Greetings friends. Tension headaches are something I see regularly in my clinical practice of massage therapy. Many clients present with the symptoms of tension headaches and most of these stem from tense muscles in the upper neck and basal areas of the skull.
What are the symptoms of tension headaches?
Tension headaches often begin in the back of the head and upper neck as a band-like tightness or pressure. Tension headaches also are described as a band of pressure encircling the head with the most intense pain over the eyebrows. The pain of tension headaches usually is mild (not disabling) and bilateral (affecting both sides of the head). Tension headaches are not associated with an aura (see below) and are seldom associated with nausea, vomiting, or sensitivity to light and sound. Tension headaches usually occur sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people. Most people are able to function despite their tension headaches.
These are the most common type of headache that people experience. This is often related to pain and tension in the neck region. A disorder of the neck joints or the muscles that connect to the base of your scull may refer pain into your head; this is because the nerves that are in your neck are also connected to your head and face.
Your neck may be causing your headache if:
- Your doctor has cleared you of any other factors that may be contributing to your headache
- Your neck pain radiates from the back to the front of your head
- Headache is worsened by neck movement or by holding your neck in the one position for example staring at the computer screen throughout the day with your chin poke forward
- Headache is eased by pressure at the base of your skull
- This type of headache may not always be relieved by medication
Main Causes of Tension Headaches
Trigger points (TrPs), or muscle knots, are possibly the world’s most common cause of aches and pains, and yet they are rarely diagnosed correctly. Having too many stubborn trigger points is called “myofascial pain syndrome” (MPS). Many people that work in a sitting position like office workers are prone to these from the constant strain placed on the muscles of the neck and skull.
Under the back of the skull must be the single most popular massage target in the human body. No other group of muscle gets such rave reviews. It has everything: deeply relaxing and satisfying sensations, and a dramatic therapeutic relevance to one of the most common of all human pains, the common tension headache. And no wonder: without these muscles, your head would fall off. They feel just as important as they are.
Along with lots of other neck muscles, the suboccipital group — usually just called “the suboccipitals” — work overtime to keep your head balanced on top of your spine. In particular, they initiate and control fine movements. This is no small task: if you’re a big person, your head may weigh as much as a 10-pin bowling ball, and it is resting on a foundation only about one third as wide. Consequently, these muscles never really stop working.
The suboccipitals are also partly “antagonized” (balanced) by the jaw muscles. This is an odd arrangement. Generally speaking you’ve got one muscle or group of muscles that pulls one way, and then muscles on the other side of the joint that pull the other way. But the jaw muscles do not affect the spinal joints, and cannot directly work against/with the suboccipitals to balance the head. Nevertheless, they do: muscle studies have shown that the jaw muscles behave much like they would in a truly balanced working relationship with the suboccipitals. If the jaw muscles tighten, the suboccipitals tighten. Both of these muscle groups routinely harbour trigger points that cause headaches (among other things), and together they are the source of most tension headaches. Trigger points are also extremely likely to be a trigger for migraines and cluster headaches.
Massage Can Help
If I could have only one group of muscles to get massaged regularly, this is the one I’d choose! A study done by the Boulder College of Massage Therapy in the USA in 2002 showed that the massage therapy method used in the study has the potential to be used effectively as a non-pharmaceutical intervention for tension headaches. Most people sadly reach for the drugs when these occur and this can add up to a big bill each year not to mention the the damage these drugs can have in their side effects; the most commonly used are Ibuprofen and Paracetamol. Whilst paracetamol is a gentler option, it is still not addressing the cause. Looking at prevention is the better, longer term solution.
Regular massage therapy sessions are not only a great way to aid in relieving these types of headaches, it goes a long way to preventing them recurring. As a natural health professional, I am always an advocate for prevention! Seeing your massage therapist anywhere from weekly to monthly to have these and other areas massaged is a proven way to help prevent and alleviate tension headaches.
Nutrition and Herbs Can Also Assist
Certain foods can trigger tension headaches, including:
- Monosodium glutamate (MSG), a flavor enhancer found often in food from Chinese restaurants
- Foods containing the amino acid tyramine, found in red wine, aged cheese, smoked fish, chicken livers, figs, and some beans
- Peanut butter
- Some fruits, like avocado, banana, and citrus
- Dairy products
- Meats containing nitrates — bacon, hot dogs, salami, cured meats
- Fermented or pickled foods
- Foods and drinks containing caffeine
If you suspect that any of these foods cause your headaches, you could follow an elimination diet, eliminating all the items on this list from your diet and then reintroducing them one at a time. Pay close attention to whether the number of headaches increases after eating particular foods. Then you know which trigger foods to avoid.
5-hydroxytryptophan (5-HTP, 400 – 600 mg per day) — Your body makes the amino acid 5-HTP and converts it into serotonin, an important brain chemical. Researchers think changes in brain chemicals may be related to tension headaches, and some of the drugs used to treat headaches work by affecting serotonin. Based on that thinking, 5-HTP has been proposed as a treatment for tension headaches. Several studies indicate that 5-HTP may be effective for migraines, but the evidence is mixed for tension headaches. One study found that 5-HTP did not reduce the number of headaches people had, but it did allow them to reduce their use of other painkillers. More studies are needed to tell whether 5-HTP helps treat tension headaches. If you take an antidepressant, or supplements such as St. John’s wort or SAMe, you should not take 5-HTP. If you are pregnant or breastfeeding, do not take 5-HTP without first asking your doctor.
Other nutrients that aid in headache relief are :
- Vitamin B2 (Riboflavin) – It is required by the body to use oxygen and the metabolism of amino acids, fatty acids, and carbohydrates. Riboflavin is further needed to activate vitamin B6 (pyridoxine), helps to create niacin and assists the adrenal gland. It may be used for red blood cell formation, antibody production, cell respiration, and growth. It eases watery eye fatigue and may be helpful in the prevention and treatment of cataracts. Vitamin B2 is required for the health of the mucus membranes in the digestive tract and helps with the absorption of iron and vitamin B6.
Although it is needed for periods of rapid growth, it is also needed when protein intake is high, and is most beneficial to the skin, hair and nails. Food sources of vitamin B2 include Organ meats, nuts, cheese, eggs, milk and lean meats are great sources of riboflavin, but is also available in good quantities in green leafy vegetables, fish, legumes, whole grains, and yogurt.
- B6 (Pyridoxine) – Pyridoxine is required for the balancing of hormonal changes in women as well as assisting the immune system and the growth of new cells. It is also used in the processing and metabolism of proteins, fats and carbohydrates, while assisting with controlling your mood as well as your behaviour. Pyridoxine might also be of benefit for children with learning difficulties, as well as assisting in the prevention of dandruff, eczema and psoriasis.
It assists in the balancing of sodium and potassium as well promotes red blood cell production. It is further involved in the nucleic acids RNA as well as DNA. It is further linked to cancer immunity and fights the formation of the toxic chemical homocysteine, which is detrimental to the heart muscle.
Women in particular may suffer from pre-menstrual fluid retention, severe period pains, emotional PMS symptoms, premenstrual acne and nausea in early pregnancy. Mood swings, depression as well as loss of sexual drive is sometimes noted when pyridoxine is in short supply and the person is on hormone replacement therapy or on birth control pills. Food sources of vitamin B6 include brewer’s yeast, eggs, chicken, carrots, fish, liver, kidneys, peas, wheat germ, walnuts.
- Calcium – This is required in the formation of bone structure, especially at an early age when bones are growing, and in old age when the ability to absorb calcium decreases. It also promotes a healthy heart and nerves and aids in blood clotting. Most western diets are slightly calcium deficient. The symptoms of this include muscle cramps, joint pain, insomnia, tooth decay and high blood pressure. Severe deficiencies can lead to osteoporosis. Food sources include dairy foods, green leafy vegetables, legumes, boney fish like sardines.
- Magnesium – Works alongside calcium to maintain muscle and nerve impulses and bone density. It is also essential for the functioning of many enzyme pathways, and is linked with protein synthesis and the production of some hormones. Deficiencies in magnesium have been strongly linked with cardiovascular disease and muscle spasms. There is strong evidence that some heart attacks may be caused by cramping in the arteries connected to the heart, rather than blockages. Magnesium is a vital component of chlorophyll and is present in all green leafy vegetables, nuts and seeds and also seafoods like mussels and oysters.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care practitioner.
- Peppermint (Mentha x piperita) — Peppermint oil, applied topically to the forehead, has shown some promise in very early studies. In one study, applying a 10% peppermint oil solution to the temples relieved pain about as well as acetaminophen (Tylenol). But more research needed to know for sure if peppermint oil is effective. Be careful not to get peppermint oil or any essential oil into the eyes.
- Tiger Balm (contains various oils including camphor, menthol, cassia oil, and clove oil) — Tiger Balm is an over-the-counter ointment used for muscle pain. One study found that applying Tiger Balm to the forehead helped relieve headache pain better than placebo and about as well as acetaminophen (Tylenol).
- Feverfew (Tanacetum parthenium, 50 – 80 mg per day) — Feverfew has been used traditionally to treat headaches, and several well-designed studies have found that it may help prevent and treat migraines. However, not all studies agree, and it has not been studied to see if it can prevent or treat tension headaches. Feverfew can increase the risk of bleeding, and should not be taken with blood thinners such as warfarin or clopidogrel. If you are allergic to ragweed you may also be allergic to feverfew. Women who are pregnant or breastfeeding should not take feverfew.
So there you go. There’s more you can do to help those tension headaches than you thought. Perhaps it’s time to visit your massage therapist more often and to take a look at your food intake. Hope the helps.
Until next time.
Craig Hitchens – MST Natural Health Specialist.
My own clinical experience.
This article is for informational purposes only and is not to replace the advice and treatment of trained professionals. Always consult your health care professional before embarking on any therapy program.