We’re updating our post here seeing as the dreaded tension headache has become all too common in the work from home / COVID world we now find ourselves in.
If you’ve ever battled against a tension headache this will be familiar. The light and colour in your life just doesn’t seem as bright when the pressure and pounding in your head feels relentless. The good news is that tension headaches are treatable and even preventable. It’s something that physiotherapists treat every day in clinic. In this post we’ll take you through it.
Need relief from your tension headache?
What is a Tension Headache
A tension-type headache can be caused by many things, especially neck pain. It’s important to rule out other causes of headaches before treating the tension headache itself.
A tension headache is correctly known as a cervicogenic headache. It’s where the neck joints are suffering and sending messages to your central pain processing centre (in your brain) which is driving the pain response.
The exact statistics are a little varied but researchers have identified that between 5% and 22% of all headaches are tension-type headaches. This puts a tension-type headache up there with migraine headaches and primary headaches as the most common types of headaches.
What Causes Tension Headaches
We have a complex relationship between our spine, the nerves emanating from within the spine, the muscles that stabilise our neck and a few other smaller structures. When these structures get loaded outside their optimal zone of stress they transmit signals to our brain which interprets these and provides us with a pain response – a tension-type headache!
Sometimes this overload is due to the position we sit at for work, in front of computer monitors with our necks held in the same position for hours on end. Other times it’s from spending too long in the car with our car headrest tilting our neck into a position that it’s not comfortable being in.
And we can get a tension headache or neck pain if we don’t have enough strength in our neck muscles to stabilise our head and move it successfully.
How a Physio Treats a Tension Headache
A physio will perform a physical examination to determine why your neck muscles, joints or nerves are sending signals up to your brain which are being computed into a pain signal.
For many of us this would involve a careful assessment of your neck paying attention to posture, positioning and movement range and quality.
Depending on what areas need to be addressed your physio will develop a plan for you which might include manipulation of tender areas to change the signals being transmitted upstairs. This is usually a comfortable and gentle hands on massage of your soft tissues.
Your physio might then look to mobilise with exercises to increase the range and or quality of your neck joints.
Most importantly, your physio will look at what muscle strength is needed and what can be improved. This part is the most likely to have the biggest effect in the long term of not just fixing your current tension headache, but stopping them from returning.
Exercises To Fix a Tension Type Of Headache
In the following videos our Pascoe Vale physical therapist Dominic demonstrates a number of different exercises that can be used to fix tension headaches. As with any health advice, this is not specific to your needs. These are purely examples.
Gentle Neck & Shoulder Stretch
This exercise will provide temporary relief for tight feeling neck muscles. It’s not recommended for those with severe pain, sensitivity to light or migraine headaches.
Another early exercise to help get your stiff neck moving again. Completing spinal wave movements are useful for those who spend a lot of time looking up. That’s all you painters and cyclists out there.
The next level of physical activity to treat a chronic tension-type headache is to build up neck and muscle strength. Monkey shrugs are a must do exercise to build strength and resolve muscle tension.
Shoulder Strength Series
In this video Pascoe Vale physiotherapist Dom is demonstrating how to build up shoulder strength. Because of the cross over between the shoulder and neck muscles this will help in the long run. As you gain more strength you will have less severe headaches and be less reliant on pain medications.
If you’d like to learn more about exercises to resolve a stiff neck you can read about them here.
Does This Sound Like You?
The trick that almost everyone with tension headaches has tried before coming to a physio is to change their activities to the best of your abilities. If tension-type headaches and neck pain were purely caused by positions or movements then this would be an easy solve in most cases.
Often to get rid of tension-type headaches and prevent them coming back for good there will be a few changes that need to be made. Keeping a headache diary can help identify some of your causative factors. Your physio can combine this with your physical examination and medical history to develop a plan just for you.
Resolving any underlying stiffness or muscle weakness with exercises are effective treatments in the long term. Ensuring there’s no blockages in any blood vessels or visual disturbances from any related medical condition will give you the confidence to start on your path to being over your head pain. Tension-type headaches will be a thing of the past and you can enjoy your daily activities again.
What Else Can a Physio Do For My Severe Headache
You want more?
Working at the level of the tissues under load in the neck will provide amazing relief and respite for sufferers of tension headaches and neck pain. There is also another under utilised treatment area which can also be beneficial. Our brains.
Our brains are the only area in our body we truly feel pain. We do not have pain receptors in our neck, in our arms, our fingers or toes. We only have signalers which send information up to the brain, but none of these signals are yet pain signals! They’re purely bits of information our brain computes into a feeling, and pain is one of the most primal of all our feelings.
Our brain takes the signals from our tissues such as pressure, temperature or internal strain and then performs a complex equation where the output, a feeling is produced. Too much temp, pressure, strain or all three equals pain.
Now our brain also takes other signals into account when calculating what feeling and how intense it should be. Our level of rest, our levels of stress, our levels of nutrition all influence this equation. Importantly our own past history also influences this equation as well.
An example of this in action is someone who has previously had a lot of tension headaches who is sitting at their computer workstation for 4 hours. They missed lunch to work to a deadline. They didn’t sleep well due to stress from working too hard. There’s a very high chance that in this instance that person’s brain will perform the equation and it will equal a big bad neck-headache.
Let’s contrast this with someone who hasn’t had a tension headache before, they’re on holiday, sitting on the beach with their favourite book with their neck fixed in the same position reading for more than 8 hours. This person is rested, relaxed and has enjoyed a beautiful healthy meal. Their brain has likely received MORE temperature, pressure and strain signals coming to it than the former.
But, because of the other factors they are much less likely to suffer with a tension type of headache. If they do, it would be of a much lesser intensity.
Your expert physio can guide you through some clear goal setting and education to give you more control of your symptoms by helping you understand this complex relationship in much more detail than a blog post can provide.
And maybe your physio can prescribe a beach side holiday whilst they’re at it? If you are suffering with a neck-headache or neck pain book in with our expert Pascoe Vale physiotherapists for your consultation today.
Speed Round – Tension Headache FAQ
How long does a tension type of headache last?
It depends on many things including;
- The severity or presence of an initial injury/injury causing the muscle spasm.
- How quickly the muscles relax after treatment.
- Your current state of health.
- What else is going on in your life right now.
- Any medications you may be taking.
- And finally…your age.
Does taking anti-inflammatory drugs help a tension headache?
Yes, they can. The most common cause of headaches is muscle strain or spasm in the neck and shoulders. This type of pain usually responds to over-the-counter analgesics such as aspirin, ibuprofen, naproxen sodium, and paracetamol. These are available without prescription at your local chemist. If you have been diagnosed with an underlying medical condition that may be causing this problem, then your doctor will likely prescribe medication for you.
Should I see my doctor about my chronic tension headaches?
Chronic tension headaches are often related to the muscle spasm, weakness and stiffness we discussed above. Ensuring you are on top of these factors will go a long way to resolving your chronic headaches. That being said, your GP is an excellent source of advice and help as well as being able to identify if high blood pressure, blood clots or other neurological symptoms are involved in your recurrent headaches.
Having a supportive treatment team of yourself, your physio and your doctor gives you the best chance at resolving your headaches.
If you’re looking for treatment for your tension headaches then book in with our physiotherapy team today.