Head and Neck Pain

Our heads hold the key to processing the information from the world both incoming and outgoing. Our eyes see dangers and the brilliance of the world around us. Our ears hear incoming threats as well as sweet nothings from a lover or spouse. Our mouths experience the world through taste and keep our bodies full of the nutrients we need to survive,(and then there is ice cream, we can’t forget the ice cream). The world around us is brought to you by the senses in our head, when there is dysfunction the impact can be meaningful and sometimes devastating. Let’s take a closer look at some of the areas that soft tissue can play a role.

Headaches

Headaches can be mild or they can leave us unable to leave our dark rooms for days on end. Frequent or long lasting headaches such as migraines, can be triggered by a number of factors that are unrelated to soft tissue and including food allergies, fragrances, bright lights, stress and hormones to name just a few. Soft tissue dysfunction will not be a significant reliever of these types of triggers but there are several muscles and bony structures that can play a role in headaches and headache relief.

How do you know if you have a tension headache and massage can help? You will most likely have headache pain that allows you to continue your daily activities. While not great, tension headaches are not as debilitating as some of their counterparts. Your pain may feel like pressure in your head or like your head is being squeezed. As the name suggests, if you feel tension in your head you most likely have a tension headache to thank for it.

If you suspect that your headaches are caused by tension, there are 8 neck muscles that are notorious for headache symptoms. If your pain matches any of the patterns below it may be muscle related and relief can potentially be experienced within a few sessions.

Where you feel your headaches can indicate what muscles are involved, let’s take a look at some of the usual suspects.

Trapezius – pain associated with this muscle may feel like a question mark running from the same side eye around the ear and down the side of the neck. Sometimes pain can be along the same side jaw mainly at the curve from the ear to the bottom of the jaw.

Temporalis – pain above the ipsilateral (same side) eye, along the side of the head (the soft spot of the skull next to the eye) or even as a toothache (same side upper teeth usually)

Masseter – pain in same side ear, above the same side eye or even the back teeth of the same side jaw (both upper and lower)

SCM – pain that runs up the same side of the neck, behind the ear on the same side as the pain, from the cheek bone and above the eye on the same side as the pain.

Occipitalis – pain on the top of the head that may also run down the same side back of the head, also in the orbit of the eye, same side.

Suboccipitals – pain that runs on along the skull just over the ear and at the base of the skull

Semispinalis – pain that runs up the back of the skull, usually on the side that is painful. It can also show up as pain at the temple

Splenius Capitis/Cervices – pain on the top of the head

It is important to note that headaches can often be the symptom of dangerous medical conditions. If your headache is something new or feels unlike previous headaches, you have had or experiencing difficulties related to cancer or blood clotting,or are taking new medications you should start with your physician first before seeking the help of a massage therapist.

Whiplash

Been in a car accident? Bumped your head on a cabinet? Ever rode a rollercoaster? Ever had a slip or fall? Ever had a concussion? If you answered yes to any of these questions you most likely have whiplash. If left untreated you may be experiencing loss of cervical rotation, headaches, loss of cervical curve, dizziness, stiffness of the neck, painful muscle spasms, tenderness to touch in the affected muscles, Thoracic Outlet Syndrome, pins and needles in your arms or hands, and/or loss of sleep due to pain. Regardless of how long ago you experienced your whiplash, if you have not sought soft tissue treatment specifically for this malady you should seriously consider doing so.

What is whiplash? In simple terms, in the case of a car accident, it is when your body is strapped into a car seat and traveling at the speed of the car (either in motion or standing still) and an outside force impacts your vehicle. Upon impact, the body is firmly affixed to the seat and will stop traveling, your neck and head, on the other hand, being free to move, continue to do so beyond their normal positioning over the body (hence, whip). The lash occurs when your head and neck reach their farthest point and recoil back towards and past the fixed body (lash). You can imagine all the problems that would occur while muscles are being lengthened and retracted from acceleration and deceleration. While the biomechanics are much more involved you will get a rudimentary picture from our description. Whiplash will involve both muscles on the front and back of your neck, both requiring treatment.

What muscles might these be and how does this process affect them?

Anterior Muscles of Whiplash

Longus colli – can lock the neck causing loss of cervical cure

SCM – clavicular branch can create dizziness, the entire muscle can create forward head posture

Hyoid muscles – can create difficulty in swallowing

Digastrics –

Posterior Muscles of Whiplash

Semispinalis Capitis/Cervicis – can make it difficult to to look up

Splenius Capitis/Cervicis – can make it difficult to to look up

Suboccipitals – can cause headache symptoms and limit range of motion

Levator Scapula – can be influenced by SCM and strain to counter balance excessive forward head posture

Upper traps – Can create headache issues and make it hard to lift your head or rotate your neck

Rhomboids – may create rounding of the shoulders

Rotators – limits rotation of the trunk of the body

Multifidus – can make it difficult to stand up straight if damaged

Digastrics – aids in swallowing and movement of the jaw

Thoracic Outlet Syndrome (TOS)

When the nerves of the arm (the brachial plexus) along with the subclavian artery and vein are compressed into the clavicle several problems may arise from this scenario. You may get pins and needles in your arms and hands, you may feel like your neck, arm or hand is puffy, your hands may feel cold or puff (sometimes it is only single sided), you may experience weakness in grip or your hand and arms may fatigue easily. All of these may be signs of Thoracic Outlet Syndrome.

Where are your points of entrapment

There are several points of entrapment that can compress the entire brachial plexus. Below are those areas.

1) Radicular Entrapment of the Brachial Plexus as it emerges from the Spine

As the brachial plexus leaves the spine the cervical components can create compression

2) Muscular Entrapment of the Brachial Plexus

-The brachial plexus can get squeezed between the anterior and middle scalene causing it to lose its ability to send signals

-The subclavius muscle attaches to the first rib and can create a crush as the brachial plexus passes between the clavicle and the first rib

-Pectoralis minor also can crush the brachial plexus against the ribs of 3,4 and 5 if it is to tight

3) Bony Entrapment of the Brachial Plexus

-First rib as anterior and middle scalenes tighten and compress it against the clavicle

-First rib as subclavius shortens and tightens the first rib against the clavicle

-3rd,4th, and 5th rib are compressed into the brachial plexus by an overly tight pectoralis minor

-The humeral head is drawn up and into the A/C joint by an excessive rounded postural position, compressing the brachial plexus as it moves to divide into its different divisions.

TMJD

Temporomandibular Joint Disorder. Can have many causes. Since this joint is one of the most utilized joints in the body it can take a beating. Some of the most common reasons this joint can cause pain include, stress, misalignment, grinding, gum chewing, imbalance in the body especially at the pelvis, forward head posture, inflammation, trauma and clinching. Some appliances made to protect your teeth can also misalign the jaw and cause pain. The most problematic demographic for TMJ are females from 20 to 40 years of age.

There are 4 basic reasons for TMJD and include arthritis, misalignment of the joint, disc dislocation and inappropriate muscular contractions. Medical massage can assist with the last of these causes. Let’s take a closer look at what the muscles involved in TMJD actually do and how you can discern which may be causing your jaw pain.

The muscles of mastication (chewing) include

Masseter – assists the lower jaw with closing and sliding forward of the upper jaw (mandibular elevation and protrusion)

Temporalis – also assists the lower jaw with closing and helps it slide under and behind of the upper jaw (mandibular elevation and retrusion)

Lateral and – assists the lower jaw open, slide forward from the upper jaw and moves it from side to side (mandibular depression, protrusion, and lateral excursion)

Medial Pterygoids – assists the lower jaw close, slide forward from the upper jaw and moves it from side to side (mandibular elevation, protrusion, and lateral excursion)

Cervical Muscles – such as the group of hyoid muscles and the digastrics can all play a roll in opening of the lower jaw (mandibular depression)

How can you identify if your problem is TMJD. Some simple tests you can try at home can help you identify the need to get further help. If you open your mouth slowly and you see that it pulls in a sideways motion as you open, this could be muscular dysfunction. Your bite may also be affected by muscular contractions causing your teeth to misalign. If you also have forward head posture or rounded shoulders these can be contributing factors to TMJD. In some cases a feeling of fullness in the head or ringing in your ears (tinnitus) paired with dizziness can also be indicators.

Dizziness

If you suffer from dizziness, and other methods to correct this problem have not been helpful, your problem may lie with muscles that are too tight.

The sternocleidomastoid (SCM), may be your culprit. The clavicular head can create a sensation of dizziness while the attachment at the mastoid may be a contributing factor in both TMJ and tinnitus. Sitting up in bed from a flat position, being in a car accident, a slip and fall incident or even forward head posture (text neck) will also create tension in this muscle that can bring on the dizziness symptoms. Treating this muscle and retraining some of your dysfunctional movement patterns can alleviate or eradicate these symptoms all together.

Sinus Pain or Congestion

Sometimes muscular contractions can compress the body’s apparatus that allow sinus congestion to drain. Cupping can assist in clearing this tension and assist in the moving of congestion out of the sinus cavities. Releasing specific muscles in the neck can also improve these symptoms and reduce pressure in the head.

Tinnitus

Tinnitus, also known as ringing in the ears, has many causes including overexposure to loud noises, circulatory issues, being involved in an accident, or as a part of the aging process and hearing loss. If you recognize that this is happening in one ear only, there may be a muscular component to your symptoms. There are several muscles and even the positioning of your jaw that can be the culprit. Since there is no definitive reason tinnitus occurs, finding a solution can be quite difficult and may be a process of elimination for most people.