Posts

, , , , ,

Headaches – From the Neck Up

We have talked before about headaches from a massage perspective previously. However, there are many reasons for headaches that may be cause to see a physiotherapist as well. Check out this case study for headaches from the neck!

Case Study NP

What does it feel like?

NP comes into the clinic, he is a 35 year old father of 3 and works a desk job for the past 5 years. Before that he was working on-site in construction, often looking overhead. In the past 2 years since his third child was born he is noticing he is getting more frequent headaches. Often his headache is is on the right side behind his eye and in the temple. As NP gets talking he realizes that he also has some dull pain in the shoulder and arm; but this pain is occasional compared to the headaches. He finds that when he is working at his desk by the end of the day the headache is nearly unbearable. By the time he gets home he has difficulty playing with his kids, and it’s starting to impact his ability to work around the house and cabin.

He doesn’t recall a specific injury to his neck, but NP does have a cabin and boat at the lake and loves trying new water sports. Just before his third child came friends came to the lake and decided to take the tube out where he was flipped multiple times.

This all-too-familiar story can have multiple ways that it could have begun – a whip lash injury, strain of the neck or shoulders, etc. Let’s focus on this case study and some of the possible reasons WHY this happens, what we can do about it, and how you can start your road to recovery TODAY! 

What Causes Headaches?

The neck is actually a highly complex unit. We have multiple bones in the neck (seven to be exact!), nerves that travel from the neck up into the scalp and down into the arms, plus all the ligaments, tendons and muscles. The body is an amazing thing when you think of all the moving parts. Generally speaking we are able to maintain a pain-free lifestyle; however sometimes we need a little help.

One of the reasons that we can develop headaches is because of neck dysfunction. In this instance NP is experiencing referral from the upper cervical spine (C1-3). This is why he has pain near his eye. Increased stress and posture issues can also significantly impact headaches.

If you have headaches, a physiotherapy assessment could benefit you!

What does an assessment look like?

NP came for an appointment at the beginning of the day because it worked better with his schedule. He was worried that not being severely symptomatic would be a problem for the assessment. He was relieved when he heard that the therapist would be able to evaluate the neck regardless of the amount of current pain.

The assessment took a look at his overall neck range of motion. NP was surprised to discover that he had more difficulty tipping his right ear to his right shoulder, and shoulder checking over the right. When the therapist had him lay down to evaluate the neck movement and muscle tension he was significantly more tender on the right side at the base of the skull.

During the assessment the therapist identified some specific muscle weakness and tension that would need to be addressed.

NP was surprised that during the appointment the therapist was able to recreate his headache symptoms and shoulder pain. He wanted to make sure that he could get back to his normal home-life routines. NP booked his next 4 appointments weekly and was sent home with exercises and stretches to get him started.

Over the next four weeks NP attended his appointments for some manual therapy from the physiotherapist and updates to his home program. He was pleased that by week 3 his headaches seemed to be significantly better.

NP resolved his headaches within 6 weeks, and returned for a flare-up 4 months later. The flare-up lasted 2.5 weeks and after resolving has not returned since he is able to manage any issues with his home program.

How long until I am better?

The recovery period usually varies from client to client, depending on the severity and frequency of signs and symptoms. Other factors include:

  • How long the headaches have been going on, how severe they are
  • What areas are contributing (neck mobility, muscle tension, etc)
  • Commitment to the home exercise program

Straightforward cases we tend to see client’s 1x/1-2 weeks for a total of 4 to 6 sessions. These sessions include manual therapy to help restore joint and muscle mobility as well as exercises for their home program.

Don’t delay! Schedule your assessment today to get started your journey to recovery!

/by
, , , , , ,

Do YOU have TMJ?

Have you heard of your temporomandibular joint (TMJ)? It’s one of the most used joints in your body. Did you know physiotherapy can help with TMJ problems?

Your TMJ, also known as your jaw joint, is used for eating, talking, expressing emotion (both consciously and unconsciously) and breathing.

Pain associated with dysfunction in this area may be felt in the jaw line, cheek, ear, temporal region (side of head) and commonly associated with headaches and neck pain. TMJ problems, or TMJ dysfunction (TMD) can also present as inability to fully open your mouth, pain with chewing, popping/cracking with opening and closing your mouth, and/or grinding/clenching of teeth.

Some of the causes of TMJ problems can be derangement or displacement of a disc between your mandible (jaw bone) and skull, muscle dysfunction, habitual clenching/grinding (bruxism), or trauma to the face and jaw. Common contributing factors to TMD can be stress, anxiety, prolonged opening of the mouth (e.g. during dental procedures), mandibular malalignment or orthodontic work to name a few.

A physiotherapist will assess the TMJ by asking a detailed history, taking observations of jaw alignment, posture, and neck position. They will observe how the individual opens and closes their mouth, looking for abnormal movements patterns, and observe for clicking from the TMJ. The therapist will palpate externally for muscle tone, and to assess the movement of the TMJ. Using gloves an intra-oral assessment will be completed as well to determine how the joint is functioning, and to further assess the myofascial system. The neck is generally assessed as it can commonly contribute to dysfunction in the TMJ.

Following an assessment, a treatment plan and home program will be developed.

Ms. W comes in with complaints of pain through the right greater than left temporal region of her jaw, inner ear on right, frequent headaches and stiffness in the jaw that is often worse in the morning. Recently she has begun to noticing a clicking from her right jaw, especially when she yawns or eats chewier items. Her dentist advised her she likely has TMJ problems and recommended that physiotherapy may help.

The physiotherapist may ask a few of the following questions: How long have you been dealing with this problem? Do you ever find yourself clenching your jaw in times of stress or have you been told you grind your teeth overnight? Any recent dental procedures? Any history of trauma to the face or neck?

As mentioned above the TMJ is one of the most frequently used joints in the body. Most clients who receive treatment for their jaws have been experiencing symptoms for some time, and often did not know that physiotherapy can help. Commonly they have seen their doctor or dentist prior to seeking treatment.

In the case above the individual likely has a longer standing history of clenching, also known as bruxism. Commonly people can do this subconsciously during their sleep, or in times of stress. When frequently clenching the muscles of the face and jaw can become fatigued and become sources of pain. When muscle are held tight for long enough they can start to alter the way the jaw moves, and lead to problems with a disc located between the jaw and the skull.

The physiotherapist will develop a treatment plan specific to Ms. W’s presentation completing treatment specific to the muscles surrounding the TMJ and the joint itself.

 

If any of the symptoms described sound familiar, book in for an assessment today!

/by