It’s Just a Headache
Written by Robyn Atkinson
Headache is considered one of the most common disorders globally, however most headache sufferers do not seek treatment. Instead, they rely on over the counter medication to ease their pain - sometimes for many years without end. Unfortunately pain medication only masks the pain, with the underlying cause ready to trigger the head pain again. This merry-go-round of numbing the pain with pills is a widely accepted solution for headache pain…but should it be?
Think of pain as your body’s way of telling you that something isn’t right. Whether it’s repeated headache attacks, constant daily headaches or migraine, taking the time to investigate the cause of your headache can save you from future pain (and pills). Pain medication can be a quick and easy solution, but without addressing the root cause of the pain - your headache is likely to always return. Not to mention, most pain medication can exacerbate your headaches over the long-term (also known as medication overuse headache).
Headaches are classified as either primary or secondary. Primary headaches, such as migraine and tension-type headache have no known cause. Headaches from a known cause such as neck dysfunction or from pain medication overuse are classified as secondary headaches. With approximately 300 different types of headache however, it may be difficult to decide where to start looking for non-pharmaceutical relief. Luckily, there is a common feature between most headache types:
a sensitised trigemino-cervical nucleus (TCN)
- also known as the lower brainstem.
The lower brainstem extends into the spinal canal (down to the 3rd bone of the spine). Joint or muscle dysfunction in those top 3 levels of the neck will sensitise the TCN/lower brain stem causing pain to refer into the head, giving you a headache or migraine. Over time, sensitisation of the lower brain stem can lower the body’s threshold to hormones, stress, fatigue, wine, cheese etc. giving these factors the potential to cause a headache. But these triggers may not be the cause of your headache - your sensitised brainstem likely is!
Fortunately, physiotherapy can help headache sufferers. I, Robyn Atkinson, have been trained in the Watson HeadacheⓇ Approach. This method is an internationally renowned and researched method of examination and treatment for headaches. Its’ accuracy is unparalleled: specific tests can confirm upper neck disorders responsible for headache and migraine and isolate the specific joint/structure involved. The Watson HeadacheⓇ Approach utilises small amplitude techniques (no cracking or manipulation) to confirm involvement of the neck through reproduction and resolution of your usual head pain.
This targeted and gentle treatment to the upper neck, reduces sensitisation of the lower brainstem, leading to long-term resolution of your headaches, ability to return to what you love to do (and eat and drink!) without getting a headache or migraine. No more pills, no more avoiding the things that you love.
How do I know if my headache is coming from my neck or a sensitised brainstem?
Your headache may be caused by neck dysfunction if you experience any of the following:
Still not sure if the root of the problem could be within your TCN/brainstem? Consider these 4 headache myths:
Actually, you do not need to have neck pain in order to have a headache that is caused by neck dysfunction. Impairments in the neck joints, muscles or discs can sensitise the TCN/brainstem causing headache without causing neck pain. The best way to determine if your headache is coming from your neck is to receive a physiotherapy assessment. Your physiotherapist will confirm involvement of your neck through reproduction of your headache followed by alleviation of the pain by sustained pressure over the structures in the upper neck. Reproduction of pain followed by amelioration indicates neck dysfunction and an underlying sensitised TCN.
Associated symptoms such as nausea and dizziness have been found to improve with hands-on therapy in cases where the sensitised brainstem is responsible for triggering those symptoms. Furthermore, it is common for headaches to present with an overlap of headache type symptoms (i.e. migrainous and tension-type). Determining underlying neck dysfunction, regardless of the predominant headache classification or diagnosis, is crucial in the effective management of your headache.
Many headache sufferers that I see have been suffering from headaches for a decade or more. They may get them everyday or a couple times a month. Eventually, when they decide enough is enough - they seek help. Medicating for a headache seems harmless at the time, but how long would you be willing to employ this strategy? It is curious how pills have become synonymous with headache management (several different commercials come immediately to mind for me). We wouldn’t be satisfied with long-term pain relief for an injured ankle, but covering up headache symptoms has somehow become status quo. Is it possible that we have been conditioned to accept headache pain, when similar pain in other parts of the body would trigger us to find the cause rather than a temporary band-aid solution?
Relief from strategies such as massage, may only be part of the solution. If the headaches keep coming back, chances are the root cause has not been addressed. With the potential for multiple contributing factors, headache management should be individualised. In addition to hands-on therapy for the neck, physiotherapy can also provide relief from head pain through postural correction; advice on positioning when asleep or at your desk; strengthening exercises for the neck and shoulders; and self-management pain relieving strategies.
Should I consider other causes before booking a physiotherapy appointment?
You may consider seeing your optometrist if you haven’t had your vision checked recently or believe your headaches may be due to eye strain. On a more serious note, a very small percentage of headaches will have a more sinister cause that requires emergency care: if your headache is severe or came on suddenly without cause (within seconds), has been worsening or is unlike any other headache you’ve ever experienced - seek medical attention. If you’re not sure however, your physiotherapist will be able to guide you in the appropriate management of your head pain.
Effective treatment is available for the following headache types through The Headache Clinic:
To enquire or book an appointment, please call our friendly reception team on (09) 366 4480 and ask about The Headache Clinic or book online HERE.