Headaches & Migraines
At Pro Motion Physical Therapy we specialize in treating headaches. Headaches can be caused by many different dysfunctions and the most typical name for a headache is a migraine. A true migraine is a brain and nervous system disorder whose symptoms almost always include intense headaches and they can be triggered by visual strains, light sensitivity, moving objects, diet, hydration or menstrual cycle. However, we find that most headaches are orthopedic headaches and although they can sometimes have similar symptoms as migraines, orthopedic headaches can be treated and symptoms can be resolved. During the evaluation, your PT will
determine the source of your headache. They can be coming from trigger points of muscles, joint tightness and/or neural tension referring pain.
Muscle induced headaches: Muscles are meant to function in a proper length tension relationship in order to move joints and provide stability. When a muscle is resting in a too lengthened or shortened position or if the muscle is too weak to stabilize the joint then it becomes irritated and inflamed. When a muscle is in a chronic state of inflammation, segments of the muscle can be “stuck” in the contracted state, a trigger point. You can easily find trigger points in your shoulders when someone gives you a massage. There is a specific pain pattern for specific muscles and these referred pain patterns can present as headaches. For example, Sternocleidomastoid muscle refers pain/headache around the eye (http://www.triggerpoints.net/muscle/sternocleidomastoid). Your sub occipital muscles refer pain to the temporal region (http://www.triggerpoints.net/muscle/suboccipital-group). With soft tissue massage, dry needling(link), stretching and stability exercises we are able to relax those trigger
points and alleviate the headache.
Spinal joint mobility restrictions: Your cervical spine consist of seven vertebrae and there two joints for each segment. With a chronic forward head posture the cervical spine loses it’s natural curve, lordosis. Because of this posture the mid cervical spine becomes more straight and the base of your skull, sub occipital region, becomes compressed. This posture also lead to over stress of the C5/6 or C6/7 joints which is why those segments are most commonly surgically fused with severe disc herniation. When these joints rest in this posture for an extended period of time the joint capsule adapts to this position. When joints are resting in a
dysfunctional position they become irritated and will cause headaches. For example, your occiput and first cervical vertabrae, C1, will refer pain to behind you eye. C1/C2 will refer pain to your eyebrow, C2/C3 forehead. At Pro Motion PT we are able to restore the proper mobility of the spinal facet joints with joint manipulation(link) and in conjunction with dry needling, stretching and exercises help restore the natural curvature of the spine, alleviating pressure on the joints and associated muscles.
Neural tension: Nerves can be a source of pain and headaches as well. We like to think of a nerve as a water hose. If the hose gets pinched or compressed it leads to an insufficient blood supply traveling down the nerve, like when you kink a hose. The most important part of good quality PT is to identify the nerve that is impinged and determine where it is getting pinched. For example, the Greater Occipital Nerve ( https://www.physio-pedia.com/Greater_Occipital_Nerve ) leaves the base of the skull and travels up the back of your head. It travels through the sub occipital muscles and if those muscles are tight and inflamed, as described above, it can pinch the nerve and lead to headaches in the back and top of your head. Another nerve commonly pinched and miss diagnosed is the Dorsal Scapular Nerve ( https://www.physio-pedia.com/Dorsal_Scapular_Nerve ), this referred pain is along your
shoulder blade on your back. This muscle comes from your neck and travels through you medial scalene which commonly becomes tight and pinches the nerve.
It is not uncommon to have multiple tissues referring pain and causing headaches. As mentioned above, a decreased sub occipital space leads to shortening of the sub occipital muscles, compressing the greater occipital nerve. All three of them can cause headaches.
Headaches can be very debilitating. Unfortunately, imaging, tests and visits to your doctors offices don’t provide many answers. You are stuck with managing your headaches with medications and progressing to botox injections. While those treatments are great at helping manage pain, they are not addressing the cause. Our team finds the source of the headaches and helps restore the tissue to a happier, less irritated state to bring your healing process full circle.