Headaches Ruining your Day? How to End Them Now: - Onward Denver
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Headaches can put a serious damper on your ability to enjoy your day and be productive. Did you know there is different treatment based on which one is causing your symptoms? Consider some serious interventions to relieve your headache for good before reaching for the Advil.

Key Points:

This article will focus on:

  1. Identifying five common headache presentations
  2. Understanding what is causing the symptoms
  3. Educating on effective treatment techniques and prevention strategies

1. Tension Headaches

Image result for tension headache picture
Described as a band-like pressure or pain, tension headaches usually refer from the neck.

Tension headaches are often caused by contractions in head and neck. Common triggers include poor posture, fatigue, eye strain, stress and alcohol.

Symptoms:

  • Described as a sensation of a tight band across the forehead with tenderness and sensitivity in the scalp, neck, and top of the head
  • Pain present on both sides of head
  • Reported as a steady ache with slow onset

Treatment:

This is largely driven on the cause of the symptoms and can be diagnosed with a thorough evaluation with a physical therapist or chiropractor. Common recommendations include:

  • Spinal manipulation
  • Dry needling
  • Postural exercises such as chin retractions or neck/back extensor strengthening
  • Stretching of upper traps, levator scapulae, and scalenes
Using a lacrosse ball can be an easy way to apply acupressure on yourself at home.

2. TMJ Headaches

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Illustration of TMJ headache referral pattern.

These present similar to tension headaches. The origin tends to be related to jaw clenching, tight muscles in face, displacement of the tempomandibular disc or abnormal jaw range of motion.

Symptoms:

  • Pain is usually felt at the top of head, eyes, and near the jaw
  • A sensation of tightness, similar to wearing a tight hat or having your hair pulled
  • Noticing tenderness around jaw after sleeping or during periods of stress

Treatment:

  • Reducing jaw clenching with a night guard, relaxation exercises, awareness of response to stressful situations
  • Physical therapy can provide interventions such as dry needling and soft tissue massage to relieve pain; mobilization of the jaw joint can also improve function, muscle length and range of motion. Check out this recent blog by Onward Tennessee for the most effective exercise techniques for pain relief

3. Cervicogenic Headaches

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“Ram’s horn” distribution of pain in cervicogenic headaches.

Often referred to as a “Ram’s Horn” headache due to symptom referral pattern, cervicogenic headaches are extremely common. They tend to affect individuals working a desk job or those who have situations that require prolonged sitting/posturing. These are generated by the upper neck joints and muscles, namely our suboccipitals. Think of these muscles as antennas; they create small movements of our neck and head and are extremely important in providing our brain information regarding our location and safety. If we spend a long period of time in the same position, these muscles lack motion, which trigger an “alert” (pain) referral pattern to this area to improve. Other traumatic events such as whiplash, fracture, and dislocation can cause similar pain. These often cause guarding and reduced motion.

Symptoms:

  • Referral pattern is usually seen on one side, starting in the neck and coming up around the ear to the temple region (like a ‘ram’s horn’)
  • Pain is described as tender, aching, or dull
  • Reduced flexibility of the neck

Treatment:

If identified, a physical therapist can help put an end to these utilizing the following:

  • Spinal manipulation, specifically of the upper cervical joints
  • Dry needling to relieve muscle tension
  • Mobilizing and improving range of motion of the upper neck with retractions and flexion of these joints
  • Utilizing a SNAG strap can provide as a useful tool to self-mobilize rotation at home (see below)
Cervical SNAGs can be an effective treatment to restore range of motion and reduce pain.

4. Migraine Headaches

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Migraines tend to produce a pulsatile pain present on one side of the face/head.

This may be one of the more debilitating headaches on the list and usually diagnosed by exclusion and/or symptom presentation. It is considered a neurological condition. Common triggers include: skipping meals, caffeine withdrawal, sleep deprivation, anxiety/stress and genetics.

Symptoms:

  • Pain described as pulsatile in nature
  • Covering one side of the face or neck
  • Sensitivity to light, sound, and visual changes (referred to as an “aura” including blind spots, flashing lights, stars etc.)
  • Nausea and vomiting may occur

Treatment:

Given the complexity of the symptoms and various causes, a physician may be consulted to allow for appropriate interventions to be implemented. This may include the following:

  • Lifestyle modification – stress management, acupuncture, meditation
  • Medications to relieve symptoms that are migraine-specific, anti-nausea, and NSAIDs

5. Cluster Headaches

Image result for cluster headache
Cluster headaches usually present as a stabbing, sharp pain in the eye/temple region.

These tend to be more rare and diagnosed by exclusion and symptom presentation as well. This can be quite debilitating and extremely painful.

Symptoms:

  • Pain is described as throbbing and stabbing, specifically around the eye or temporal region on one side of the face
  • Autonomic symptoms accompany the pain and may include the following: nasal congestion, eye tearing, eyelid swelling or drooping, forehead/facial sweating and flushed skin on one side of the face
  • Migraine-like symptoms including sensitivity to light and sound and nausea/vomiting

Treatment:

Identifying triggers can be a powerful tool in managing symptoms. Vasodilation has been known to generate a new onset of a cluster headache. Other notable activities that cause an event may include:

  • Abrupt change in sleeping habits
  • Alcohol
  • Prolonged anxiety

Avoiding the triggering behaviors above may help prevent onset. Exercise has also been shown to improve symptoms as this induces vasoconstriction. Preventive medications such as verapamil can be also useful if prescribed by a physician.

Summary:

Z-Press is an effective exercise for those with shoulder and neck pain.

Hopefully this lends insight into the variety of headaches that may occur and aid in the selection of treatment best suited to solve your symptoms. Physical therapy can be an excellent tool in conservative, yet effective management of headaches. Avoiding over-usage of prescription medications, opioids or surgery is the overall goal. At Onward Denver, we are confident in identifying the type of headaches as well as utilizing skills such as manual therapy, dry needling, spinal manipulation and strengthening in the overhead position to help you get rid of headaches for good. Don’t wait, schedule an appointment today!