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Pressure mounts across your forehead. It grips your temples. The top and sides of your neck throb. Your jaw and shoulders cry out in dull, achy frustration.
Tension headaches abound, affecting nearly 80 percent of us at some point in our lives. For some, these headaches feel ever-present.
As an acupuncturist, I often work to help people find relief from chronic recurring tension headaches. Headache triggers vary, including hormonal and barometric changes, environmental toxins, stress, teeth grinding, trigger foods, and imbalances in the body. Specifically, though, I have observed an uptick in patients with tension headaches — headaches stemming from muscle tightness in the neck and shoulders. With the rise in texting and remote computer work, forward head posture has proliferated, prompting muscle tightness and pain.
Palpating the tissues of the neck, shoulders, jaw, and scalp clarifies the muscles most tightly bound; the upper trapezius and sternocleoidal masteoid (SCM) muscles are especially common culprits. The infraspinatus and suboccipital muscles can be co-offenders.
Some take pain medication to temporarily soothe the system, but when looking for lasting relief, the integration of three steps is salient.
First, find and release the tense tissue and associated trigger points. Second, foster concurrent ease in nervous system so the muscles maintain the release (rather than reverting to their previously entrenched tension patterns). Third, implement postural changes, strengthening, lengthening, and whole-body internal health to prevent recurrence.
TRIGGER POINT ACUPUNCTURE
One especially effective technique to relieve tension headaches is trigger point acupuncture (also termed “dry needling”). An active trigger point is a particularly tender point on a taut band of muscle tissue. When pressed, the trigger point may recreate the patient's symptoms (in this case their headache); when released, the symptoms dissipate.
Sometimes, I release trigger points manually by pressing and holding the point for an extended period, but I find that needles are more efficient and effective. The needles penetrate the taut tissue and precisely engage with it. At the moment of release, the patient often experiences a local muscle twitch sensation, which is clearly visible and palpable to the practitioner as well. Most of my patients love this sensation as it immediately heralds a feeling of muscle relaxation, and often headache relief.
ACUPUNCTURE & CRANIOSACRAL THERAPY
Concurrently with trigger point release, for lasting relief, it is essential to reeducate the muscles and the nervous system. When tense neck and shoulder muscles have become a person's default pattern, the body's fascial system (system of connective tissue penetrating and connecting every cell and tissue in the body) comes to expect localized tightness as a part of the body's overall posture pattern, and recreates it.
Acupuncture and craniosacral therapy are particularly powerful tools to help usher the body into the parasympathetic mode (rest, digest, heal) for nervous system reeducation and acceptance of this newly relaxed muscle state. I affectionately name the Zen energetic state that acupuncture and craniosacral therapy elicit the "acuzone." By integrating these two modalities with trigger point release (described above) and bringing the patient into a state of deep relaxation, the patient experiences more lasting shifts.
STRENGTHENING AND HABIT CHANGES
Once the acute tension is released, for truly lasting headache relief, it is imperative to change the postural patterns and repeated movements that created the tension in the first place. Sometimes this piece involves working with a physical therapist to learn to build strength in weak muscles in the neck and shoulders. When muscles needed for a task are weak, other muscles less-suited to the job are recruited to compensate. These in turn can become easily depleted, tight, and replete with trigger points.
Awareness of the repetitive movements that elicited the neck and head tension initially is likewise key. I work with patients to pinpoint these activities and tendencies and make shifts. Often people make changes in the ergonomic setup of their computer, in the way they position their head when holding their phone, in the way they adjust their car headrest, in their pillow, and in way they sleep. Often these changes lead to immediate and significant improvements in tension headache frequency and intensity.
WHOLE BODY PERSPECTIVE
There are effective ways to release tissue tension at home before it builds to a headache. Of course, the ideal method is prevention (via strengthening, postural, and habit changes described above). But once trigger points are present, self-massage with myofascial balls can help prevent escalation. Another home method of easing tense tissue involves applying topical herbal liniments to the neck and shoulders in order to foster blood flow to the area. Picture a dry, stiff sponge (your tight muscle tissue) becoming replete with fluid (blood) and thus becoming pliable and relaxed. I find these liniments are particularly effective when coupled with the local application of infrared therapy. Infrared waves penetrate further into the tissue than a traditional heat pad and more effectively ease tightness.
Of course, the healthier you are as a whole, the more resilient and responsive to treatment. A healthy body has the bandwidth to quickly make tissue shifts because it is not overloaded by competing challenges. By optimizing nutrition and digestion we can better absorb our nutrients, providing our bodies with the building blocks to heal.
I hope these tools give you new ideas for finding lasting ease. Wishing you a year free from tension headaches and full of relief.
Annie Lindberg is a licensed acupuncturist, Chinese Medicine practitioner, and Ayurvedic practitioner. She owns and practices at The Point Acupuncture & Ayurveda, located in Madison Park and is a regular Madison Park Times health columnist.