What may have been missed in considering headache pain—Upper crossed syndrome and cervicogenic headaches.
Have headaches derailed your day and have you grown sick of trying solutions, (ie injections and medications) that aren’t really helping? Do you have difficulty concentrating, difficulty sleeping, difficulty working on the computer or driving in the car, difficulty doing your hair? Has anyone even asked about or looked at your posture in your daily activities, observed muscle tension, and assessed strength in your head and shoulders? If not, this is likely a missing link, that if addressed, can make a world of difference in improving your headaches.
Headaches can be caused by imbalances amongst muscle tightness and weakness in your head and shoulders which also affects the mobility of joints. Over time the body will adapt certain movement patterns that result in elongated and weak muscles on the front of the neck and shortened and tight muscles on the back of the neck. The main culprit in creating this condition is gravity and the fact that the majority of day to day activity is out in front of us and brings the body into a forward, rounded position. If there is limited effort to unload from this position through the day, the body adapts and can result in pain or headache. Pain is generated from the tight muscles that have been overworked and lack support from the opposite weak muscles. The referral pain from these muscles creates a headache sensation.
Upper crossed syndrome depicted—a contributor to cervicogenic headaches.
These headaches are called cervicogenic headaches and are often missed or categorized as other headaches. If your headaches are made worse in certain positions such as prolonged sitting, carrying a bag or backpack, reading, or worsen with stress, this is likely a cervicogenic headache. If you, or a trained physical therapist, can reproduce your headache by pressing on muscles in your head and neck, that is also an indication of a cervicogenic headache. It is also indicative that physical therapy can be utilized to reduce these headaches.
Relief is not far off if this type of headache is identified as contributing to your pain. There are multiple strategies for addressing cervicogenic headaches.
Treatment should include a personalized approach to:
Manual therapy, which includes massage, or use of dry needling or cupping to decrease muscle tension, improve circulation, and reset imbalanced nerve muscle patterns.
Joint mobilization to upper neck, shoulders, and mid spine to facilitate new movement patterns.
Breathing techniques to assess patterns contributing to tightness and weakness imbalances and integrate techniques into practices for stress management.
Postural unloading exercises to integrate throughout the day to offload overworked muscles and engage underutilized muscles to regain balance of the body.
Muscle activation exercises to re engage under utilized muscles and reinforce new movement patterns.
Progressive strengthening and stability exercises.
Address other symptoms related to cervicogenic headaches including jaw pain, dizziness or feeling of vertigo, shoulder, upper/mid back pain, and other lifestyle factors that can contribute to systemic inflammation and pain.
Plan for independent management of exercises and techniques to avoid return of symptoms.
Physical therapy just may be your missing link for headache solutions.
