How to manage your headache

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How to manage your headaches

Headaches comprise one of the most common pain conditions worldwide and are a common cause for visits to medical practitioners and physiotherapists. According to clevelandclinic.org, up to 75% of adults would have experienced a headache in the last year, and headache is a major cause of absenteeism from work or school. Headaches are also common among children. Most children will have had a headache episode by the time they reach high school.

What causes headaches?

The mechanisms involved in the development of headaches have not yet been clearly established. There is an interaction between your brain, blood vessels, surrounding nerves and muscle tissue. The nerves seem to become hyper-reactive to various factors, or triggers. This results in pain in your head, face or neck. The pain may be throbbing, constant, sharp or dull, and range from mild to severe pain. Having a headache can be very frustrating and reduce your ability to concentrate or perform daily activities.

Many of us will recover from a headache episode. However, when headaches become a chronic, debilitating pain condition, it has a major impact on your work, social and family life, as well as your general well-being. Many people suffering from frequent headaches may experience depression and/or anxiety as a result thereof.

Due to its high prevalence, chronic headaches can have a negative impact on the socio-economic environment. The person suffering from frequent headaches will need time off work. The World Health Organisation (WHO) reports that headache disorders are among the 10 most disabling conditions in the general population. In women, headaches are one of the five most disabling disorders.

More than 150 types of headache disorders have been identified. In this blog, we will discuss the most common types of headaches, how they present, and what can be done to alleviate, treat and/or manage them.

Headaches are classified into 2 main categories:

Primary/ Vascular Headaches

This group is caused by a medical condition. The headache is the condition. Usually related to vascular (blood flow) changes.

Include:

  • Migraine headache
  • Cluster headache
  • Tension-type headache

Secondary/ Non-vascular Headaches

This group are related to another medical conditions or other factor such as exercise. Headache is a symptom.

Include:

  • Cervicogenic headaches (Neck pain)
  • Exercise-induced headache
  • Post-traumatic headaches (e.g. head injury)
  • High blood pressure
  • Sinus congestion headache
  • Tumour
  • Medication overuse headache
  • Infection
  • Disorders of the brain’s blood vessels

Headaches may be triggered by many things. Think of a glass of water. Each trigger fills your glass bit by bit. Eventually your glass overflows and causes a massive headache. Environmental triggers that may result in the development of a headache include certain foods (such as caffeine, alcohol, fermented foods, chocolate and cheese), exposure to allergens, secondary smoke, and strong odours (chemicals, perfume). Other common triggers include:

  • Changes in sleeping or eating patterns
  • Depression or emotional stress
  • Excessive use of medication
  • Poor or prolonged postures that places excess strain on your eyes, neck or back
  • Light or noise
  • Weather changes

Follow these 4 steps to treat and manage headaches without medication.

Step 1: Understand how headaches work.

Physiotherapists are equipped with skills and knowledge to help you determine what type of headache you may be suffering from. Once you and you physiotherapist understand the origin of your headache, you can treat and manage it more effectively.

Characteristics of the most common types of headaches are summarised in the table below:

Characteristics of Headaches

Step 2: Observe your posture

The majority of us work at a desk and in front of a computer. A study done in 2007 showed that people with chronic neck pain demonstrate a reduced ability to maintain an upright posture. They also found that these people have a more forward-head posture, which is a known causative factor in the development in neck pain and therefore headaches. When you have a forward-head posture, your head is in fact much heavier to carry. This causes the muscles in your neck to work extra hard to carry your head. Stiffness and tension in your neck muscles can trigger a headache.

Make sure to change your posture regularly during working hours, and make sure to get up and move around or stretch every half-hour to an hour.

Please see the guidelines below for optimal workplace setup. This will help to avoid build-up of tension in your neck, back or shoulders, and ultimately assist in preventing the development of a headache.

Fig 2: How to set up your work station.

Correct posture at workstation

Step 3: Do regular physical activity

Female athleteResearch repeatedly shows that regular exercise can reduce stress and improve general well-being. Stress-related muscle tension can aggravate or lead to the development of a headache. Regular physical activity helps release endorphins, which are our natural “feel-good hormones”. Physical activity also stimulates blood flow, improves mobility and strength of muscles and connective tissue, and promotes a healthy nervous system.

Physical activity can be anything, as long as you move your body! Find something that works for you. Try to accumulate physical activity throughout your day e.g. go for a walk outside during your lunch hour or when you take a call, perform a few chair squats or wall push-ups when you get up to make a cup of coffee, take the stairs instead of the elevator or park your car at the furthest parking.

Your physiotherapist can also develop an exercise program specific to your needs.

Step 4: Book an appointment with a physiotherapist

Physiotherapy has been shown to be immensely helpful in the treatment of headaches. Research shows that people suffering from headaches, who receive regular physiotherapy treatment, need less medication to manage their headaches.

Most people reach for medication once a headache arises. In some instances, medication is necessary. Our aim is to reduce your need for medication, and provide alternative, healthier and more long-term strategies to alleviate, treat or manage your headaches.

What can you expect from your physiotherapy session?

At Just Physio we do a thorough evaluation at your first consultation. This includes discussing your history and onset of pain, as well as factors that may contribute to the development of your headache. Your physiotherapist will then assess your neck, shoulders, jaw and spine to observe for stiffness or dysfunction in the joints, muscles and nerves.

Treatment will involve identifying your specific headache triggers, and implementing strategies to avoid or manage these. Your physiotherapist will address associated joint and muscle tension in your neck, jaw, shoulders and upper back. This is done by using massage, joint mobilisation techniques, dry needling, electrotherapeutic modalities, and specific exercises and stretches. We may incorporate relaxation and breathing techniques to further assist tension release. We also teach you self-management strategies to prevent or treat future episodes.

Remember the glass of water? Physiotherapy helps to empty your glass again! It is important to remember that physiotherapy treatment is not a quick-fix. We recommend that you start by attending 2 sessions per week, and gradually reduce the frequency of your sessions. In this way we prevent your glass from overflowing.

Each patient is unique and different, therefore a treatment program will be developed according to the specific needs of each of our patients.

Call to book your appointment with one of the physiotherapists at Just Physio today!

Book at Just Physio!

By attending physiotherapy, looking at your posture and doing exercises you will be able to manage your headaches without medication! Book now and take the first step in managing your headache without medication.

References:

  1. https://www.pogophysio.com.au/blog/the-most-common-types-of-headaches/
  2. https://www.who.int/news-room/fact-sheets/detail/headache-disorders
  3. LJ Stovner et al. 2007 Mar. Available at: https://pubmed.ncbi.nih.gov/17381554/
  4. https://www.medicalnewstoday.com/articles/vascular-migraine
  5. https://academic.oup.com/ptj/article/87/4/408/2742122

Written By: Adrien Dannhauser (BPhyst, SPT1) and Marelize Maritz (BPhyst)