Help! My Head Hurts....Too Much Stress!

Are you stressed out from work or school? Do you get headaches that are increasing in frequency and related to stress and tension? If so, you may be suffering from the most common type of headache, the muscle tension headache.  This type of headache affects 25 million people in the US.  It usually peaks in men and women, aged 30-40 years of age and also increases with the level of education (most likely because higher educated people usually think wayyyy too much...I can vouch for that!).  These headaches occur as a response to stress. Who doesn't have stress this day and age? Since we are overworked, overbooked, and don't sleep enough, stress can add up causing pain and muscular tension. 

So what defines this type of headache, you ask?  The type of pain you feel is brought on by stress, anxiety, tension, or other factors, is moderate in intensity, and doesn't increase with activity level.  It occurs chronically (repetitively), is on both sides of the head, feels like your head is being squished (vice-like), does not feel like it's pulsing, and muscle spasm is involved.  The tension headache can last from 30 minutes up to 7 days, but usually you have fewer than 15 headache days per month, unless trauma or injury is the cause of this type of headache.  This headache is most common when you are an adult, but can really occur at any age. Let's face it, as you age, you have more stress because life becomes more real and can freak you out.  There is so much more to think about as an adult, unlike as a child where all you care about are insects, scraped knees, and playing with toys....ohhh how those were the good old days.  Back to reality though...this increase in age and stress level causes these terrible headaches.  If you have been in a car accident and had whiplash, you can also start to get tension headaches, but the symptoms can change a bit if that's the case. 

So hmmm...since stress is the culprit here, what exactly causes this headache? Stress itself or chemical changes in the body? Well, there are mixed results from research that can help describe the possibilities, however, it is still unclear.  It could be disturbance in hormones related to the hypothalamus, brain stem, and spinal cord.  It could be caused by changes in the circuits that occur inside the brain.  It has been shown that chemical signals are abnormal during tension headaches, so that could be the cause or effect...hmmm I guess we really don't know.  It is all still being researched.  You will find that most people with headaches have difficulty finding treatments, especially if they are migraines.  My mom is one of these people that struggles to find the answer.  Hopefully with further research, there will be an answer and these headaches will melt away....or one can only hope and pray that is the case.   

So why is a PT talking about headaches? Well, there is something I can do for you if you have tension headaches....something that research actually shows is helpful! Yayyy for an answer for some people!  People with tension headaches, often have poor posture.  As discussed in my post about Work Place Ergonomics (http://www.mononarehabpt.blogspot.com/2012/02/work-place-ergonomics-101.html), posture is very important in maintaining good spinal alignment.  Your head weighs 8-10 pounds (depending on how big your noggin is!).  If you sit all day with your head forward (ears don't line up with your shoulders), gravity pulls on it and all of the muscles in the back of the neck that attach to your head have to hold that sucker up.  Do you know how much tension you are placing on them? A lot...let's just say that.  No wonder they are irritated! Postural education is only the beginning of where I begin with patients.  Next, I evaluate spinal alignment because some muscles that are innervated by the nerves in the upper cervical spine (top of the neck) are usually angry for a reason, if it's not just because of posture.  If any vertebrae are misaligned or caught up by tight tissue, they need to be mobilized (so I get them moving!). There are several manual techniques I can perform to loosen up the spinal joints and get things moving properly again.  If I can't fix the alignment with my techniques, I will refer you to a chiropractor (they are pretty darn helpful, if you coincide chiropractic adjustments with strengthening exercises provided by a PT).   I also perform some soft tissue mobilizations (oooo massage!) to help loosen up the irritated tissues.  A combination of stretches, soft tissue mobilizations, joint mobilizations, and strengthening of the muscles in the mid-back are usually very successful at improving posture and relieving these tension headaches. 

Along with physical therapy, it is important to control stressors in your life.  Regular exercise, yoga, deep breathing, and making sure you're organized will help reduce stress in your life.  Check out http://igo-fitness.com/yoga.html and join a yoga class.  They are fantastic to help reduce stress, improve flexibility, and increase overall mindfulness.  Massages are also a great way to help reduce muscle tension, however the effects are only temporary if you don't fix the underlying problem. Check out Groupon for massage deals in your area.  Also, a healthy diet and regular sleep schedule are necessary to improve your well-being and helps to regulate your body's hormones properly.  You can also make your muscles happy by checking out my post on loving the foam roll (http://www.mononarehabpt.blogspot.com/2012/04/love-foam-roll.html). This foam roll can help loosen up some muscles in the upper back that attach to your neck and head.  If you are struggling with tension headaches, see your doctor for a script for physical therapy and come see me.  The sooner you start physical therapy, the less chronic your condition becomes.  Pain medicine is only temporary and only masks the problem if not used with other treatments such as massage, physical therapy, and chiropractic care.  Come see me and I will help make your tension melt away.  Give me a call today at 608-222-2325 or email me at mononarehabpt@gmail.com.

Resources:

Image from Google Images (Tension Headaches)

Goodman, Fuller, Boissonnault, Pathology: Implications for the Physical Therapist, 2nd Edition, Philadelphia, Saunders, 2003