Headaches are commonly categorized as tension, migraine or sinus in origin. They may also be caused by a pathological disease process that is far less common than the other three causes.

Tension headaches are typically caused by physical or emotional stress. This includes factors such as eyestrain, poor posture, a neck injury like whiplash, or even conditions such as temporomandibular joint dysfunction. Migraine headaches, while vascular in origin, are often triggered or exacerbated by hypertonic soft tissue in the cervical region. Sinus headaches arise from increased pressure in the sinus cavities around the nose and eyes. It is not uncommon to find myofascial trigger points in the suboccipital and posterior scalenes region that refer to the sinuses and either initiate or aggravate a sinus headache.

Tension headaches are the most common type of headaches. Quite simply, tightness in the neck and shoulder muscles seems to be the most direct cause. In our experience, myofascial trigger points in any of the muscles of the neck and shoulders can “trigger” pain in the head, whether it be behind the eyes, at the base of the skull, toward the back or side of the head or that “tight band” around the head. Deactivating these trigger points and relieving tension in the muscles through therapeutic massage can frequently decrease the frequency and intensity of tension headaches.

Aggravating factors include: Headaches can also be initiated by certain foods and food additives (chocolate, nitrates, aspartame, etc.), medication interactions, lack of adequate water intake, skipping meals, smoking and drinking alcohol.

Self-health Measures: The most obvious, yet the most difficult measure to decrease or eliminate headaches is to slow down and have regular periods of rest and relaxation. Quite simply, try to eliminate one of the elements in the stress-tension-pain cycle.

Tension headaches also can be decreased or eliminated through a number of methods:

• Implementing a regular and moderate exercise program.
• Utilizing meditation.
• Reducing caffeine intake.
• Eating more whole foods and fewer fast or processed foods.
• Sitting quietly to eat meals, avoid eating on the run.
• Increasing flexibility in the neck and shoulder muscles.
• Cessation of smoking and tobacco use.
• Improving workplace ergonomics.
• Establishing regular sleep and wake patterns.
• Making time for relaxation, hobbies and varied recreational activities.
• Receiving periodic therapeutic massage or bodywork.
• Developing a trusting, emotional support outlet with friends, family or a therapist.

Stretching Recommendations: Doing the neck and shoulder routines daily as can create considerable relaxation and flexibility in the neck muscles, thereby producing an improvement in frequency, duration and intensity of headaches.

By Jill Bielawski and Jerry Weiner

Originally published in Massage & Bodywork magazine, February/March 2000.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.

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