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Headaches & Treatments

Back Clinic Headaches & Treatment Team. The most common cause of headaches can relate to neck complications. From spending excessive time looking down at a laptop, desktop, iPad, and even from constant texting, an incorrect posture for extended periods of time can begin to place pressure on the neck and upper back, leading to problems that could cause headaches. The majority of these types of headaches occur due to tightness between the shoulder blades, which in turn causes the muscles on the top of the shoulders to tighten and radiating pain into the head.

If the source of the headaches is related to a complication of the cervical spine or other regions of the spine and muscles, chiropractic care, such as chiropractic adjustments, manual manipulation, and physical therapy, can be a good treatment option. Also, a chiropractor may often follow up chiropractic treatment with a series of exercises to improve posture and offer advice for future lifestyle improvements to avoid further complications.


Migraine Physical Therapy: Relieving Pain and Restoring Mobility

Migraine Physical Therapy: Relieving Pain and Restoring Mobility

For individuals who suffer from migraine headaches, can incorporating physical therapy help decrease pain, improve mobility, and manage future attacks?

Migraine Physical Therapy: Relieving Pain and Restoring Mobility

Migraine Physical Therapy

Cervicogenic migraine headaches can cause pain, limited motion, or confusing symptoms like dizziness or nausea. They may originate from the neck or cervical spine and be called cervicogenic headaches. A chiropractic physical therapy team can assess the spine and offer treatments that help improve mobility and decrease pain. Individuals may benefit from working with a migraine physical therapy team to perform treatments for specific conditions, quickly and safely relieving pain and returning to their previous level of activity.

Cervical Spine Anatomy

The neck is comprised of seven stacked cervical vertebrae. The cervical vertebrae protect the spinal cord and allow the neck to move through:

  • Flexion
  • Extension
  • Rotation
  • Side bending

The upper cervical vertebrae help support the skull. There are joints on either side of the cervical level. One connects to the back of the skull and allows motion. This suboccipital area is home to several muscles that support and move the head, with nerves that travel from the neck through the suboccipital area into the head. The nerves and muscles in this area may be a source of neck pain and/or headaches.

Symptoms

Sudden motions can trigger symptoms of cervicogenic migraine, or they may come on during sustained neck postures. (Page P. 2011) The symptoms are often dull and non-throbbing and may last several hours to days. Symptoms of cervicogenic migraine headache may include:

  • Pain on both sides of the back of the head.
  • Pain in the back of the head that radiates to one shoulder.
  • Pain on one side of the upper neck that radiates to the temple, forehead, or eye.
  • Pain in one side of the face or cheek.
  • Reduced range of motion in the neck.
  • Sensitivity to light or sound
  • Nausea
  • Dizziness or vertigo

Diagnosis

Tools a physician may use may include:

  • X-ray
  • MRI
  • CT scan
  • Physical examination includes neck range of motion and palpation of the neck and skull.
  • Diagnostic nerve blocks and injections.
  • Neck imaging studies may also show:
  • Lesion
  • Bulging or herniated disc
  • Disc degeneration
  • Arthritic changes

Cervicogenic headache diagnosis is usually made with one-sided, non-throbbing headache pain and a loss of neck range of motion. (Headache Classification Committee of the International Headache Society. 2013) A healthcare provider may refer the individual to physical therapy to treat cervicogenic headaches once diagnosed. (Rana M. V. 2013)

Physical Therapy

When first visiting a physical therapist, they will go through medical history and conditions, and questions will be asked about the onset of pain, symptom behavior, medications, and diagnostic studies. The therapist will also ask about previous treatments and review medical and surgical history. Components of the evaluation may include:

  • Palpation of the neck and skull
  • Measures of neck range of motion
  • Strength measurements
  • Postural assessment

Once the evaluation is completed, the therapist will work with the individual to develop a personalized treatment program and rehabilitation goals. Various treatments are available.

Exercise

Exercises to improve neck motion and decrease pressure on cervical nerves may be prescribed and may include. (Park, S. K. et al., 2017)

  • Cervical rotation
  • Cervical flexion
  • Cervical side bending
  • Cervical retraction

The therapist will train the individual to move slowly and steadily and avoid sudden or jerky movements.

Postural Correction

If forward head posture is present, the upper cervical spine and the suboccipital area could compress the nerves that travel up the back of the skull. Correcting posture may be an effective strategy for treatment and can include:

  • Performing targeted postural exercises.
  • Utilizing a supportive neck pillow for sleep.
  • Using a lumbar support when sitting.
  • Kinesiology taping may help increase tactile awareness of back and neck position and improve overall postural awareness.

Heat/Ice

  • Heat or ice may be applied to the neck and skull to help decrease pain and inflammation.
  • Heat can help relax tight muscles and improve circulation and may be used before performing neck stretches.

Massage

  • If tight muscles are limiting neck motion and causing head pain, a massage can help improve mobility.
  • A special technique called suboccipital release loosens the muscles that attach the skull to the neck for improved motion and decreased nerve irritation.

Manual and Mechanical Traction

  • Part of the migraine physical therapy plan may involve mechanical or manual traction to decompress the neck’s discs and joints, improve motion in the neck, and decrease pain.
  • Joint mobilizations may be used to improve neck motion and manage pain. (Paquin, J. P. 2021)

Electrical Stimulation

  • Electrical stimulation, like electro-acupuncture or transcutaneous neuromuscular electrical stimulation, may be used on the neck muscles to decrease pain and improve headache symptoms.

Therapy Duration

Most migraine physical therapy sessions for cervicogenic headaches last about four to six weeks. Individuals may experience relief within a few days of starting therapy, or symptoms may come and go in different phases for weeks. Some experience continued migraine headache pain for months after starting treatment and use techniques they learned to help control symptoms.

Injury Medical Chiropractic and Functional Medicine Clinic specializes in progressive therapies and functional rehabilitation procedures focused on restoring normal body functions after trauma and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our natural programs use the body’s ability to achieve specific measured goals. We have teamed up with the city’s premier doctors, therapists, and trainers to provide high-quality treatments that empower our patients to maintain the healthiest way of living and live a functional life with more energy, a positive attitude, better sleep, and less pain.


Chiropractic Care For Migraines


References

Page P. (2011). Cervicogenic headaches: an evidence-led approach to clinical management. International journal of sports physical therapy, 6(3), 254–266.

Headache Classification Committee of the International Headache Society (IHS) (2013). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia : an international journal of headache, 33(9), 629–808. doi.org/10.1177/0333102413485658

Rana M. V. (2013). Managing and treating headache of cervicogenic origin. The Medical clinics of North America, 97(2), 267–280. doi.org/10.1016/j.mcna.2012.11.003

Park, S. K., Yang, D. J., Kim, J. H., Kang, D. H., Park, S. H., & Yoon, J. H. (2017). Effects of cervical stretching and cranio-cervical flexion exercises on cervical muscle characteristics and posture of patients with cervicogenic headache. Journal of physical therapy science, 29(10), 1836–1840. doi.org/10.1589/jpts.29.1836

Paquin, J. P., Tousignant-Laflamme, Y., & Dumas, J. P. (2021). Effects of SNAG mobilization combined with a self-SNAG home-exercise for the treatment of cervicogenic headache: a pilot study. The Journal of manual & manipulative therapy, 29(4), 244–254. doi.org/10.1080/10669817.2020.1864960

Discover the Benefits of Craniosacral Therapy for Pain Relief

Discover the Benefits of Craniosacral Therapy for Pain Relief

For individuals suffering from neck pain and headaches, can craniosacral head massage therapy help provide relief?

Discover the Benefits of Craniosacral Therapy for Pain Relief

Craniosacral Therapy

Craniosacral therapy is a gentle massage to release fascia or connective tissue network tension. The therapy is not new but has gained new attention because of the public interest in natural pain treatments and therapies. Studies are limited, but clinical research is ongoing to see if the therapy can become a mainstream treatment option. The therapy aims to alleviate the symptoms of various health ailments and conditions, including:

  • Headaches
  • Neck pain
  • Complex regional pain syndrome – CRPS
  • By relieving compression in the lower back, head, and spinal column, cerebrospinal fluid circulation is restored, and the body rhythms within the nervous system are reset. This provides pain relief, lowers stress, and improves overall well-being.

Massage Objectives

Several conditions and ailments said to benefit from craniosacral therapy include (Heidemarie Haller et al., 2019) (Heidemarie Haller, Gustav Dobos, and Holger Cramer, 2021)

  • Headaches
  • Migraines
  • Chronic pain conditions
  • Stress-related disorders
  • Anxiety
  • Depression
  • Tinnitus – ringing in the ears
  • Dizziness
  • Infantile colic
  • Gastrointestinal disorders
  • Attention deficit hyperactivity disorder – ADHD
  • Asthma
  • Therapy to relieve cancer treatment side effects.

The focus areas are those along the fascia, the connective tissue that holds organs, blood vessels, bones, nerve fibers, and muscles in place. By working this tissue through gentle-pressure massage, practitioners help to calm the fight-or-flight response by relaxing the sympathetic nervous system. The symptoms will determine what areas of the body necessitate craniosacral therapy. Individuals with headaches will be given a head or neck massage. Other areas involved in craniosacral therapy include: (Heidemarie Haller, Gustav Dobos, and Holger Cramer, 2021)

  • Back
  • Around the spinal column.
  • Other areas like the joints or muscles.
  • The pressure applied during craniosacral therapy is light and not the same as a deep tissue massage.
  • Light pressure is applied over the affected fascial tissue to help reset certain body rhythms that could play a role in pain and other symptoms. (Heidemarie Haller, Gustav Dobos, and Holger Cramer, 2021)

Parasympathetic and Sympathetic Nervous System

  • The parasympathetic and sympathetic nervous systems control various body responses.
  • The parasympathetic nervous system supports proper rest and digestive functions, and the sympathetic nervous system regulates the body’s fight-or-flight response. (Cleveland Clinic. 2022)

Therapy Techniques

The massage techniques used in craniosacral therapy rely on low pressure intended to be as gentle as possible. The fingertips are often used to avoid applying too much pressure. Healthcare providers work the areas between the skull and the bottom of the spine to identify and reset imbalances within the body and the cerebrospinal fluid. If there is an imbalance in cerebrospinal fluid, the massage therapist will reposition the individual or press on the area to release and/or increase circulation. The techniques work to improve the body’s ability to regulate physiological responses. (Heidemarie Haller et al., 2019) During and after the session, individuals may experience different sensations, including: (Biodynamic Craniosacral Therapy Association of North America, 2024)

  • Relaxation.
  • Feeling like being in a meditative state.
  • Sleepiness.
  • Energized.
  • Feeling a sense of warmth.
  • Deeper breathing.
  • Feeling the body is straighter and taller.

Individuals Who Should Not Receive Craniosacral Therapy

Craniosacral therapy is considered safe; however, some individuals should avoid it or consult a healthcare provider before trying it. Those recommended not to receive the treatment include individuals with the following ailments or disorders:

  • Concussion or other traumatic brain injuries.
  • Blood clots.
  • Brain swelling.
  • Brain aneurysm – a blood-filled bulge in a blood vessel in or around the brain.
  • Conditions that cause cerebrospinal fluid buildup.

Treatment

Craniosacral therapy is offered by several healthcare providers, including:

  • Craniosacral therapy licensed massage therapists
  • Physical therapists
  • Occupational therapists
  • Osteopaths
  • Chiropractors

These professionals know how to perform the massage technique correctly.


Tension Headaches


References

Haller, H., Lauche, R., Sundberg, T., Dobos, G., & Cramer, H. (2019). Craniosacral therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials. BMC musculoskeletal disorders, 21(1), 1. doi.org/10.1186/s12891-019-3017-y

Haller, H., Dobos, G., & Cramer, H. (2021). The use and benefits of Craniosacral Therapy in primary health care: A prospective cohort study. Complementary therapies in medicine, 58, 102702. doi.org/10.1016/j.ctim.2021.102702

Cleveland Clinic. (2022). Peripheral Nervous System (PNS) (Health Library, Issue. my.clevelandclinic.org/health/body/23123-peripheral-nervous-system-pns

Biodynamic Craniosacral Therapy Association of North America. (2024). What is a session like? www.craniosacraltherapy.org/what-is-a-session-like-

Say Goodbye to Headaches with Acupuncture

Say Goodbye to Headaches with Acupuncture

Can individuals dealing with headaches find the relief they are looking for from acupuncture to reduce pain-like symptoms?

Introduction

As part of the musculoskeletal system, the neck is part of the upper body portions and allows the head to be mobile through full rotations without pain and discomfort. The surrounding muscles, ligaments, and tendons help protect the cervical spinal region and have a fantastic relationship with the shoulders. However, the neck area can succumb to injuries, leading to pain-like symptoms that can cause pain and discomfort in the upper regions. One of the pain-like symptoms that correlates with neck pain is headaches. Headaches can vary in acute to chronic stages as they affect many individuals and the various factors that correlate with them. When headaches start to form, many individuals will look at multiple treatments to reduce the pain-like symptoms that correlate with headaches and have the relief they deserve. Today’s article looks at the various factors that correlate with headaches, how headaches cause overlapping risk profiles with neck pain, and how treatments like acupuncture can reduce headaches. We talk with certified medical providers who consolidate our patients’ information to provide treatments like acupuncture to minimize headaches. We also inform and guide patients on how acupuncture can benefit many individuals dealing with neck pain associated with headaches. We encourage our patients to ask their associated medical providers intricated and important questions about their pain-like symptoms that correlate with headaches and neck pain. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

The Various Factors Correlating Headaches

 

Have you been experiencing tension around the back of your neck after a long day? Do you feel a dull ache after staring at the computer or phone screen? Or do you feel a pounding sensation that you must lie down for a few minutes? Many of these pain-like scenarios are associated with headaches that affect many individuals from time to time. Headaches are correlated with various biochemical and metabolic risk profiles or changes that cause central sensitization and neuronal dysfunction. (Walling, 2020) This causes many individuals to develop acute or chronic pain-like symptoms that affect their heads and various locations around the face and the neck area. Some of the multiple factors that can lead to the development of headaches include:

  • Stress
  • Allergies
  • Tension
  • Inability to sleep
  • Lack of water and food
  • Traumatic injuries
  • Bright strobing lights

Additionally, other factors like obesity can become a strong risk factor for secondary headaches like migraines to have symptoms of intracranial hypertension impact the body. (Fortini & Felsenfeld Junior, 2022) This could lead to the development of neck pain caused by headaches.

 

Headaches & Neck Pain

When it comes to headaches associated with neck pain, many individuals will experience tension and pain in the surrounding muscles and the ongoing symptoms. Neck pain can cause overlapping risk profiles to muscles, ligaments, facet joints, and visceral structures of the neck that can trigger the development of a headache or become a symptom that co-exists with a neck disorder. (Vicente et al., 2023) Additionally, neck pain and headaches are strongly associated as muscular pain plays a role in headache development as they provide negative consequences within their social lives. Headaches can hinder a person’s ability to concentrate, while neck pain causes limited mobility and stiffness. (Rodriguez-Almagro et al., 2020

 


Tension Headaches Overview- Video


Acupuncture Reducing Headaches

When individuals are dealing with headaches, many will incorporate home remedies to reduce the tension they are experiencing from the various factors. This can provide temporary relief to mitigate the effects of the pain-like symptoms associated with headaches. However, when the pain from headaches becomes unbearable with neck pain in the mix, that is where non-surgical treatments could be the answer. Non-surgical treatments are effective on pain caused by headaches and customized to the person’s pain. For example, acupuncture could help with headaches and neck pain. Acupuncture is one of the oldest forms of non-surgical treatments; highly trained professionals use solid thin needles to be placed in various acupoints in the body to restore energy flow and reducing pain associated with headaches. (Turkistani et al., 2021)

 

 

Acupuncture can even help reduce the frequency and duration of headaches while disrupting the pain signals and help provide insight into the positive effects of pain reduction. (Li et al., 2020) When people start incorporating acupuncture as part of their health and wellness treatment plan, they will feel their headaches reduced and their neck mobility back to normal. Through consecutive treatment, they will feel much better and become more aware of the various factors pertaining to headache production while making small changes to reduce their chances of returning. 

 


References

Fortini, I., & Felsenfeld Junior, B. D. (2022). Headaches and obesity. Arq Neuropsiquiatr, 80(5 Suppl 1), 204-213. doi.org/10.1590/0004-282X-ANP-2022-S106

Li, Y. X., Xiao, X. L., Zhong, D. L., Luo, L. J., Yang, H., Zhou, J., He, M. X., Shi, L. H., Li, J., Zheng, H., & Jin, R. J. (2020). Effectiveness and Safety of Acupuncture for Migraine: An Overview of Systematic Reviews. Pain Res Manag, 2020, 3825617. doi.org/10.1155/2020/3825617

Rodriguez-Almagro, D., Achalandabaso-Ochoa, A., Molina-Ortega, F. J., Obrero-Gaitan, E., Ibanez-Vera, A. J., & Lomas-Vega, R. (2020). Neck Pain- and Unsteadiness-Inducing Activities and their Relationship to the Presence, Intensity, Frequency, and Disability of Headaches. Brain Sci, 10(7). doi.org/10.3390/brainsci10070425

Turkistani, A., Shah, A., Jose, A. M., Melo, J. P., Luenam, K., Ananias, P., Yaqub, S., & Mohammed, L. (2021). Effectiveness of Manual Therapy and Acupuncture in Tension-Type Headache: A Systematic Review. Cureus, 13(8), e17601. doi.org/10.7759/cureus.17601

Vicente, B. N., Oliveira, R., Martins, I. P., & Gil-Gouveia, R. (2023). Cranial Autonomic Symptoms and Neck Pain in Differential Diagnosis of Migraine. Diagnostics (Basel), 13(4). doi.org/10.3390/diagnostics13040590

Walling, A. (2020). Frequent Headaches: Evaluation and Management. American Family Physician, 101(7), 419-428. www.ncbi.nlm.nih.gov/pubmed/32227826

www.aafp.org/pubs/afp/issues/2020/0401/p419.pdf

Disclaimer

Overcoming Chronic Tension Headaches with Effective Treatment

Overcoming Chronic Tension Headaches with Effective Treatment

For individuals affected by headaches that occur 15 or more days a month for more than three months, can knowing the signs and symptoms help healthcare providers help treat and prevent chronic tension headaches?

Overcoming Chronic Tension Headaches with Effective Treatment

Chronic Tension Headaches

Most individuals have experienced a tension-type headache. The pain is usually described as a dull tightening or pressure on both sides of the head, like having a tightening band around the head. Some individuals experience these headaches frequently, a condition known as chronic tension headaches. Chronic tension headaches are uncommon but can be debilitating, as they can interfere with a healthy quality of life and daily living.

  • Tension headaches are typically caused by stress, anxiety, dehydration, fasting, or lack of sleep and usually resolve with over-the-counter medications. (Cleveland Clinic. 2023)
  • This is a primary headache disorder that affects around 3% of the population.
  • Chronic tension headaches can occur daily and negatively impact the quality of life and daily functioning. (Cleveland Clinic. 2023)

Symptoms

  • Tension headaches can be referred to as stress headaches or muscle contraction headaches.
  • They can present with dull, aching pain and include tightness or pressure across the forehead, sides, or back of the head. (Cleveland Clinic. 2023)
  • Additionally, some individuals experience tenderness on the scalp, neck, and shoulders.
  • Chronic tension headaches materialize 15 or more days a month on average for more than three months.
  • The headache can last for several hours or be continuous for several days.

Causes

  • Tension headaches are typically caused by tight muscles in the shoulders, neck, jaw, and scalp.
  • Teeth grinding/bruxism and jaw clenching can also contribute to the condition.
  • Headaches can be brought on by stress, depression, or anxiety and are more common in individuals who:
  • Work long hours in stressful jobs.
  • Don’t get enough sleep.
  • Skip meals.
  • Frequently consume alcohol. (Cleveland Clinic. 2023)

Diagnosis

Individuals experiencing headaches that interfere with daily life or need to take medication more than twice a week are recommended to consult a healthcare provider. Before the appointment, it can be helpful to keep a headache diary:

  • Record the days
  • Times
  • Description of the pain, intensity, and other symptoms.

Some questions the healthcare provider may ask include:

  1. Is the pain pulsating, sharp, or stabbing, or is it constant and dull?
  2. Where is the pain most intense?
  3. Is it all over the head, on one side, on the forehead, or behind the eyes?
  4. Do the headaches interfere with sleep?
  5. Is working or doing tasks difficult or impossible?

A healthcare provider will likely be able to diagnose the condition based on symptoms alone. However, if the headache pattern is unique or different, the provider may order imaging tests, like MRI or CT scans, to rule out other diagnoses. Chronic tension headaches can be confused with other chronic daily headache disorders like chronic migraine, hemicrania continua, temporomandibular joint dysfunction/TMJ, or cluster headaches. (Fayyaz Ahmed. 2012)

Treatment

Pharmacological therapy for chronic tension headaches usually involves preventive medication.

  • Amitriptyline is one medication that has been found to be beneficial in chronic tension headache prevention.
  • A tricyclic antidepressant is a sedating medication and is usually taken before sleeping. (Jeffrey L. Jackson et al., 2017)
  • According to a meta-analysis of 22 published studies in the Journal of General Internal Medicine, these medications are superior to placebo in reducing headache frequency, with an average of 4.8 fewer headache days per month.

Additional preventive medications may include other antidepressants like:

  • Remeron – mirtazapine.
  • Anti-seizure medications – like Neurontin – gabapentin, or Topamax – topiramate.

A healthcare provider may also prescribe medication to treat headache episodes, which include:

  • Prescription non-steroidal anti-inflammatory drugs or NSAIDs, including acetaminophen, naproxen, indomethacin, or ketorolac.
  • Opiates
  • Muscle relaxants
  • Benzodiazepines – Valium

Non-Medication Treatment

Behavioral therapies are sometimes used on their own or in combination with medication to prevent and manage chronic tension headaches. Examples include:

Acupuncture

  • An alternative therapy that involves using needles to stimulate specific points on the body believed to connect with certain pathways/meridians that carry vital energy/chi throughout the body.

Biofeedback

  • In Electromyography – EMG biofeedback, electrodes are placed on the scalp, neck, and upper body to detect muscle contraction.
  • The patient is trained to control muscle tension to prevent headaches. (William J. Mullally et al., 2009)
  • The process can be costly and time-consuming, and there is little evidence to support its effectiveness.

Physical Therapy

  • A physical therapist can work out stiff and tight muscles.
  • Train individuals on stretches and targeted exercises for loosening tight head and neck muscles.

Cognitive Behavioral Therapy/CBT

  • Involves learning how to identify headache triggers and cope in a less stressful and more adaptive way.
  • Headache specialists often recommend CBT in addition to medication when developing a treatment plan. (Katrin Probyn et al., 2017)
  • Teeth-grinding and jaw-clenching training/treatment can help when they are contributors.
  • Regular exercise, as well as practicing healthy sleep hygiene, can be beneficial in prevention.

Supplements

Some individuals with chronic tension headaches may find relief using supplements. The American Academy of Neurology and the American Headache Society report the following supplements can be effective: (National Center for Complementary and Integrative Health. 2021)

  • Butterbur
  • Feverfew
  • Magnesium
  • Riboflavin

If the headaches come on suddenly, cause waking up from sleep, or last for days, it’s important to consult a healthcare provider to rule out any underlying causes and develop a personalized treatment plan.


Tension Headaches


References

Cleveland Clinic. (2023). Tension Headaches.

Ahmed F. (2012). Headache disorders: differentiating and managing the common subtypes. British journal of pain, 6(3), 124–132. doi.org/10.1177/2049463712459691

Jackson, J. L., Mancuso, J. M., Nickoloff, S., Bernstein, R., & Kay, C. (2017). Tricyclic and Tetracyclic Antidepressants for the Prevention of Frequent Episodic or Chronic Tension-Type Headache in Adults: A Systematic Review and Meta-Analysis. Journal of general internal medicine, 32(12), 1351–1358. doi.org/10.1007/s11606-017-4121-z

Mullally, W. J., Hall, K., & Goldstein, R. (2009). Efficacy of biofeedback in the treatment of migraine and tension type headaches. Pain physician, 12(6), 1005–1011.

Probyn, K., Bowers, H., Mistry, D., Caldwell, F., Underwood, M., Patel, S., Sandhu, H. K., Matharu, M., Pincus, T., & CHESS team. (2017). Non-pharmacological self-management for people living with migraine or tension-type headache: a systematic review including analysis of intervention components. BMJ open, 7(8), e016670. doi.org/10.1136/bmjopen-2017-016670

National Center for Complementary and Integrative Health. (2021). Headaches: What You Need To Know.

Headache On Top Of The Head: Causes, Symptoms And Relief

Headache On Top Of The Head: Causes, Symptoms And Relief

Individuals experiencing headaches on top of the head could be caused by different factors. Can recognizing what triggers pain or pressure help prevent this type of headache, and healthcare providers develop effective treatment plans?

Headache On Top Of The Head: Causes, Symptoms And Relief

Headache On Top of The Head

Various factors could cause a headache on top of the head; common causes include:

  • Stress
  • Sleep problems
  • Eye strain
  • Caffeine withdrawal
  • Dental problems
  • Hormonal changes
  • Alcohol consumption

Causes

Many causes have to do with underlying issues happening in other parts of the body.

Stress

  • Stress is a common cause of headaches, including one on top of the head.
  • Researchers don’t know exactly how stress causes headaches, but they think it causes tightening of the muscles in the back of the head or neck, which
  • pulls the tissues down, resulting in pain or pressure in the scalp and/or forehead area.
  • These are also called tension headaches.
  • Headaches caused by stress generally feel like dull pressure rather than throbbing pain.

Sleep Problems

  • Not getting enough sleep can induce a headache on top of the head.
  • When the mind and body do not get proper sleep, it can interfere with body functions like temperature, hunger, and sleep-wake cycles, which can lead to headaches.
  • It is common to feel more stressed when sleep-deprived, which can cause or compound a headache and other symptoms.

Eye Strain

  • You may develop a headache on the top of your head after you’ve been reading, watching, or otherwise focusing on something for a while.
  • Over time, your eye muscles tire and have to work harder, causing them to contract.
  • These spasms can lead to headaches. Squinting can make the muscle contractions even worse.

Caffeine Withdrawl

  • Individuals may feel pain on the top of their heads if they skip their regular coffee.
  • Regular caffeine consumption can lead to dependency and withdrawal symptoms, which include headaches when intake is reduced or stopped.
  • This type of headache can be moderate to severe and can feel worse with activity.
  • Most individuals start to feel better from caffeine withdrawal after a week. (World Health Organization. 2016)

Dental Problems

  • Teeth issues like cracks, cavities, or impaction can irritate the trigeminal nerve, setting off head pain.
  • Teeth grinding can also lead to headaches.

Hormonal Changes

  • Individuals who have a low level of thyroid hormone may experience headaches.
  • This could be from having too little thyroid or a symptom of the condition.
  • Like stress-induced headaches, this type is generally dull and not throbbing.
  • Some women may feel pain on the top of their heads before menstruation triggered by estrogen levels dropping.

Alcohol

  • Some individuals develop a headache on the top of their head or elsewhere within a few hours after drinking alcohol.
  • This is known as a cocktail headache.
  • Alcohol-induced headaches usually resolve within 72 hours.
  • The mechanism behind this headache is not fully researched, but it’s been thought that the widening of blood vessels in the brain/vasodilation when consuming alcohol may trigger head pain.
  • This type of headache is different than a hangover headache that comes from overconsumption and is based on dehydration and the toxic effects of alcohol. (J G Wiese, M. G. Shlipak, W. S. Browner. 2000)

Rare Causes

Top-of-the-head pain can also result from more serious and rare causes:

Brain Tumor

  • Headaches are one of the most common symptoms of brain tumors.
  • A headache on the top of the head depends on the location and size of the tumor. (MedlinePlus. 2021)

Brain Aneurysm

  • This is a weak or thin area in a brain artery that bulges and fills with blood, which can cause a life-threatening rupture.
  • Headaches are the most common symptom. (Brigham and Women’s Hospital. 2023)

Brain Bleed

  • Also known as a brain hemorrhage, this condition can cause intensely painful and quick headaches.
  • Brain bleeds can be caused by head trauma, high blood pressure, an aneurysm, a bleeding disorder, or liver disease. (New York-Presbyterian. 2023)

Treatment

Treatment for reducing a headache on top of the head includes:

  • Putting an ice bag over the area to reduce inflammation.
  • Getting an eye examination.
  • Making healthy lifestyle adjustments like drinking more water throughout the day.
  • Less caffeine intake.
  • Changing sleep patterns for a healthier, rested mind and body.
  • Taking a therapeutic bath to relax the body.
  • Gentle exercises like walking, pilates, or yoga.
  • Practicing deep breathing.
  • Mindfulness exercises like meditation.
  • Taking non-steroidal anti-inflammatory medication or NSAIDs like aspirin, Advil/ibuprofen), or Aleve/naproxen.

Depending on the cause and symptoms, a doctor may suggest specialist treatment options like:

  • Physical therapy
  • Cognitive behavioral therapy
  • Chiropractic therapy
  • Acupuncture
  • Prescription medication

A medical professional will be able to help identify the type of headache being experienced, offer treatment options, and advise on how to manage triggers.


Neck Injuries, El Paso, Texas


References

World Health Organization. (2016) Headache disorders.

Wiese, J. G., Shlipak, M. G., & Browner, W. S. (2000). The alcohol hangover. Annals of internal medicine, 132(11), 897–902. doi.org/10.7326/0003-4819-132-11-200006060-00008

MedlinePlus. (2021) Brain tumor.

Brigham and Women’s Hospital. (2023) Brain aneurysm.

New York-Presbyterian. (2023) Brain hemorrhage.

Head Pressure

Head Pressure

Can chiropractic treatment protocols diagnose what’s causing head pressure in individuals, and provide effective treatment?

Head Pressure

Head Pressure

Head pressure can have various causes and symptoms that affect different areas depending on whether the cause is a headache, allergies, injury, illness, or disease. The location of the pressure or pain can help a doctor of chiropractic determine the cause.

  • The underlying factor is usually not life-threatening, but the pressure that has built can be the result of serious conditions like a head injury or brain tumor.
  • Chiropractic ​care, which includes a combination of spinal manipulation, active and passive exercises, and massage, is often used for headache management and prevention. (Moore Craig, et al., 2018)
  • Chiropractic therapy is often sought out for tension and cervicogenic headaches, migraines, and each responds differently to the treatment.

The Head

  • The head is made up of a complex system of lobes, sinuses/channels, blood vessels, nerves, and ventricles. (Thau L, et al., 2022)
  • The pressure of these systems is regulated and any disruption to this balance can be noticeable.
  • Diagnosis can be difficult to figure out what is causing discomfort or head pressure.
  • Pain, pressure, irritability, and nausea are all symptoms that can occur with headaches. (Rizzoli P, Mullally W. 2017)

Location

  • Head pressure in more than one spot is possible with a migraine or a severe cold. (American Migraine Foundation 2023)
  • Pain can present in more than one area if there has been a head injury.
  • If the pressure is more specific in a certain region, it can help provide clues about the cause of the symptoms.
  • Medical issues can cause pressure in different areas. (Rizzoli P, Mullally W. 2017)
  • An example is a sinus infection which can cause pressure under the eyes and around the nose.
  • A migraine or tension headache can present as: (MedlinePlus. Migraine 2021)
  • A tight band around the head.
  • Pain or pressure behind the eyes.
  • Stiffness and pressure in the back of the head and/or neck.

Causes of Pressure

The root cause of the problem is not always clear. There can be a number of potential causes.

Tension Headache

Tension headaches are the most common that feels like pressure squeezing the head. They usually develop because of tightening scalp muscles caused by:

  • Stress
  • Depression
  • Anxiety
  • Head injuries
  • Unusual positioning of the head or illness can cause tension headaches.

Other than muscle tension, tension headaches can develop from: (MedlinePlus. Tension headache.)

  • Physical stress
  • Emotional stress
  • Eye strain
  • Fatigue
  • Overexertion
  • Overuse of caffeine
  • Caffeine withdrawal
  • Over alcohol use
  • Sinus infections
  • A cold or flu
  • Smoking
  • Tension headaches can also run in families. (MedlinePlus. Tension headache.)

Sinus Headache

  • A sinus headache – rhinosinusitis – is caused by a viral or bacterial infection in the sinus cavities. (American Migraine Foundation 2023)
  • There are sinus cavities on each side of the nose, between the eyes, in the cheeks, and on the forehead.
  • The location of where these headaches cause pressure varies, depending on which sinuses are infected. (Cedars Sinai. Sinus Conditions and Treatments)
  • Sinus infection headaches are obvious from the discolored nasal drainage.
  • Individuals can have facial pain and pressure, lose their sense of smell, or have a fever. (American Migraine Foundation 2023)

Ear Conditions

  • The ears help the body sense movement and balance.
  • A problem in the inner ear that helps control balance can cause a type of migraine known as a vestibular migraine. (American Speech-Language-Hearing Association)
  • This type of migraine doesn’t always present with pain symptoms.
  • Problems with balance and feelings of vertigo/sense of spinning are common with these types of migraines. (American Migraine Foundation)
  • An ear infection can also cause feelings of head pressure and/or pain.
  • Infections can cause pressure to build on the delicate structures of the middle and inner ear.
  • These infections are usually caused by viral illness or bacteria. (FamilyDoctor.org)

Neurological Causes

  • Neurological diseases and conditions can lead to increased pressure in the head.
  • The pain symptoms depend on the specific cause.
  • For example, a stroke can affect the whole head, while decreased brain fluid levels may affect just the base of the skull.
  • The latter condition is known as intracranial hypertension which means increased pressure in the brain. (Schizodimos, T et al., 2020)
  • For some individuals, there is no clear cause, this is known as idiopathic intracranial hypertension. (Wall, Michael. 2017) (National Health Service 2023)

Other causes of increased intracranial pressure include:

Other

  • Head pressure can also occur only at times when standing up, bending down to pick up an object, or otherwise changing posture in some way that blood pressure is affected.

Chiropractic Treatment

The Injury Medical team will develop a personalized treatment plan to help relieve pressure symptoms through a multidisciplinary approach that can include. (Moore Craig, et al., 2018)

  • Spinal manipulation
  • Low-load craniocervical mobilization
  • Joint mobilization
  • Decompression
  • Deep neck flexion exercises
  • Neuromuscular massage
  • Physical therapy exercises
  • Relaxation techniques
  • Stress management
  • Nutritional recommendations

Multidisciplinary Evaluation and Treatment


References

Moore, C., Leaver, A., Sibbritt, D., & Adams, J. (2018). The management of common recurrent headaches by chiropractors: a descriptive analysis of a nationally representative survey. BMC neurology, 18(1), 171. doi.org/10.1186/s12883-018-1173-6

Thau, L., Reddy, V., & Singh, P. (2022). Anatomy, Central Nervous System. In StatPearls. StatPearls Publishing.

Rizzoli, P., & Mullally, W. J. (2018). Headache. The American journal of medicine, 131(1), 17–24. doi.org/10.1016/j.amjmed.2017.09.005

American Migraine Foundation. Is it a migraine or a sinus headache?

MedlinePlus. Migraine.

MedlinePlus. Tension headache.

Cedars Sinai. Sinus conditions and treatments.

American Speech-Language-Hearing Association. Dizziness and balance.

American Migraine Foundation. What to know about vestibular migraine.

FamilyDoctor.org. Ear infection.

Schizodimos, T., Soulountsi, V., Iasonidou, C., & Kapravelos, N. (2020). An overview of the management of intracranial hypertension in the intensive care unit. Journal of Anesthesia, 34(5), 741–757. doi.org/10.1007/s00540-020-02795-7

Wall M. (2017). Update on Idiopathic Intracranial Hypertension. Neurologic Clinics, 35(1), 45–57. doi.org/10.1016/j.ncl.2016.08.004

National Health Service. Intracranial hypertension.

National Institute of Neurological Disorders and Stroke. Hydrocephalus. www.ninds.nih.gov/health-information/disorders/hydrocephalus

Heat Induced Headaches: El Paso Back Clinic

Heat Induced Headaches: El Paso Back Clinic

When temperatures are elevated in summer, heat-induced and severe headaches like migraines are common during the hot months. However, a migraine caused by heat is not the same as a headache caused by heat, as the two have different symptoms. What they have in common is that they’re both triggered by the way hot weather affects the body. Understanding the causes and the warning signs of a heat headache can help prevent and treat potentially dangerous heat-related conditions. Injury Medical Chiropractic and Functional Medicine Clinic use various techniques and therapies customized to the individual to relieve pain and improve function.

Heat Induced Headaches: EP's Chiropractic Clinic

Heat-Induced Headaches

Headaches and migraines are common, affecting 20 percent of women and nearly 10 percent of men. An increase in frequency can be caused by

  • Dehydration.
  • Environmental factors.
  • Heat exhaustion.
  • Heat stroke.

A heat-induced headache can feel like a dull pulsing ache around the temples or in the back of the head. Depending on the cause, a heat-induced headache may escalate to a more intensely felt internal pain.

Causes

A heat-induced headache may not be caused by the hot weather but by how the body responds to heat. Weather-related triggers of headaches and migraine include:

  • Sun glare
  • Bright light
  • High humidity
  • Sudden drops in barometric pressure
  • Weather conditions can also cause changes in serotonin levels.
  • Hormonal fluctuations are common migraine triggers that can also cause headaches.
  • Dehydration – can trigger both headaches and migraine.

When exposed to higher temperatures, the body needs more water to compensate for the lost water as it uses and sweats it out. Prolonged exposure to high temperatures puts the body at risk for heat exhaustion, one of the stages of heat stroke, with headaches as a symptom of heat exhaustion. Any time the body is exposed to high temperatures or spends a long time outside in the hot sun, and a headache occurs afterward, a heat stroke is possible.

Heat Headache Symptoms

Symptoms of a heat-induced headache can vary according to the situation. If the headache is triggered by heat exhaustion, the body will have heat exhaustion symptoms and head pain. Heat exhaustion symptoms include:

  • Dizziness.
  • Muscle cramps or tightness.
  • Nausea.
  • Fainting.
  • An extreme thirst that does not go away.

If the headache or migraine is related to heat exposure but not connected to heat exhaustion, the symptoms may include the following:

  • A throbbing, dull sensation in the head.
  • Dehydration.
  • Fatigue.
  • Sensitivity to light.

Relief

Individuals can be proactive about prevention.

  • If possible, limit time outside, protect the eyes with sunglasses, and wear a hat with a brim when staying outdoors.
  • Exercise indoors in an air-conditioned environment if able.
  • Increase water consumption as temperatures rise, and utilize healthy sports drinks to replenish electrolytes.

Home remedies can include:

Chiropractic Care

Chiropractic treatment can include:

  • Craniocervical mobilization involves gentle chiropractic pressure on the neck to adjust the joints.
  • Spinal manipulation involves applying more force and pressure at certain points along the spine.
  • Neuromuscular massage includes kneading joints and muscles and relieves pain by releasing pressure from compressed nerves.
  • Myofascial release massage is aimed at the tissues that connect and support muscles and focuses on trigger points in the back and neck or head to relax muscles and improve blood circulation.
  • Trigger point therapies target tense areas to help relax muscles while improving blood flow and relieving stress.
  • Traction therapy.
  • Decompression therapy.
  • Exercises designed specifically to reduce pain.

From Inflammation to Healing


References

Bryans, Roland, et al. “Evidence-based guidelines for the chiropractic treatment of adults with headache.” Journal of Manipulative and physiological therapeutics vol. 34,5 (2011): 274-89. doi:10.1016/j.jmpt.2011.04.008

Demont, Anthony, et al. “Efficacy of physiotherapy interventions for the management of adults with cervicogenic headache: A systematic review and meta-analyses.” PM & R: the journal of Injury, Function, and Rehabilitation vol. 15,5 (2023): 613-628. doi:10.1002/pmrj.12856

Di Lorenzo, C et al. “Heat stress disorders and headache: a case of new daily persistent headache secondary to heat stroke.” BMJ case reports vol. 2009 (2009): bcr08.2008.0700. doi:10.1136/bcr.08.2008.0700

Fernández-de-Las-Peñas, César, and María L Cuadrado. “Physical therapy for headaches.” Cephalalgia: an international journal of Headache vol. 36,12 (2016): 1134-1142. doi:10.1177/0333102415596445

Swanson JW. (2018). Migraines: Are they triggered by weather changes? mayoclinic.org/diseases-conditions/migraine-headache/expert-answers/migraine-headache/faq-20058505

Victoria Espí-López, Gemma, et al. “Effectiveness of Physical Therapy in Patients with Tension-type Headache: Literature Review.” Journal of the Japanese Physical Therapy Association = Rigaku ryoho vol. 17,1 (2014): 31-38. doi:10.1298/jjpta.Vol17_005

Whalen, John, et al. “A Short Review of the Treatment of Headaches Using Osteopathic Manipulative Treatment.” Current pain and headache reports vol. 22,12 82. 5 Oct. 2018, doi:10.1007/s11916-018-0736-y