaches.
Headaches after Whiplash injury
Whiplash injury of the neck is a sudden acceleration-deceleration injury of the cervical spine following a road traffic accident. The sudden contraction of the neck muscles to protect the head and neck results in pain in the neck and shoulder region often accompanied by headaches that can last for weeks or months.
Deep neck flexor strengthening exercises, stretching and joint mobilisation techniques help to successfully alleviate these headaches. Including scapular bracing and postural correction exercises ensure that the pain does not recur again.
How do we treat headaches at Naas Physio Clinic?
At Naas Physiotherapy Clinic our physiotherapy and chiropractor treatments provide excellent results for Cervicogenic, Tension, Migraine, Post whiplash, Fibromyalgia and TMJ dysfunction.
Our efforts are directed towards a thorough assessment and accurate diagnosis as proper diagnosis is vital for the success of the treatment. This includes eliminating red flag. Red flags are serious systemic causes of head pain such as tumours, aneurysms, hypertension etc.
We believe in using the right mix of available treatment techniques to come up with a treatment plan that is unique for each patient and will provide optimal results. Our highly qualified and dedicated team is well trained in the art and skill of mobilisation and manipulation – key tools to ease the head symptoms significantly.
Our approach to the headache problem
Tension and Migraine headaches may be triggered by poor neck postures, neck muscle tightness and restricted neck range of motion. Many patients are actually unaware that the discomfort in their necks could be related to their recurrent head symptoms.
Such patients can benefit hugely from cervical joint manipulation, trigger point release, and exercise rehabilitation of the neck muscles followed by postural correction. Acupuncture can also provide pain relief in these cases.
Patients with Cervicogenic (neck driven) headache respond excellently to facet joint mobilisation, stretching and strengthening of neck and upper back muscles. Trigger point release, acupuncture, soft tissue massage, and deep neck flexor strengthening also provide long lasting relief in these cases. We also advise you on work place ergonomics which plays an important role in preventing the recurrence of pain.
Naas Physio Clinic offers a variety of treatment options
Naas Physio Clinic takes pride in having the best qualified Physiotherapists & Chiropractors who specialise in the treatment of headaches. We believe in continued professional development and regular practical training in the form of workshops that keeps us abreast with the latest knowledge and treatment techniques.
At Naas Physio Clinic we use the best combination of approaches to provide a long term relief to our patients. We offer the following treatments:
- Spinal Mobilisation
- Spinal manipulation
- Stretching
- Strengthening
- Deep soft tissue massage
- Trigger point release therapy
- Scapular stabilisation exercises
- Postural & ergonomic correction
- Deep neck flexor (core) muscle strengthening
- Myofascial release
- Acupuncture and Dry Needling
Reference:
Falsiroli L and Rafanelli M (2019). Manual Therapy and Quality of Life in People with Headache: Systematic Review and Meta-analysis of Randomised Controlled Trials. Curren Pain and Headache Reports, 23(10). https://pubmed.ncbi.nlm.nih.gov/31401702/
To book an appointment at Naas Physio Clinic Naas call:
(045) 874 682
or email us at info@physioclinic.ie
For further information on conditions treated go to:
www.physioclinic.ie/conditions