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  • Spencer Noble, PT, DPT, Cert. MDT, Cert. Dry Needling

What do headaches, neck pain, and poor posture have in common?

Updated: May 30, 2021

Physical Therapy | Headache | New Braunfels, TX
Major headache

They all tend to be a significant finding with patients suffering a specific form of headache. Those that suffer from chronic headaches know they are incapacitating, frustrating, and time-consuming. Going from specialist to specialist can be depressing as it seems like no one has the “right” answer for you. They use a diagnosis like migraines and give you some medicine to help when they flare up which may help but only temporarily. This headache variation presents with pretty specific symptoms and is often controllable with simple but specific movements. They are a very common occurrence in those that tend to sit at a computer all day with no postural support. There is a reason they say, “sitting is the new cigarettes”.

I cannot count the number of patients that have mentioned migraines or tension headaches in the medical history that end up being cervicogenic headaches. The presentation warranted testing which should have been recognized. This has become a significant problem in my eyes because many of these patients had battled their headaches for years with no true relief attained due to a missed diagnosis. There are a few simple checks that you can perform to determine the likelihood of this being what is ailing you.

The first and most important rule of thumb is that these headaches are unilateral in nature, meaning that they only affect one side of the head at a time. Interestingly they also tend to follow a pretty specific pattern. Do you know what a ram’s horn looks like? Imagine this shape and place it on the side of your head starting at the base of your skull looping up and over your ear toward your temple/eye. This seems a bit ironic since these headaches can feel like someone is cracking your head open!

The next common denominator is that most patients report some level of neck pain and soreness. This symptom is often associated with limited neck range of motion. Research seems to support that the most commonly limited movement is looking up over your head. I believe there are multiple reasons for this, including static posturing which may lead

to mechanical dysfunction and reduced soft tissue extensibility associated with this movement.

Physical Therapist | Headache | New Braunfels, TX

The most recent data looked at the posturing of the whole spine rather than just the head and neck and found that any malalignment even in the lumbar spine leads to a higher incidence of cervicogenic headaches. This is pretty logical as each segment of the spine will affect the segments above and below it. So, for those that spend all day sitting at a computer, drive home sitting in the same position, and sit down on the couch to “unwind” from the day you will have a much higher chance of experiencing these symptoms. Now the good thing here is that I do not truly believe that posture alone is responsible. From my clinical experience, it is the lack of movement out of these positions that tends to lead to dysfunction. There are some very simple movements that you can implement to minimize to effects of these positions. Of course, with anything else, healthcare-related there will be instances where we need to dive a little deeper into the cause of symptoms in order to resolve them.

A good place to start would be to check out our older post on the slouch-over-correct movement which is generally tolerated well and can be very beneficial! This can be found here:

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