By Principal Physiotherapist Jodie Krantz
To get relief from tension headaches, follow this process to ensure effective diagnosis and treatment.
Step 1: Get a check up from your GP
Although most headaches are harmless, it’s a good idea to see your GP to ensure it is not being caused by something more serious. You should see your doctor immediately if you have severe pain, which is not relieved by normal over-the-counter medications, if it was related to a head injury, or involves loss of consciousness, fever, vomiting, blurred vision, difficulty speaking or numbness of the arms or legs. Your doctor can assist with diagnosing the cause of your headaches. Tension headaches and migraines are the most common cause of headaches and many people have a combination of the two.
While visiting your GP, consider discussing your stress levels and mood. Anxiety and depression can be contributing factors when you have recurrent headaches.
Step 2: Start keeping a headache diary
This will help you to keep track of your headaches, to know whether you are improving and to get a better understanding of the likely triggers for your headaches. Taking your headaches diary with you when you visit a health care professional assists with the process of diagnosis and treatment of your headaches. Download a headache diary here.
Step 3: Get a headache assessment from your Physiotherapist
See your Physiotherapist for a check up. Ask for an assessment of your posture, flexibility, muscle strength and endurance, as these factors are likely to be contributing to your headaches. Some headaches are caused by referred pain from the small facet joints in your neck. These headaches often respond well to gentle mobilization techniques.
A common cause of headaches is poor posture. People who get recurrent tension headaches are often holding their head too far forward, causing the muscles at the back of the neck to work overtime. They may also have a tendency to hunch the shoulders forwards and upwards, tightening the upper trapezius and other adjacent muscles. These muscles are often the primary source of the headaches which are felt in the back of the head and neck, in the temples and behind the eyes. The pain is often described as being like a tight band around the head.
Once you’ve had an assessment your Physiotherapist can help you work out a treatment and / or home exercise programme to relieve your headaches. At Free2Move our approach is to provide the minumum necessary one-to-one treatments and get you self-managing through a customised exercise programme in the shortest possible time.
Step 4. See your Dentist
Jaw tension is another common cause of tension headaches. It’s a good idea to have your dentist check whether you have been clenching or grinding your teeth. A lot of people – some dentists say most – clench their teeth in their sleep. This will be evident from the wear patterns on your tooth enamel. A night guard (occlusal splint) can often reduce or even eliminate headaches associated with jaw tension. The Feldenkrais Method is also very helpful for reducing jaw and neck tension, which can lead to headaches.
Try a free Feldenkrais Lesson on Releasing your Neck and Jaw. You can also see your Physiotherapist for one-to-one assessment and treatment of jaw pain or tension.
Step 5: Get an ergonomic assessment of your workstation
Do you sit at a computer for long periods of time? How is your posture while you work? Although most people try to maintain good posture at their desk, this is hard to attain and even harder to sustain if your ergonomic set-up is incorrect. Consider asking your employer to arrange an ergonomic assessment of your workstation. To request an ergonomic workstation assessment in Perth Western Australia, Contact Us at Free2Move.
The two most important factors are your chair and your monitor. Most good ergonomic chairs have 3 levers underneath, one to adjust chair height, one for the angle of the seat and a third for the angle height and position. The back rest should also be adjustable so that the lumbar support is in the right place. Get your chair properly adjusted and each day when you sit down to begin your work check that it’s in the right position. Use a footstool if required and ensure that the top of your monitor is level with, or just below the height of your eyes.
Speaking of eyes, when was the last time you had them tested? Eye strain can also be a cause of tension headaches.
Last but not least, get up out of your chair and walk around once an hour at the very minimum. There are some great programmes and apps now to help remind you about this. Make sure you have a system in place.
Step 6: Improve your exercise regime
It’s not a theory, it’s a fact: regular cardio-vascular exercise can reduce the frequency, severity and duration of tension headaches. Exercise helps because it improves circulation to all your muscles, reduces stress and tension, and has a beneficial effect on the brain and nervous system, through which all pain is sensed.
Aim to spend a minimum of 2.5 hours every week participating in an enjoyable form of moderately vigorous activity. The ideal is 30 to 60 minutes of exercise at least 5 days per week. You can walk, swim, cycle or play sport – anything that increases your heart rate and gets you breathing a little more deeply. This needs to become part of your regular routine, so it’s a good idea to put a structure in place that supports that.
Walking often works because it’s free and you don’t need any special equipment or environment. It’s also a form of locomotion and an fundamental ability to maintain as you get older. So walk to work, walk your dog or walk with a friend and help each other maintain your exercise goals. If it’s too wet or hot you can even walk inside your local gym or shopping centre.
Step 7. Reduce your stress levels
Stress often contributes to recurrent or chronic tension headaches. People who are stressed may resort to unhealthy ways to reduce stress, such as excess use of alcohol, smoking, taking pills or drugs, overeating, excess consumption of sugar or caffeine. Some people avoid facing their worries and concerns by being so busy they never have time to slow down or by watching TV to avoid thinking or feeling.
Important aspects of reducing stress are eating a balanced nutritious diet, participating in regular exercise and getting adequate sleep.
Healthy ways to relax include things like going for walk in nature, taking a hot bath by candlelight or getting a massage. Consider doing some gardening, listening to music, or playing with a pet. You could consider taking classes in Feldenkrais, meditation or Tai Chi. Whatever you do, build it into your weekly routine and set aside time that you will devote to relaxing your mind and body.
Reducing stress includes taking responsibility for the way that you manage problems, thoughts and emotions. If you can’t change the circumstances that result in stress, change the way you respond to it. For help and support with managing stress in Australia, talk to your GP about a referral to a Clinical Psychologist. You may be eligible for a rebate through Medicare.