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Feldenkrais Method
Headaches, Tension and Chronic Daily Headache, Cervicogenic Headache, Migraine, Sinus Headache, Cluster Headache

There are many causes and types of headaches: Tension and Chronic Daily Headache, Cervicogenic Headache, Migraine, Sinus Headache, Cluster Headache. See links for headache charts: nlm.nih.gov, nlm.nih.gov

Tension Headaches constitute 90% of all headaches. Symptoms consist of persistent pain like a steel band around the head, and/or on the top of the skull. Mental stress, anxiety, eyestrain, as well as muscle tension from the jaw, neck, shoulders can cause pain that radiates up to the head.

Patients with tension headaches usually get the headache as the day progresses and do not wake up with the headache. There is no associated nausea, vomiting or sensitivity to light with a tension headache.

Treatment: Most people rely on some type of oral pain reliever such as Ibuprofen, Excedrin or Tylenol. Another approach is to consider the possible causes of tension and make adjustments to reduce them.

Some causes might be: eye strain due to excess light or glare, eyestrain when your glasses are in need of replacement; neck strain as a result of looking up instead of straight at your computer screen, neck strain from raising one's head to adjust focus while wearing bifocals, poor posture causing excess neck tension, carrying heavy items (or children) creating neck tension, neck tension when looking down to feed a baby in one's arms or while sewing/quilting in one's lap. Whenever neck or eyestrain are the cause of headaches, intermittent Alexander "lying on books" gives a person relief from the build-up of neck tension as well as a cranial release. Learning how to recognize and release neck tension while in activity are key learning objectives in the Alexander Technique. There are Kurashova Tissue Re-education Techniques that target tight muscles in the neck area: para-spinals, scalenes and sternocleidomastoids. These techniques not only relax muscles but can calm greater occipital nerve irritation (at the base of the skull), which can be a source of tension headaches.

Chronic Daily Headaches occur 15 or more days a month, are usually on both sides of the back of the head and neck and range from moderate to severe in intensity. Chronic daily headaches can often be a combination of migraine and tension headache.

Cerivcogenic Headaches constitute about 17% of headaches and have as their origin some dysfunction of the cervical vertebrae or muscles of the neck and jaw.

Treatment: Positional release and Kurashova Tissue Re-education Techniques can help release the tight tissues of the neck and restore cervical alignment. I usually recommend that patients consult with a NUCCA practitioner for gentle C1 (first cervical vertebra) manipulation.

They use low emission X-ray to diagnose the degree of displacement and verify the correction after the first treatment. It is the most precise correction of C1 that I know of. (See links advancedspinalcare.com and nucca.org)

Here are examples of common neck dysfunctions that cause headache/face pain.

1) Common symptoms of a skull/C1 dysfunction are pain above or behind the eye usually on one side, pain in the morning increasing with work (sleeping on one's belly with head in extension/rotation can cause it).

2) Shooting occipital/neck pain occasionally extending to the lower face can be caused by bilateral skull/C1 dysfunction. This pain is usually increased by forward bending of the head.

3) Arnold's Neuralgia or otherwise known as Greater Occipital Nerve pain is caused by irritation of the greater occipital nerve usually in the area of C2, which presents as sudden, one-sided attacks of sharp shooting electrical-type pain in the neck and rear skull.

Rotation plus flexion or extension of the head can provoke this pain. (See H 1)

4) Auriculomandibular neuralgia is usually one sided occipital headache pain radiating to the lower ear and jaw. Often C2-C3 and C3-C4 facet joints are hypermobile.

5) Often pain, buzzing and vertigo are referred to the ears without clear evidence of ear pathology when there is C2-C3 facet joint dysfunction.

6) Eye pain can occur with C3 dysfunction.

7) Neck and scalp pain can radiate from ropey fibrotic semispinalis capitus muscles up through the scalp aponeurosis.

8) Levator Scapula muscle spasm can cause one-sided skull/C1 compression, causing one-sided suboccipital and neck pain all the way up under the ear.

Migraine Headaches occur most often in people between the ages of 20-35, are more prevalent for women and decrease in frequency with age. These headaches are often hereditary. Of all headaches about 6% are migraines. Migraine headaches are believed to be neurologic in origin and have a vascular component. They last any where from 4 to 72 hours, including a headache-free period.

This is not a daily headache. Routine activity usually makes the pain worse. Environmental changes, too much or too little sleep, certain foods, estrogen fluctuation, stress/anxiety, weather/temperature changes, bright lights or computer screens, strong odors and high altitudes all may trigger a migraine headache. See site for list of possible triggers healthsquare.com.

The Classic Migraine includes 5 stages:

1) Prodrome: During the 24 hour period before a migraine headache more than half of sufferers experience unusual symptoms such as changes in sensory perception (sensitivity to light/smells), changes in mood, memory and speech problems, excessive yawning (a sign of need for more oxygen) and/or the craving of special foods (especially starchy food).

2) Aura: Ten minutes to an hour prior to the onset of a migraine patients may report irritability or restlessness, nausea or loss of appetite, seeing shimmering borders around objects, flashing lights, distorted hearing and in some cases slurred speech, weakness, numbness or pins and needles around the lips or hands.

3) Headache: The migraine headache phase follows with pain, usually pulsing/throbbing on one side (occasionally on both sides or traveling between sides) and there may be sensitivity in the muscles of the scalp and neck. During this time sensory stimuli such as smells, light, touch or sound become irritants so many people find they must rest in a darkened, quiet room.

4) Resolution: Following a period of rest/sleep, an emotional outburst or an episode of vomiting, the headache resolves.

Treatment: Identifying the individual's migraine triggers is critical in managing and preventing migraines. There are many theories as to the cause of migraines. More of the current research points to a problem within the neurological system rather than the vasculature as the initiating source of migraine headaches.

Various drug treatments are available from your doctor.

However, the Kurashova migraine treatment protocol targets neck blood vessels and tight muscles around them. The techniques normalize blood flow toward as well as away from the brain using manual tissue techniques, treating the neck. The muscles of the neck surrounding the carotid blood flow are often tight and contracted. Treatment normalizes the tone of these muscles as well as the smooth muscle of the blood vessels. Treatment can only begin during a headache free period or in the prodrome phase.

For ongoing prevention of all types of headaches I recommend cervical spine evaluation and treatment by a NUCCA chiropractor.

Good alignment of the C1 (first cervical vertebra) insures that the area below the skull does not comprise nerves or circulation. Balanced alignment of the C1 also creates a domino effect down the spine, hence helping to align the whole skeleton. See links advancedspinalcare.com and nucca.org.

Sinus Headaches, which occur in the sinus cavities, can contribute to or help trigger other types of headaches. Sinus headaches are most commonly thought to occur in response to allergens either in food or the environment (pollen/mildew/mold). If you suspect you have reoccurring sinus headaches you should consider being tested for food and environmental allergies.

See Other Resources for practitioners who can help with food allergies. There is a Kurashova Tissue Re-education Technique that can help reduce the swelling in sinuses, and regular craniosacral work can also help with chronic sinus problems.

Cluster Headaches are vascular in origin and usually start in patients between the ages of 20-30 years old. They are more prevalent for men than women and for persons who drink, smoke and/or do drugs. This headache can last from10 minutes to 4 hours and in some cases can occur up to eight times a day. Starting behind one eye, it may radiate into the temple, nose, jaw, chin or teeth.

Tearing/redness of the eyes and or drooping of the eyelid, stuffy/runny nose and facial sweating on the side of the pain can accompany it. Similar to migraines, cluster headaches may also have symptoms of nausea, vomiting, cold hands, dizziness and sensitivity to light and sound. There are two types, episodic and chronic. Episodic cluster headaches are followed by a long pain free period of remission. The chronic cluster headaches are more rare, occurring in only 10-20% of cluster headache sufferers, and patients have no more than a one-week headache-free period within a year. Since these headaches are usually triggered by exposure or ingestion of noxious substances, lifestyle changes are integral to treatment.

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MovementWise Christine Inserra P.T.
Certified Teacher of the Alexander Technique & Feldenkrais Method
Physical Therapy serving Chicago and the Greater Chicagoland Area