any patients present to the clinic complaining of headaches or tension in their head typically described as a pressure behind their eyes. It is important to be clear that there are numerous causes of headaches and many different types but one of the more common headaches are called tension-type headaches. Tension-type headaches are classified as secondary headaches as they are a result of underlying issues in the head and or neck. Tension-type headaches are typically a result of pain referred from a source in the neck that is perceived in one or more areas of the head or face. The characteristic signs and symptoms include mechanical exacerbation of pain, reduced neck range of motion, tenderness in the neck and trigger points that refer pain to the head. When myofascial pain (muscle pain) such as trigger points are the cause of a headache in the absence of other clinical signs the headache is diagnosed as tension-type.
Now you may be asking what is a trigger point and how does it create pain in our muscles. A trigger point is a hyperirritable spot, a palpable nodule in a taut band of skeletal muscle. Direct compression of a trigger point can elicit local tenderness, local twitch response and referred pain. Referred pain is when pain is perceived at a location other than the site of a painful stimulus. Trigger points can develop within a single muscle or a group of muscles, as a direct result of injury to the fibres from trauma, repetitive motion, or periods of immobility. Mechanical factors such as poor posture or ergonomics cause muscles to undertake frequent and improper loads that also attribute to trigger points.
A group of muscles that frequently experience trigger points is known as the suboccipital muscles. This is a group of four muscles that are located at the base of the skull and are responsible for subtle movements between the skull and first and second vertebrae in our neck. The suboccipital muscles commonly become tense and tender due to factors such as poor ergonomics when sitting at the computer or scrolling on our phones, eye strain, and trauma such as a whiplash injury. Pain from the suboccipital muscles commonly feels like a band wrapping around the head or a pressure behind the eyes. Therefore, tightness and trigger points within the suboccipitals muscles can be a large contributor of headaches for many people.
So now you may be asking how do you know if a headache or pressure behind your eyes is being caused from the suboccipitals muscles? Common signs and symptoms of a headache stemming from the suboccipitals include:
Pain, stiffness, and a dull ache in the upper neck and base of the skull
Pain on the back of the head, forehead and behind the eyes
A pattern of headaches that develop after prolonged use of your cell phone, laptop computer or other prolonged static position
Occasionally may experience visual disturbances or nausea however those tend to be more common in migraine type headaches
So, what can you do to relieve headache pain caused by the suboccipital muscles? Rest assured, trigger points respond very well to conservative treatment options!
I cannot stress enough how important it is to be properly examined by a healthcare practitioner when experiencing any new symptoms or injuries. As previously mentioned there are many different types of headaches or reasons someone could be experiencing headache-like symptoms and we do not want to just assume it is caused by referred pain from trigger points in the muscles. Once the injury has been properly assessed and a diagnosis has been achieved, you may then begin to receive the appropriate treatment. Effective treatment for tension-type headaches includes treating the affected muscles. As a chiropractor I have many different techniques I can use to treat these tight muscles including soft tissue or active release techniques, acupuncture/dry needling, stretching and education to avoid re-aggravation of the tissues.
Remember, although you may feel a headache in your forehead, you may actually be experiencing referred pain caused by a tight muscle/trigger point. The location of the pain you are feeling is not always where the injury or the dysfunction is rooted. Very often during assessments I am able to recreate the patient’s headache by simply pressing on their trigger points. Trigger points do not only create headaches but can be found anywhere throughout your body and therefore can present as other types of pain. When experiencing an injury, visiting your chiropractor or physiotherapist can be very beneficial as they are able to properly assess and diagnose any limitations that you may be experiencing and provide an appropriate treatment plan.