Individuals that experience frequent headaches can have sensitive headache trigger points. Every case is different and requires a thorough examination before a proper and personalized chiropractic treatment plan can begin. Headaches can be brought on from a variety of causes. This could be:
Temporomandibular joint dysfunction (TMJ)
Tightness in the neck muscles
Low blood sugar
High blood pressure
The majority of recurrent headaches fall into three types:
Tension headaches, also known as cervicogenic headaches
Tension headaches are the most common and affect around 77% of individuals experiencing chronic headaches. Most individuals describe a tension headache as a consistent dull ache on one side of the head and sometimes both sides. They are often described as having a tight band/belt around the head or behind the eyes. These headaches usually start slowly, gradually and can last for a few minutes or days. They tend to start in the middle of the day or before the end of the day.
These headaches can be the result of stress and/or poor posture. The most common cause is subluxations in the upper back and neck, usually combined with active headache trigger points. This stresses the spinal muscles in the upper back and neck. A tension headache or stress headache can last 30 minutes to a few days. Chronic tension headaches can last for months. The pain can be severe; however, these headaches are typically not associated with symptoms like throbbing, nausea, or vomiting.
If the top cervical vertebrae shift out of their position and lose their normal motion, a small muscle called the rectus capitis posterior minor/RCPM begins to spasm. This small muscle has a tendon that slips between the upper neck and the base of the skull. It attaches to a thin, sensitive tissue called the dura mater that covers the brain. The dura mater is very pain-sensitive. When the RCPM muscle goes into spasm, the tendon pulls the dura mater causing a headache. Individuals that work at a desk station for long hours tend to experience headaches from this cause. Another cause comes from referred pain caused by headache trigger points in the Sternocleidomastoid/SCM or levator muscle on the side of the neck. This cause tends to happen more to individuals that have suffered a whiplash injury with muscle damage in the neck region.
Migraines are intense and throbbing headaches that are associated with nausea and sensitivity to light or noise. They can last for a few hours to a few days. Many experience visual symptoms known as an aura just before they come on. This is described as seeing flashing lights or when things take on a dream-like appearance. However, even in individuals that don’t experience the aura, most can tell that a migraine is getting ready to present. Individuals usually have their first attack before age 30. They tend to run in families supporting a genetic component. Some have attacks several times a month, while others can have less than one a year. Most individuals find that migraines happen less and become less severe as they get older.
These headaches are caused by the constriction of blood vessels in the brain. During the constriction period, there is a decrease in blood circulation. This is followed by dilation/enlargening of the blood vessels. This is what leads to the visual symptoms. Then the blood vessels dilate, generating a rapid increase in blood pressure inside the head. This increased pressure is what leads to a pounding headache. Every time the heart beats, it sends another shock wave through the carotid arteries in the neck into the brain. There are different theories as to why the blood vessels constrict, but they are still unknown. What is known is that several factors can trigger a migraine. This includes:
Lack of sleep
Foods that are high in an amino acid known as tyramine
Cluster headaches are very short excruciating headaches. They are usually felt on one side of the head behind the eyes. These headaches affect about 1 million individuals and are more common in men. This type of headache tends to happen at night. They are called cluster headaches because they tend to happen one to four times a day over several days. After one cluster is over, it could be months or even years before they present again. Like migraines, cluster headaches cause the dilation of the blood vessels in the brain, increasing the pressure.
Headache trigger point therapy involves four muscles. These are the:
The Splenius muscles involve two individual muscles, the Splenius Capitis and the Splenius Cervicis. These muscles run along the upper back to the skull base or the upper cervical/neck vertebrae. Trigger points in the Splenius muscles are a common contributor to pain that travels through the head to the back of the eye and top of the head.
The Suboccipitals are a group of four small muscles that maintain proper movement and positioning between the first cervical vertebra and the skull base. Trigger points in these muscles can cause pain that feels like it’s happening inside the head, from the back to the eye and forehead. Individuals report that the whole side of the head hurts. This is a pain pattern similar to a migraine.
The Sternocleidomastoid muscle runs along the base of the skull, behind the ear, down the side of the neck. It attaches to the top of the sternum/breastbone. Although most are not aware of this muscle’s trigger points, the effects are evident. This includes:
Referred pain tends to be eye pain, headaches over the eye, and can even cause earaches. An unusual characteristic of SCM headache trigger points is that they can cause dizziness, nausea, and balance problems.
The trapezius muscle is the large, flat muscle in the upper and middle back. Pain can be felt in the temple and back of the head. A common trigger point is located at the top of the muscle. This particular point can activate secondary trigger pointsin the temple or jaw muscles, leading to jaw or tooth pain.
Stress can be a trigger.
Depression, anxiety, frustration, and even pleasant excitement can be associated with headache development.
A headache diary can help determine whether factors like food, weather, and/or mood correlate with headache patterns.
Repeated exposure to nitrite compounds can result in a dull headache accompanied by a flushed face. Nitrite dilates blood vessels and is found in products like heart medications, and is also used as a chemical to preserve meat. Processed meats containing sodium nitrite can contribute to headaches.
Foods prepared with monosodium glutamate or MSG can result in headaches. Soy sauce, meat tenderizers, and various packaged foods contain this chemical as a flavor enhancer.
Exposure to poisons, even household varieties like insecticides, carbon tetrachloride, and lead, can contribute.
Contact with lead batteries or lead-glazed pottery.
Foods that are high in the amino acid tyramine should be avoided. This could be ripened cheeses like cheddar, brie, chocolate, and pickled or fermented food.
Chiropractic adjustments are highly effective for treating tension headaches, especially those that originate in the neck. Research has found that spinal manipulation resulted in almost immediate improvement and had fewer side effects and longer-lasting relief than taking common medications. There is a significant improvement by manipulating the upper two cervical vertebrae, combined with adjustments to the area between the cervical and thoracic spine.
Body Composition Testing
Vibration exercise is believed to stimulate the muscle fibers without going to a gym or stressing the bones. One study broke up postmenopausal women into three groups: resistance training, vibration training combined with resistance training, or no exercise/training. Their body composition was measured before starting the study. After the study was completed, the findings included:
Both the resistance group and the resistance group with vibration training increased lean tissue mass.
The control group did not show an increase in lean tissue and, in fact, gained body fat.
The combination group, using vibration training with resistance training, showed a drop in body fat.
Another study placed male athletes in a training program that included vibration training. The first group had lower-limb strength training combined with vibration training, and the other had lower-limb strength training without vibration training. The researchers found that the athletes in the vibration training group improved leg extension strength by five percent. In addition, the vibration training groups balancing ability and vertical lift/jumping test improved as well.
Bryans, Roland et al. “Evidence-based guidelines for the chiropractic treatment of adults with headache.” Journal of manipulative and physiological therapeutics vol. 34,5 (2011): 274-89. doi:10.1016/j.jmpt.2011.04.008
Chaibi, Aleksander et al. “Chiropractic spinal manipulative therapy for cervicogenic headache: a single-blinded, placebo, randomized controlled trial.” BMC research notes vol. 10,1 310. 24 Jul. 2017, doi:10.1186/s13104-017-2651-4
Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014; 37: 42-63.
Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011; 34: 274-89.
A trigger point is a knot or bundle of stiff spine muscle tissue that you can’t move or relax, and when touched pain spreads to the neck, shoulders, and upper back.
Pretty much everyone can relate to this type of pain in the neck or what is known as myofascial pain syndrome when several of these trigger points are grouped.
How to ease the pain and prevent it
Trigger points can form in muscles all over the body. Myofascial pain syndrome in the neck happens when trigger points develop in the muscles of the shoulders, upper back, and neck.
A Trigger Point
Trigger points have a unique connection to America. They were first identified in the 1940s by Janet Travell, MD, who was John F. Kennedy’s doctor. JFK had severe chronic back pain and had trigger point injections to ease the pain.
A trigger point is a sensitive area within the muscles. They are typically described as knots and feel like a bundle of tense, contracted muscles that twitch and spread pain when touched. The spreading pain is known as referred pain. Example: Trigger points in the shoulder send pain into the neck.
Trigger points cause muscles to stress and to contract. This results in:
Limited muscle movement
Formation of Points in The Neck
They are usually caused by mechanical factors (factors that strain or stress the muscles).� Spinal trauma, like whiplash from an automobile accident or sports-related injury, can create trigger points.
They also develop through repetitive actions and routine everyday chores that can hurt the spine over time.
Straining the neck muscles from poor posture for extended times like craning the neck while working on a computer, carrying a heavy bag that stresses the muscles of the neck, upper back, and shoulders.
Trigger Points vs Fibromyalgia Tender Points
Trigger points do get confused with tender points of fibromyalgia. Trigger points and tender points are both defined as local areas of pain but are not the same.
Tender points do not cause referred pain the way trigger points do.
Tender points are symmetrical meaning that they are on both sides of the body. Whereas trigger points do not follow a symmetrical pattern.
But it can become complicated because individuals with fibromyalgia can have both tender points and trigger points. People with fibromyalgia can also have myofascial pain syndrome.
Trigger Point Diagnosis
Trigger points are a regular cause of different types of spine pain, that can range from neck pain to low back pain. However, doctors are still trying to understand how trigger points produce referred pain. This is why diagnosing trigger points can be difficult for doctors.
They are complex because they are easy to pinpoint but difficult to diagnose. As they can directly cause muscle pain but they can mimic other pain making conditions exactly the way Myofascial pain and fibromyalgia get confused.
These types of pain that do not go away could be caused by trigger point/s in the neck.
Individuals with chronic neck pain that don’t seem to have a cause, could be trigger points. A doctor will refer you to a physical therapist, chiropractor or another spine specialist to conduct an examination for trigger points.
Treatment can range from home remedies, chiropractic care, physical therapy and if severe muscle injections. There is no one treatment that works, as everyone and their injuries are different, meaning that various treatment options need to be looked into.
Before starting any home therapy, discuss it with a trained professional like a doctor, chiropractor, massage therapist, or physical therapist to identify the location of the trigger point to effectively treat it.
Treated with massaging the area but can be tough with hard-to-reach places in the upper back. If unable to reach the point slowly and gently roll over a foam roller, golf or tennis ball for quick relief.
Massage therapists are trained in relieving muscle pain. Deep tissue massage can relieve an irritated area. Regular massage sessions can reduce pain and prevent the points from reemerging.
Physical therapy treats trigger points in different ways, this includes:
A cooling spray is applied followed with stretches to relax and relieve the contracted muscle/s
Muscle relaxants can be used to reduce the symptoms and relieve pain. However, these meds can have all kinds of side effects, and become habit-forming, so use should be limited and in conjunction with a proper chiropractic/physical therapy treatment plan.
If the pain continues despite the non-surgical treatments or worsens, then your doctor could recommend trigger point injections. Injections are late-stage therapy. Doctors want to avoid patients becoming dependant on injections and will prescribe injections with an exercise, chiropractic/physical therapy program for maximum relief and effectiveness.
The majority of people have felt tight muscles around the neck. Utilizing proper posture and healthy spinal mechanics can prevent trigger points and myofascial pain syndrome.
�Neck Pain and Chiropractic Treatment El Paso, Texas
Many people who have trigger points or myofascial pain syndrome in their spine have knots and tightness throughout their back and neck. To prevent myofascial pain syndrome one needs to practice a healthy lifestyle that promotes good spine health. Stretching and exercising regularly can help keep stress under control and prevent tension from building up, which makes it harder for trigger points to activate and cause pain.
Many people think of joints, bones, and the, skeletal system when they think of chiropractic, but in fact, the muscles also play an integral part in supporting the body. The muscles are layers and interwoven work to move and stabilize the spine, facilitate the movement of the body�s joints, and aid in respiration. When there is pain within this system, chiropractic can be a very effective treatment. More patients are turning to chiropractic care to treat a variety of painful conditions because it does not use addictive pharmaceuticals with unpleasant side effects; it is completely natural. Chiropractic can also keep patients from requiring surgery in many cases. So when it comes to myofascial pain and trigger points, this form of treatment is often considered optimal.
What is Myofascial Pain?
In simple terms, myofascial pain is simply pain in the muscles. When you break down the word, �myo� means muscle and �fascia� refers to the connective tissue that are interwoven throughout the body.
The pain originates in specific trigger points that are located in the muscles and fascia at various areas of the body. The pain can range in intensity from mild and annoying to severe and debilitating.
What are Trigger Points?
Trigger points are tightened, hypersensitive spots that can be located in any muscle. Different people may have different trigger points. It isn�t like specific lower back pain or neck pain which occur in particular areas of the body. Trigger points can vary from person to person.
When trigger points form, they become nodules or spots that exist in one of the muscle�s taut bands. The patient may experience a variety of symptoms including pain, weakness, burning, tingling, and other symptoms.
What often makes trigger points challenging to locate is that they cause what is known as referred pain. In other words, the person may experience the pain at the exact location of the trigger point, or the pain can be referred to other areas in the body. Referred pain usually has fairly consistent pain patterns so it can be traced to the origin � eventually.
Around 85% of the pain that individuals experience is attributed to myofascial pain. The trigger points determine whether the pain is chronic or acute. It is a condition that is very common.
How do Trigger Points Form?
Trigger points form when the muscle undergoes trauma of some type. The trauma can come from disease, accidents, related work conditions (from persistent, repetitive motion), and sports injuries.
Activities or habits that place a repetitive, long-term strain on the muscles can also cause trigger points. Poor posture, improper ergonomics, and repetitive movements are the most common of these types of activities. Emotional and physical stress are often identified as causes of irritating trigger points.
Benefits of Chiropractic for Myofascial Pain and Trigger Points
Chiropractic care is often a preferred treatment for myofascial pain due to its effectiveness and drug-free approach. Patients who undergo treatment will usually experience a dramatic decrease in their pain level, or it will be eliminated.
They also enjoy increased strength, flexibility, and range of motion. With continued chiropractic care, they will find that they have more endurance for work and recreational activities and even sleep better. It should be noted that sleep disruptions are a common complaint associated with myofascial pain.
Overall, chiropractic can give patients with myofascial pain a better quality of life with decreased incidence of injury. They are often able to lower their pain medication or eliminate it.
Because chiropractic is a whole-body approach, patients learn healthy habits including diet, exercise, and mental wellness. Most of all, they can live with less pain or no pain at all.
Doctor of Chiropractic
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