5 Common Tension Headache Patters - & How to Relieve Them Naturally
If you've ever had a headache that hijacks your day, you're not alone - and you're definitely not imagining it. Lately, I've seen more people reaching out about headaches. They can be mildly annoying to life-altering. I’ve seen people come in for treatment with discomfort that causes irritability and lack of focus, and I’ve seen people whose lives have been changed to the point of being out of work, and unable to do many daily tasks.
There are many kinds of headaches, which makes treatment a complicated process. I'll focus on tension headaches in this blog, but there are other kinds as well. First, we need to determine the type of headache. Migraines, cluster headaches, and tension headaches are the most common, and they are seen frequently in the clinic. Cluster headaches are intense, stabbing pain, usually on one side of the face. They occur in groups or cycles. Migraines are often deep and throbbing, and they are often accompanied by nausea, vomiting, and visual disturbances. Many people come in thinking they have migraine headaches, but they turn out to be tension headaches. Tension headaches can mimic migraines, but they have a predictable pattern. Tension headaches are probably the most common type of headache, and one of the easiest to treat. They usually originate in muscles of the neck, and radiate into specific patterns in the head. In this blog, we’ll discuss five most common patterns seen in tension headaches, as well as what to do about it, and how to prevent them.
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This muscle travels up the back of your neck and attaches into the base of your skull. It functions to keep your head upright.
What it feels like: Trigger points in this muscle typically refer to the top of your head. It feels like there is pressure pushing your head down.
Why it happens: This trigger point is usually activated by chronic postural strain like a forward hunch, spending a lot of time looking down, or straight up. We see a lot of desk workers, as well as tradies with these trigger points and this headache. It is also common in whiplash and trauma.
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Similar to Splenius Capitis above, Splenius Cervicis also travels up the back of your neck. It stops short of your skull, though, so it doesn’t directly move the head. It does keep the neck upright.
What it feels like: Trigger points usually refer to the back of the head, around the base of the skull. They also refer into the eyes.
Why it happens: They are also caused by whiplash and trauma, as well as postural strain.
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The headache caused by the Upper Trapezius muscle is one of the most commonly seen. Upper Trapezius is a huge muscle, and it does many tasks. It holds your head up, and it also helps to lift your shoulders up.
What it feels like: The referral pattern of Upper Traps is typically up the back of the neck, around the ears, and into the temples. If you find yourself trying to apply pressure to your temples to relieve your headache, it may be caused by this trigger point further down your shoulders.
Why it happens: It’s often activated by postural strain, like the head forward posture, or spending a fair bit of time with your arms above your head. We also see it in whiplash and trauma, and it often shows up when exposed to cold temperatures. It was seen a lot in Canada during the winter, but it’s also seen in Australia during the summer due to cold A/C blowing on people. Watch those fans and the direction of your A/C. If you can’t adjust the flow, wear something to protect your neck and shoulders from that cold breeze.
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This headache is mean and often misdiagnosed. After blood pressure and eye issues are ruled out, many people are left frustrated not knowing what is causing these headaches. The suboccipitals are a group of tiny muscles at the base of your skull. They create little bobble-head movements in your head, and help your head to track with your eye movements. Think of them like your head’s stabilising camera gimbal! If you watch someone reading on a screen carefully, you will see little movements side to side as they read line by line.
What it feels like: It feels like pressure behind your eyes and forehead.
Why it happens: Prolonged screen use can contribute to these trigger points, as well as postural strain and whiplash.
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The Sternocleidomastoid muscle, or SCM, travels from your sternum or breastbone, and your clavicle or collar bone, up to a point in your skull right behind your ears, called the mastoid process.
What it feels like: This one is probably my favourite trigger point to release in clients because of the vast array of symptoms it causes. It not only causes a headache pattern around the ears, into the temples, and into the face, it can also cause some strange symptoms. Some of these symptoms can include dizziness, ringing in the ears, visual disturbances, and even feeling like you have something stuck in your throat. As you can imagine, many people wouldn’t think to see a massage therapist for these kinds of issues.
Why it happens: As the muscles above, these trigger points are commonly activated by postural strain and trauma, but it can also be activated by tight collars. Of note, another common activation of these trigger points is respiratory muscles. Because of the positioning of this muscle, it also acts as an accessory respiratory muscle. So, if someone is chronically coughing or hyperventilating, this muscle quickly becomes overworked. Common conditions that can cause this are COPD, asthma, and anxiety.
When we look at the major patterns through all these headaches, there seem to be some common factors. Postural strain is seen in all of them, so when we look at life changes, we know we need to strengthen the stabilising muscles of the neck and shoulders. Trauma is also best treated this way, to rebuild stability after the incident. Start by activating these muscles by squeezing your shoulder blades together behind you, and imagine yourself tucking them into your back pockets. Tilt the chin and lift the back of your head up. I like to call this the upper body reset. You can do it often at moments in your day.
Another great adjustment would be your workspace. If you work at a computer, consider moving your screen up to eye level, and closer to your body. This limits slouching to get closer to the screen. Despite how it may act sometimes, your computer doesn't feel pain. You do! Let it work for you, not against you.
Treatment in the clinic is done with ischemic compressions of the trigger points. It is like dry needling, but without the invasive needle. We find the trigger point in the muscle and press into it. You will often feel your headache for a bit, but you will also feel it go away. After it goes away, we check for any remaining headache and treat those areas. It's followed by a stretch of the affected muscles, and you are on your way!
This is not an exhaustive list, and there are many other muscles that cause different headache patterns. If you’re not sure what you are dealing with, discuss it with your healthcare practitioner, or contact us for a free 15 min consultation.
Please have any sudden or severe headache checked by your doctor or go to the ED.
