Tension headaches?-time to make changes

Tension headaches are characterized by a dull achy headache that feels like pressure from a vice on the sides of the head, neck or base of the skull.  They are by far the most common type of headache, accounting for almost 90% of all headaches. According to the Global Burden of Disease Study in 2013 , by Timothy Steiner, 20.8% of the population are affected by tension headaches and they are more common in women than men.
The frequency of these headaches can range from most commonly 4 to 6 hours to chronic headaches lasting for years.    Tension headaches are different from migraine headaches because there is rarely nausea, visual disturbance, photophobia, vomiting, or facial numbness.  Also, migraine headaches usually occur on one side of the head, often over the eye.
Nobody wants to have a headache! They can drastically interfere with your ability to get through a day. Research is inconclusive to the exact cause of tension headaches but making simple changes in your daily routine can improve your symptoms:

Sit Up Straight
Headaches are the fourth most common condition to visit my office and over the past twenty years in practice, I can say they are getting more common. One of the main reasons for this is postural strain, or what I like to call "Tech Neck".  Many of us are slumped over a phone or a computer for too many hours in a day.
Prolonged poor posture places extra strain on the muscles and joints of the neck and upper back, which causes muscle fatigue.  This fatigue then causes the muscles to form trigger points that can be a referral source of pain to the neck, head, and face.

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Get Some Sleep
Sleep is essential for so much of our overall health and is reported as the second most common trigger for tension headaches.  Sleep allows the muscles time to replenish nutrient supply, repair, and build needed tissue. Good sleep helps repair the tension caused by poor posture or stress.  

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Stressed Out?
Stress is the most common reported cause of tension headaches.  The stress response is similar to that of a cat frightened by a dog: "Flight or Fight" response occurs and the back and neck muscles are contracted, heart rate goes up, and the gut shuts down. This causes and over-reaction of the nervous system that releases chemicals into the blood stream that can cause headaches. The gut shuts down and there are important neurotransmitters made here for overall good health. When this is chronically off-balance, the gut-brain axis is not functioning properly and you are more susceptible to getting headaches.

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Time to Make Changes

Medications:
The most common used treatment for tension headaches is over-the-counter NSAIDs or pain relievers.  Studies show that these can be effective for short term relief, but are not very effective in preventing chronic tension headaches. One must be careful in using too much of these as you can get medication overuse or withdrawal headaches.  According to research from Dr. Elizabeth Loder in the British Medical Journal,  the best treatment for chronic tension headaches is a combination of exercise, relaxation therapy and amitriptyline.  Amitriptyline is a medication that can be used to prevent chronic or recurrent headaches, or medication overuse/withdrawal headaches, with the goal of decreasing the amount of painkillers that a person uses.  Opioids (eg. Tylenol #3), triptans (a medication used to abort migraines), and sedative drugs (eg. sleeping pills and muscle relaxants) should not be used in treating tension headaches.
Manual therapy:
There is a growing body of evidence that manual therapy can be an effective treatment , or adjunct treatment for tension headaches. Evidence  from the physiotherapy, chiropractic and massage therapy research shows that a combination of massage, neck stretching and strength work can decrease and even prevent tension headaches.
Lifestyle changes:
The biggest thing you can do to improve your health, and to eliminate tension headaches, is to make some lifestyle changes. Get enough sleep, drink enough water, exercise, decrease stress, eat well, and don't smoke.  Also consider watching for triggers such as caffeine overuse or withdrawal.

Tension headaches can be very disabling and interrupt a person's ability to function optimally.  If you feel you are having tension headaches, go to your health care provider and get a thorough examination and diagnosis.  Make some lifestyle changes and get active!

Activity fact: Activity fact: Often mild to moderate cardiovascular exercise can drastically or eliminate a tension headache. Get Active!
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