Tension Headache

Tension Headache

Article by John Miller

What is a Tension Headache?

A tension headache is the most common form of primary headache. It happens intermittently in up to 80% of the population. As the symptoms are not as severe as a migraine, Tension Headache is a problem if it becomes frequent or chronic.

What are the Symptoms of a Tension Headache?

Frequent Tension Headache is recognised when the sufferer has experienced at least ten headaches in one month. There are varying degrees of frequency and chronicity.

Chronic Tension Headache sufferers report headaches on more than 180 days in a year. Tension Headache pain tends to be bilateral and pressing or tightening in nature. It is of mild to moderate intensity and will not manage to interrupt work.

Tension Headache sufferers can experience symptoms associated with migraines. Symptoms include nausea and photophobia (hypersensitive to light) or phonophobia (hypersensitive to sound). But usually, only one of these symptoms.

How is a Tension Headache Diagnosed?

tension headache

There is no one specific test that identifies tension-type headaches. Your diagnosis will be made based on your health professional’s interpretation of your symptoms and how you respond to different treatments.

What about X-rays, CT scans and MRI?

Unfortunately, X-rays, CT scans and MRI’s are not diagnostic of a tension headache. You can suffer a tension-type headache with or without some abnormal findings on X-rays or scans. Likewise, scan abnormalities do not guarantee that you will experience a tension headache.

However, X-rays and scans may identify structures that could potentially be causing your tension-type headache. We recommend that you have at least cervical spine X-rays if you have been suffering headaches or head pain for any extended period.

How Can Physiotherapy or Massage Help You?

Quality neck physiotherapy or massage can have a rapid and effective result for relieving your tension headache through muscle relaxation under excessive tension. It is also important to remember that excessive muscle tension will compress, distort or irritate joint structures that cause neck headache, which will further complicate your symptoms.

Your tension-type headache treatment may include all or some of the following techniques:

  • Stiff neck joints may need to be loosened or unlocked via joint mobilisation (gentle gliding techniques), joint traction or, in specific cases, a soft and localised joint manipulation technique.
  • Hypermobile (or dynamically unstable) joints may require specific deep neck muscle strengthening exercises to stabilise, control and limit the joint movement available.
  • Tight or overactive muscles may require stretching, massage, acupuncture, dry needling, or other relaxation techniques.
  • Weak muscles may require specific strengthening exercises. This weakness may include your postural shoulder blade and neck muscles.
  • Nerve dysfunction depending upon your specific examination findings. Neurosensitivity is a common finding that needs to addressed with attentive, professional care.
  • Posture correction may be recommended via specific exercises, posture awareness techniques, taping or a posture brace.
  • They provide you with helpful advice on preventing neck dysfunction in the future, e.g. awkward neck positions and postures to avoid.

What if Physiotherapy or Massage Can’t Help You?

Since there are over 300 sources of a headache, and tension-type headache is responsible for some.

You may also be suffering from a mixed or multi-source headache. In these instances, your neck headache, another source of your head pain, could linger.

Your physiotherapist will advise you if you have symptoms that could indicate a different cause for your headache. These instances will also direct you towards further investigations or tests that may assist your diagnosis and subsequent treatment.

Mixed Headache-Migraine Types

You can simultaneously suffer one, two or more types of headache or migraine.

One type may cause another or overlap with another. For example, a painful neck can cause an increase in muscular tension, which will increase your blood pressure. In this scenario, you would be suffering a neck headache + tension headache, + migraine!

In our experience, finding the primary source of your headache or a migraine is the key to successful management.

Can an Unsupportive Pillow Cause Tension-Type Headaches?

Yes. Unfortunately, a non-supportive pillow or one not suited to your neck can predispose you to neck pain or tension-type headache.

If you suffer neck pain or headache, it is wise to ask for your physiotherapist’s professional advice regarding what pillow style and size they would recommend for you.

Pillows do vary, and the best one for your neck shape and body size will help you prevent neck pain and neck headache.

More Info

What Causes Cervicogenic Headache?

How Do You Get Rid Of A Neck Headache?

When Should You Be Concerned About A Headache?

Article by John Miller

What's Causes Cervicogenic Headache?

Your neck headache originates from a variety of musculoskeletal and neurovascular structures. These structures include the upper three neck joints, C2/3 disc, spinal cord coverings, and neck muscles. Dysfunction in these areas can trigger pain signals that travel to your trigeminocervical nucleus (TCN) in your brainstem. This information is then transmitted into your brain and interpreted as a headache (Bogduk 2003).

Upper Neck Joints

cervicogenic headache

The most likely source of your neck headache is a dysfunction of your upper neck joints. Your neck muscles or nerves become involved from pain signals that travel to your trigeminal nucleus in your brainstem, where you interpret the pain signals as a neck headache.

The most common cause of a neck headache is the dysfunction of your upper three neck joints. The most common neck joints involved are your:

  • atlantooccipital joint (O-C1),
  • Atlanto-axial joint (C1/2), and
  • C2/3 cervical spine joints.

In simple terms, your neck joints can cause a neck headache or pain if they are either too stiff or move too much (e.g. wobbly and unsupported by weak muscles) or locked in an abnormal joint position, e.g. a locked facet joint or poor neck posture. Once your neck joint becomes stressed and painful, the pain signals refer to the trigeminocervical nucleus in your brainstem. You start to feel a neck headache or, in some cases, face pain!

Your neck and headache physiotherapist can assess and correct neck joint dysfunctions that result in a neck headache. Their professional diagnosis and treatment are essential for neck headache sufferers.

Neck Muscles

Your neck and shoulder blade muscles that originate from your neck will cause pain if they are overworking, knotted or in spasm. Some of your neck muscles overwork when protecting injured neck joints. Other neck muscles become weak with disuse—this further demands your overworking muscles resulting in muscle fatigue-related symptoms. Your deep neck flexors are frequently weak or lack endurance. Your neck muscles work best when they have healthy resting tension, length, strength, power and endurance.

Your skilled physiotherapist assesses and helps you correct any muscle imbalances that result in a neck headache.

Cervical and Occipital Nerves

Nerves in your upper neck may become pinched by extra bony growths, e.g. arthritis, disc bulges or swelling. The results can result in nerve irritation or a reduction in the neural motion known as neuromechanosensitivity or abnormal neurodynamics. Irritation of your upper neck structures refer to pain messages along the nerves and cause your headache. In simple terms, your neck is the "switch", nerves are the "power cords", and your headache is where the "light" comes on.

Your headache physiotherapist can assess your neuromechanosensitivity.

More info:

Headache & Migraine

Neck Headache

Jaw Headache

Article by John Miller

How Do You Get Rid Of A Neck Headache?

Quality neck physiotherapy can have a speedy and effective result for relieving your neck headache—the key to better treatment response in confirming your diagnosis. After your assessment, your physiotherapist will start you with treatment techniques that address your problems.

Your neck headache treatment may include all or some of the following techniques:

Who Treats Cervicogenic Headaches?

In addition to relieving your neck headaches, your physiotherapist aims to address why you are experiencing neck headaches. After all, helping you to avoid future neck headaches is a crucial component of your rehabilitation. Chronic headache sufferers typically resolve their neck headaches within days or weeks.

Relief of your neck headache is quite often immediate! If a neck headache solely causes your trouble, it is common to experience instant relief as you walk out of the clinic.

Depending on the severity and the specific underlying causes of your neck headaches, most sufferers will experience a reduced headache after your initial consultation.

For more information, please consult your neck headache physiotherapist.

More info:

Headache & Migraine

Neck Headache

Jaw Headache