All in the head

Mid-winter 2021 has not been the most fun, has it? Coping with loadshedding on top of a Covid-19 third wave is enough to give anyone a headache.

Headaches are among the most common causes of pain in the world, as an article in PhysioPedia tells us: “Headache disorders are ranked as the third most disabling condition in people aged under 50 years old in the Global Burden of Disease Study.” Two out of every three people experience headaches – some pretty severe, like migraines and cluster headaches, which can be very debilitating. Many people experience cervicogenic headaches.

A cervicogenic headache is a ‘secondary headache’ which arises from problems in the cervical spine (the neck), usually due to stiff joints and muscles, or problems with the nerves in this area. The pain is referred from the neck to the head and face. The causes may be sustained posture (like sitting at your desk in one position for hours without a break) and repetitive movements. In times of stress and tension, we often hold a lot of tension in our neck muscles which can refer, metamorphosing into a headache which we may not even realise is coming from our neck. These headaches may also be associated with some sort of trauma (whiplash following an accident is one example), or problems with the temporo-mandibular joint, familiarly known to your physiotherapist as the TMJ. This is the joint that links your lower jaw to your skull, just below the level of your ear. And pain in this joint is commonly associated with stress and anxiety – we may not even be aware of doing things like grinding or clenching our teeth when we’re anxious, but the result can be a pain which translates into headache. Cervicogenic headaches may occur occasionally, or they may plague you for days, weeks or even months, till you find yourself popping pain pills frequently to cope with the pain. “Painkillers help as a temporary fix,” says Dr Ina Diener, past-President of the South African Society of Physiotherapy (SASP). ”But the ideal solution is to do something about the cause – those tight muscles and joints. Physiotherapists can do a great deal to relieve cervicogenic headaches.” As first-line practitioners (you don’t need a referral to see a physiotherapist) physios can diagnose and treat cervicogenic headaches with techniques that include:

  • – Mobilisation of stiff joints
  • – Release of trigger points
  • – Prescription of exercises aimed at strengthening, stretching and relaxing different muscles in the neck and shoulders
  • – Movements that help you become aware of how your head is positioned on your neck
  • – Assessment of your daily working posture (or other sustained position) and assistance with varying it
  • – Advice on stress management techniques

“Physiotherapists are also able to help with other headache conditions, like tension-type headaches, or even the spasm and muscle stiffness that often comes with migraines,” says Dr Diener. “It’s really worth consulting your physiotherapist for help with headaches!”

Article brought to you by the South African Physiotherapy Society!