It’s a Soft Tissue Issue…

It’s a Soft Tissue Issue!

Migraine Headaches.

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Types of Headaches

There are many different kinds of headaches, each one with distinct characteristics. The first thing to note is where and how it seems to start: Behind your eyes as a dull ache? At the back of your head with sharp shooting pains? Is it a pressure at the top of your head that spreads across the forehead? Is it in the temples shooting pain into the center of your brain?  These are examples of how you can best describe the headache, and being able to do that is the first line of determining where in the soft tissue your issue may be.

In this article, many symptoms of Migraine headaches will be addressed; common headaches can come from many sources, some of them from dietary habits (such as caffeine headaches), some from soft tissue congestion, others stem from mental or emotional strain. Here, we will only address the ones that originate from soft tissue damage, predominately those in the form of trigger points and tension.

Keep in mind that should the migraine or headache stem from another source, such as an injury or illness, the fact that you get the migraine will undoubtedly cause trigger points to form, compounding the problem further; addressing these triggers along with your prescribed treatment will help to reduce all sources and symptoms.  This may be why medication alone seems to help a little, but the pain remains due to trigger points present within the soft tissue.

Next you will want to share information with your health practitioner on the duration, progression levels, and any sensitivity that may result.  Do you hide in a dark room because light intensifies the pain? Do sounds pound into your head through your ears?  Note any dizziness, nausea, vertigo, spots before your eyes, and any other symptoms whether you think it’s related or not, include them all when describing it to health care providers.

A continuing problem with migraine/headache pain is in the diagnosis. Tests upon tests are done, only to find nothing wrong, or the source cannot be determined. Common (and very frustrating) troubles you may have are the endless numbers of tests, prescriptions that can be expensive (and most often incapacitating) and doctors that just don’t seem to find the problem.

All the “pain killers” only mask the fact that you have a headache or migraine; it’s still there, just under stealth mode while you continue throughout the day, and can actually add to the problem. By not allowing you to know you are in pain, activities (that would have been otherwise restricted while suffering from pain) cause further irritations and damage, making the problem harder to correct. This is the point when your pain medication no longer seems to help.

What are you like when you do not have a headache?

Oftentimes we are aware of, and only describe what it’s like when we are ill, overlooking many things when we are well.

°When you walk, do you seem to bump into walls or doorways (even just a little bit)?

°Can you walk a straight line when not trying to, or do you normally veer left -right, or trip over your own feet?

°Do you find small, or even large, bruises on your arms, legs, or ribs and cannot seem to recall how you got them?

°How often do you misjudge distance when reaching or grabbing for things, knocking things over with an elbow?

°Do things drop from your hands more often some days?

All of these are part of your symptoms and play a major role in determining just what is going on and where.  When symptoms are extreme, it would be a good idea to keep a journal about things like this, noting the date, and if/when during these moments of “clumsiness” you begin to experience your headaches.

Muscles that contribute to Migraine Symptoms

Beginning with the Sternocleidomastoid (SCM), the big cord that sticks out from the neck on either side, the most identifiable visually, and the source of a great many headache pains and related symptoms.  Trigger points here cause pain around the top portion of the eye socket, top of the head, back of the head, in front of the ear, even under the jaw line and chin. Dizziness lasting a few moments to a few days is often given a diagnosis of Vertigo* or Ménière’s* disease.  SCM, having two branches attaching to the clavicle, joining into one to insert just behind the ear, operate as a spatial orientation mechanism, keeping an eye on the position/balance of your head (much like the inner ear of a cat helps it track the location/relation of its body to its head).  Trigger points here are also a source of dim or blurred vision, double vision, excessive tearing, eye spasm (that annoying ‘eye twitch’), drooping eyelid (can be mistaken for thyroid issues). Some symptoms that may seem unrelated are runny nose, sinus pain and congestion, hay fever symptoms, chronic cough (from excessive phlegm), which we usually self treat with over-the-counter allergy medicines, never realizing all this is caused by a trigger point in the SCM!

Next, the Temporalis, one of the scalp muscles located on the side of your head, and can be felt easily while chewing. Triggers in this muscle contribute to the head pain along the sides, around the eyebrow, and in the upper lip/jaw area. Trigger points can form from excessive gum chewing, clenching the teeth, a sudden jarring or knock to the jaw, chronic ice crunching, and even can be present in children who suck their thumbs or pacifiers.

Frontalis is a large flat muscle that covers the top, front, and referred to as Occipitalis towards the back of the head (the one that wiggles your ears).  This muscle contributes to pain within the areas of its location, mostly the forehead from Frontalis, and along the sides and back for Occipitalis.  You can feel this muscle when your hair stylist is shampooing your hair, and is usually quite tender when trigger points are present.  Sustained facial expressions such as an interested look, holding a smile in social situations, or frowning excessively can contribute to overuse in these muscles.

Triggers in the Upper Trapezius send pain to your eye, temples, and the curve of your jaw. Overworking this muscle can cause dizziness, vomiting, headache, pain behind the eye, pain in the back of the head (high in the neck) and can also refer down the side of the spine between the shoulder blades. Shrugging your shoulders, lifting heavy objects over your head, hunching or leaning forward can cause the triggers and discomfort in this muscle. Many people relate this to feeling like “their shoulders are in their ears” and admit this is an area where they will carry their tension and stress.

Zygomaticus is one of the cheek muscles, and triggers in this muscle causes pain below the eye, in the face, over the nose, and sometimes all the way up to the middle of your forehead.  These also contribute to allergy-like symptoms such as runny nose and itchy eyes. Squinting your eyes, frowning, or constantly making the “I smell something bad” expression can overwork these muscles.

Splenius Capitus are broad muscles (like safety straps) which connect the neck vertebrae to the back of the skull. Triggers in this one can send pain to the top (crown) of your head.  This muscle is a major contributor to turning your head, and can be affected with triggers simply by sleeping on the wrong pillow, or at an odd angle, or a sudden jolt such as a roller coaster, car crash, or a surprised jerk of the head.

Semispinalis Capitus muscles connect the vertebrae of the upper back (between the shoulder blades) and the lower neck to the back of the head. You can feel these pulling when you tuck your chin to your chest, acting as a support system that pulls your head back up. Triggers here send pain in the shape of a headband that wraps around your head just above your ears.  Along with the sub-occipitals it can contribute to the pounding/expanding feeling of pain during headaches and migraines.  Constantly looking down (like at a keyboard or computer screen below your line of sight), continuous bending over and/or hunching can overwork these muscles as they try to balance your head and bring it upright (like a counter-weight).

Trigger Point Therapy

Trigger points in the above muscles are major factors to consider when treating migraine headaches and should be addressed by your health care practitioner. Massage Therapists have been working with these soft tissue issues for hundreds of years, and is by far the least invasive and an effective treatment method available.  Even when the source of a migraine is outside of the soft tissue, trigger points will undoubtedly form due to the pain and stress of experiencing the migraine, making massage/trigger point therapy an important avenue to pursue in your path to healing.

Next Issue: Carpal Tunnel Syndrome