There are many different types and causes of headaches. The National Health Service in the UK has reported that the highest incidences of headaches are tension type and neck related.
As an Osteopath, the history taking is very important in making an accurate diagnosis. Headaches can be:
- Tension: Muscular contraction
- Vascular: Migraine and cluster headaches
- Cervicogenic: Referred from the neck
- Pressure/ Inflammatory: Tumour, infection
- Cranial Neuralgia: TMJ joint or muscle pain trigeminal neuralgia
- Eyestrain, sinus problems and dehydration can also cause headaches.
After a detailed history tests and examination, an osteopath will decide whether the headaches have a musculoskeletal origin and can be treated by an osteopath, or whether further tests are required by your GP.
Musculoskeletal Causes Of Headaches
Cervicogenic headaches are usually one sided and referred to the head from soft tissues and joints of the neck. Contracted muscles can refer pain into the head from the suboccipital region.
Tension headaches usually cause pain at the base of the skull which can radiate into the forehead and temple. Pain can be referred from trigger points in the scalene muscles, trapezius, suboccipital and other muscles in the neck and shoulders.
Both types of headaches are often associated with poor posture involving rounded shoulders and a head forward posture which is often related to prolonged periods of time spent sitting at desks and computers. Stress is also a contributing factor, as muscle tension increases when the nervous system is overloaded.
Temperomandibular Joint (TMJ)
The TMJ controls chewing and movement of the jaw with the aid of surrounding muscles. Injury to the jaw or muscles of the head and neck; grinding/ clenching your teeth and stress can lead to temporomandibular problems, as the balance between teeth, muscle and joints are altered. This can lead to inflammation of the joint and subsequent face or head pain.
The majority of headaches occur due to tension and poor posture. Osteopathy is ideally placed to provide treatment and relief in these areas. Prolonged muscle tightness in the neck leads to compression within joints and nerves, which causes pain. It also restricts movement of fluids particularly blood and lymph, and poor circulation affects oxygen to the brain and prevents waste product removal which also creates pain and discomfort.
Trials have shown that a combination of manual therapy such as osteopathy, alongside an exercise program, leads to a long- term control of tension type headaches. Osteopaths use a variety of techniques to help ease headaches, from manipulation of the joints in the neck and upper back, to gentle soft tissue and trigger-point release work. Specific stretch exercises are usually given with advice on posture correction as well as an exercise regime to strengthen muscles in the neck and shoulder regions. This is essential, as stronger muscles will have more resilience and provide greater support to the skeleton to allow good sitting posture.