Nancy Whelan, PT
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Headache Pain? Here's Help
Why are headaches so common, and how can they be so debilitating? Most headaches are grouped under the term “cervicogenic headache,” meaning that the primary source of the headache is coming from the cervical spine. Whip lash injuries, disc diseases, and progressive arthritis can cause long lasting headaches. The cervical spine would need to be treated to reduce the head pain associated with these causes.
Physical therapy is often prescribed by a doctor for a patient that has chronic headaches to reduce muscle tension in the upper neck, correct improper posture, and help with vertebral disc problems. As a physical therapist assistant, I have noticed that it is very common to see a patient with neck pain complaining of headaches, whether chronic or occasional. I have found that correcting improper posture is a huge factor in reducing the severity and frequency of a patient’s headache.
Correct posture should include relaxed shoulders, in a back and down fashion, reducing rounded shoulders. The chin should be slightly tucked, reducing a “forward head” posture. A simple exercise to pull someone out of “bad” posture is called "scapular retraction"; standing up straight, with eyes level, tuck the chin slightly, and squeezing the shoulder blades together. This exercise allows a person to feel what improper and proper posture feels like and how often they may come out of the correct posture.
When the head starts to creep forward and the chin starts to lift the cervical spine goes into extension and the muscles are being stressed and stretched. After years of this forward head posture, muscular tension builds and actually pulls on the base of the skull, causing headaches.
As we age, a narrowing of the spinal canal or spinal stenosis may occur. The spinal cord and nerve roots run through this canal and as it narrows the pain often associated with it is severe headaches and chronic neck discomfort. Along with postural exercises, manual techniques to help increase joint mobility would be performed during physical therapy. Stabilization exercises would also be given to strengthen the neck musculature to help maintain the head in its proper position with less fatigue and discomfort.
Headaches can be very debilitating and can occur for several different reasons. It is important to explain your symptoms to your doctor so the proper steps can be taken to reduce the discomfort. Remember that the headaches can come from the neck and this is the area that would need to be treated. MRI’s will show disc or vertebral problems that can be treated by way of physical therapy. Try the posture exercise given above; do you find your head creep forward after a few minutes? Or your shoulders start to round forward? Remember those muscles are working very hard to hold your head up all day, so help it out with proper posture!
Contributed by Krista Magnoli, PTA at The Physical Therapy Center of West Palm Beach