Tag Archives: Thera Cane Massager

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Neck Pain and Headaches? Work Your Core?!

You may have heard that if you suffer from low back pain (LBP) that you need to work your “core” muscles, but what if you suffer from neck pain (cervicogenic pain) and/or headaches?  Well then yes, you would need to work the core muscles of the neck.  Like the lumbar spine, the neck also has a group of core muscles that are specifically designed to insure proper cervical segmental stability and to maintain proper head posture.  When weakness and dysfunction are present within this group of muscles, there is often ongoing neck pain that can lead to headaches.

Muscles of the cervical neck “core” include the deep neck flexors and deep neck extensors.  Most people don’t know the names or how to spell these rarely talked about muscles.  For those who like the nitty gritty details, the deep neck flexor muscles include the longus colli and longus capitis.  The deep neck extensor muscles include the multifidus and the semispinalis cervicis.  The sub occipital muscles (including the rectus capitus posterior major and minor) and the obliquus capitus superior and inferior also play a role in cervical stability.  These muscles as a group make up the core muscles for the cervical spine.

When classifying muscles, and especially the cervical muscles, it can be useful to think of them conceptually as global movers and local stabilizers. 

Global movers are involved in the generation of torque and produce movement.  They function more like a light switch, either moving your head or not.  When dysfunctional, there are spasms, pain, and a restricted range of movement.

Local stabilizers are the deeper muscles that control segmental movement and neutral positioning of a joint and the head.  Their activity is tonic (always on).  It’s like a light switch that is always on, but with a dimmer controlling the intensity.  Local stabilizers operate at much lower levels of contraction for long periods of time.  Dysfunction in the local muscles results in the inhibition of muscle function, delayed timing or recruitment of when the muscle is stabilizing which causes loss of segmental control and poor cervical vertebral joint positioning.  This is often associated with chronic neck pain and headaches as well as muscle spasms in some of the larger muscles (such as the upper trapezius) as it attempts to compensate for the underlying muscle inhibition.

The neck presents a unique challenge of both mobility and muscularly speaking.  It requires intricate muscular control to balance the weight of the head in space.  The neck also moves the head through a large range of motion available; all while positioning it accurately to allow us to use our senses (sight, smell, hearing, and taste) most effectively.

Mobility and stability are both vitally important to how the neck functions.  This is why the deep segmental stabilizing muscles are extremely important.  These deep core muscles (also known as the “inner unit”) have been shown to weaken in the presence of neck pain or injury regardless of the cause.  As part of a compensation pattern, one will often find that the prime mover muscles at the front of the neck, called the SCM (sternocleidomastoid muscle), become overactive trying to protect the neck.

Unfortunately, this creates excessive shear and compression forces on the neck which brings the head forward into the poking chin posture.  This dysfunction pattern tends to persist even when the pain subsides unless properly retrained.  This may explain why so many people experience recurrent episodes of neck pain.  Discover why it’s important to insure proper cervical core strength in order to not only alleviate neck pain and headaches, but also to prevent them from reoccurring.

Most of the time neck pain is mechanical in nature.  This means that there is a structural or mechanical issue affecting proper motion in the neck leading to either neck pain or headaches.  Since the trigger is mechanical (starting or worsening with certain movements), it can just as easily be reduced or eliminated if the correct movements can be initiated.  Mechanical neck pain is often experienced as cervical pain, headache pain or other correlated pain patterns in your upper back and down your arms (even to your fingers).

Neck Pain (Cervicogenic Pain) Symptoms include:

  • Pain in the front of your head, behind your eyes or side of your head.
  • Pain which begins from your neck that extends between your shoulder blades and upper shoulders.
  • Pain which is exacerbated or changed by certain neck movements or neck positions.
  • Pain which is triggered by pressure applied to the upper part of the neck near the base of the skull (known as the sub occipital area) or in the upper trapezius area.
  • Pain down one or both arms.  It can be felt as far as your fingers.
  • Stiff neck.
  • Altered or blurred vision as well as nausea, vomiting, and/or dizziness.

Potential Causes for Cervicogenic Headaches

There are plenty of reasons why one might develop neck/cervical derangements or dysfunction.  Examples include: motor vehicle accidents; sports; falls; sleeping on a poorly fitted pillow; poor posture; and carrying items that are too heavy (such as a backpack).  Chronically sustained non-symmetrical postures, stress, and a sedentary lifestyle are also potential causes.

The actual pain generating structures of the neck (listed below) vary wildly and can be difficult to pinpoint.

  • Nerve related injury or pain
  • Muscle spasms
  • Trigger points
  • Facet joint dysfunction
  • Cervical mal-alignments
  • Cervical disc issues
  • Postural dysfunction

Cervicogenic pain and headaches tend to be more common in women than men.  In general, women experience this due to minor anatomical differences.  Men tend to have muscular necks. Women tend to have longer more slender necks with less muscle to provide support to the head (meaning that there is less muscle strength for support).

Treatment for Neck Pain (Cervicogenic Pain) and Headache Pain

Research suggests the most effective management of neck pain conditions include both manual therapy (hands-on mobilization) and manipulation with specific exercises.  If you have to choose one or the other, I find that a correctly designed and implemented exercise program to be the most effective over the long term.

The first step to designing a treatment plan is by identifying a pattern to the pain.

Which head motions change or alter your neck or headache pain?  Does the pain get worse or does it improve when you turn your head?  What happens when you look up, look down, slouch or sit up straight?  What happens when you repeat this movement?

Determine how your pain responds.  This is also known as establishing a directional preference.  You might be moving in the wrong direction if the pain spreads away from the spine and down into the upper back or arm.  Stop that particular movement, and try the opposite direction.

In my experience, most episodes of cervical pain and headaches tend to respond better to cervical extension biased movements and improvements in posture.  Gaining extension in the thoracic spine is also critical to treatment.

In order to determine if extension biased (cervical retraction or extension) movements help you, I recommend starting with this exercise (as shown below).  Sit up straight, and retract your chin straight back.  Repeat 10-20 times.

Carefully monitor symptoms for peripheralization or centralization.  The rule of thumb for movement:  If the pain worsens by spreading peripherally down the arm into the hands, fingers, shoulder blade/upper back or the headache gets worse, then the condition is worsening (peripheralizing).  Stop that activity.  If the pain centralizes and returns back toward the cervical spine, and the headache pain improves (even if the pain in the neck worsens slightly), then keep moving as the condition is actually improving.

If you are unable to help or change the pain in any way, then you may need assistance from a medical provider.  For a thorough discussion and an excellent treatment resource, please refer to Treat Your Own Neck  by Robin A. McKenzie.

Once you have determined a directional preference, then you can focus on the deep core and stabilizer muscles.  For my initial neck core strengthening exercises, please refer to Deep Neck Flexion Exercises.

Once you’re able to engage the deep neck flexors, you can next progress into strengthening your scapulothoracic and postural muscles.  Be sure you are engaging the deep neck flexors during these exercises to insure proper stability of the neck.

For the I’s, T’s, and Y’s exercises (as shown below), work up to holding each position for 30 seconds.  Repeat 3 times.  Keeping the correct posture and deep cervical flexor muscles engaged during this exercise is critical to engaging the full core of the neck.

Other Treatments for Neck Pain (Cervicogenic Pain) and Headache Pain:

  • Focus on your posture.  Poor posture is the bane of modern society.  The most common example of poor posture is a forward head with rounded shoulders.  This causes excessive muscular tension throughout the cervical spine, upper trapezius region, and mid-thoracic area.  Over time, this leads to muscle weakness and dysfunction in the cervical spine and upper thoracic area.  Proper posture allows for the optimal alignment of your spine.  Neurologically speaking, this allows for your muscles to down regulate by reducing tension.  Poor posture is almost always associated with muscle knots and trigger points.  My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain is a downloadable .pdf file with my recommended stretches using foam roller exercises to address posture.  These simple exercises (with complete instructions and photos) will help you to improve poor posture and can be performed at home.

DOWNLOAD NOW: My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain

  • Manual Therapy.  An osteopathic physician, physical therapist or chiropractor can use manual therapy techniques.  This includes joint mobilization and manipulation which can be beneficial in reducing pain and addressing some of the mechanical causes.  However, manual therapy is a passive treatment.  For long term treatment and prevention, an active approach needs to be taken.  I would encourage you to perform proper exercises to insure that you have adequate cervical and upper thoracic strength and mobility.  Also, address any precipitating factors (such as poor posture).
  • Massage.  Although massage can be a form of manual therapy, it can also be thought of as separate intervention.  There are many types of body workers that can utilize many different forms of massage or manual treatments.  Many trigger points and muscle spasms will refer pain into the head (which causes the headache).  It’s important to actively and physically address the muscle tension.  This is the time to contact a massage therapist, body worker, physical therapist, athletic trainer or friend who is skillful in body work or massage to relieve the area in spasm.  The specific massage technique to use will vary according to your preference.  Massage techniques range from a light relaxing massage to a deep tissue massage or utilization of acupressure points.  This can also be an effective prevention strategy.
  • Other self-mobilization tools.  Many times, a friend or massage therapist isn’t available to assist when you need the help the most.  A foam roller cannot effective reach places in the upper back or arms, so other self-mobilization tools may be necessary.  You can get creative and use a tennis ball or golf ball, but I like a specific tool called the Thera Cane Massager.  This tool allows you to apply direct pressure to a spasming muscle.  When held for a long enough period of time, the Thera Cane Massager will usually cause the muscle spasms to release and provide much needed pain relief!
  • Topical agents.  Many topical agents can help to decrease and eliminate muscle spasms.  They can also mediate the pain response helping to reduce neck pain or headache pain.  You can apply a small amount of topical agent directly over the pain area if it’s accessible and not near your eyes.  (Please use common sense).  You may find that one product works better than another.  Some of my favorite products in my medicine cabinet include:  Biofreeze Pain Relieving Gel, Arnica Rub (Arnica Montana, an herbal rub), and topical magnesium.
  • Magnesium bath.  The combination of warm water with magnesium is very soothing and relaxing.  Magnesium is known to help decrease muscle pain and soreness.  Options include:  Epsoak Epson Salt and Ancient Minerals Magnesium Bath Flakes.  I find that the magnesium flakes work better, but they are significantly more expensive than Epson salt.
  • Acupuncture.  I am personally a big fan of acupuncture.  It is very useful in treating all kinds of medical conditions.  It can be particularly effective in treating headaches, muscle trigger points, muscle cramps, spasms, and pain as it addresses the issues on multiple layers.  Acupuncture directly stimulates the muscle by affecting the nervous system response to the muscle while producing a general sense of well-being and relaxation.
  • Medications.  Medications can be an effective short term solution to headache pain, but I strongly encourage you to transition off of medications over time.  In some cases, prescription medications may be used initially to help you tolerate the pain as you work toward prevention.  Please speak to your physician regarding prescription options.
  • Speak with your Physical Therapist (PT) or Physician (MD or DO).  If you are suffering with neck pain and headaches, there are options.  Please speak to your medical provider to determine if other causes are contributing to the problem.  Physical therapy is very effective treatment for those suffering with neck pain and headaches.  The American Physical Therapy Association (APTA) offers wonderful resources to help find a physical therapist in your area.  In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to hear your physician’s opinion as well).

Don’t give up hope!  Neck pain and headaches can be difficult to manage, but with proper care, most of the pain can be cured or effectively managed.  Begin by implementing one or two of these treatment tips, then assess how well they worked for you.  If the technique helped, continue with it then implement another strategy.

If you suffer from neck pain and headaches, which treatments have worked the best for you?  Please share below. 

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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Cervicogenic Headaches: A Real Pain in the Neck (and Head)

Cervicogenic headaches are a certain type of headache in which the head pain is specifically caused by an issue in the cervical spine.  Cervicogenic pain is often a trigger for other types of headaches, such as migraines or tension headaches.  As a physical therapist, I find it more effective to classify cervicogenic headaches separate from tension headaches.  Tension and cervicogenic headaches may be treated similarly, but in many cases, it depends on the actual dysfunction present.

Young man experiencing neck pain against a white background

Cervicogenic headaches are almost always mechanical in nature.  This means that there is a structural or mechanical cause in the neck which is leading to the headache pain.  Since the trigger is mechanical, these headaches can come on very suddenly with certain movements and can also be reduced or eliminated quickly if the correct movements can be initiated.  When the cervical spine is the cause of the pain, you may experience cervical pain, headache pain, and other correlated or referred pain in your upper back or down your arms (even to your fingers).

Cervicogenic Headache Symptoms include:

  • Pain in the front of your head, behind your eyes or side of your head.
  • Pain which begins from your neck and extends to between your shoulder blades or upper shoulders.
  • Pain which is exacerbated or changed by certain neck movements or neck positions.
  • Pain which is triggered by pressure applied to the upper part of the neck near the base of the skull (known as the suboccipital area) or in the upper trapezius area.
  • Pain down one or both arms and can be felt as far as your fingers.
  • Stiff neck.
  • Blurred vision.
  • Nausea, vomiting, and/or dizziness.

Potential Causes for Cervicogenic Headaches

There are plenty of reasons why one might develop cervical derangements or dysfunction.  Examples include:  motor vehicle accidents; sports; falls; sleeping on a poorly fitting pillow; poor posture (especially when texting); and/or carrying items that are too heavy (such as a backpack).  Chronically sustained non-symmetrical postures, stress, and/or a sedentary lifestyle are also potential causes.

The actual pain generating structures of the neck (listed below) also vary wildly and can be difficult to pinpoint.

  • Nerve related injury or pain
  • Muscle spasms
  • Trigger points
  • Facet joint dysfunction
  • Cervical mal-alignments
  • Cervical disc issues
  • Postural dysfunction

Cervicogenic pain and headaches tend to be more common in women than men.  In general, women experience this due to an anatomical difference.  Men tend to have more muscular necks while women tend to have more long and slender necks with less muscle to provide support to the head (meaning that there is less muscle strength for support).

Treatment for Cervicogenic Headaches

In cases of mechanical pain, you should be able to alter and change your neck or headache pain within a short period of time.  The first step is to establish a directional preference by identifying a pattern to the pain.

Which head motions change or alter your neck or headache pain?  Does the pain get worse or does it improve when you turn your head?  What happens when you look up, look down, slouch or sit up straight?  What happens when you repeat this movement?

Determine how your pain responds.  If it spreads away from the spine and down into the upper back or arm, beware that you are moving in the wrong direction.  Stop that particular movement, and instead try the opposite direction.

In my experience, most episodes of cervical and headache pain tend to respond better to cervical extension biased movements and improvements in posture.  Often, gaining extension in the thoracic spine is also critical to treatment.

In order to determine if extension biased (cervical retraction or extension) movements help you, I recommend starting with this exercise (as shown below).  Sit up straight, and retract your chin straight back.  Repeat 10-20 times.

cervicalextensionexercise_collage_960pxwide

Carefully monitor symptoms for peripheralization or centralization.  The rule of thumb for movement:  If the pain worsens by spreading peripherally down the arm into the hand, fingers, down into the shoulder blade/upper back or the headache is worsening, then the condition is worsening.  Stop that activity.  If the pain centralizes and returns back toward the cervical spine, and the headache pain improves (even if the pain in the neck worsens slightly), then keep moving as the condition is actually improving.

If you are unable to help or change the pain in any way, then you may need assistance from a medical provider.  For a thorough discussion and an excellent treatment resource, please refer to Treat Your Own Neck by Robin A. McKenzie.

Other Treatments for Cervicogenic Headaches:

  • Exercise.  A primary treatment modality and prevention technique is exercise.  Exercise in general has been shown to be beneficial in treating and preventing cervical pain and headaches.  However, a specific exercise program designed to maintain cervical and thoracic mobility and strength should be the main portion of your treatment.  Focus on your thoracic mobility (particularly, into extension).  Work on cervical stabilization exercises that involve the muscles that support your head and neck.
  • Focus on your posture.  Poor posture is a bane of modern society.  The most common example of poor posture is a forward head with rounded shoulders.  This causes excessive muscular tension throughout the cervical spine, upper trapezius region, and mid-thoracic area.  Over time, this also leads to muscle weakness and/or dysfunction in the cervical spine and upper thoracic area.  Proper posture allows for the optimal alignment of your spine.  Neurologically speaking, this allows for your muscles to down regulate by reducing tension.  Poor posture is almost always associated with muscle knots and trigger points.  My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain is a downloadable .pdf file with my recommended stretches and exercises to address posture.  These simple exercises (with complete instructions and photos) will help you to improve poor posture and can be performed at home.

DOWNLOAD NOW: My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain

  • Massage.  Many trigger points and muscle spasms will refer pain into the head (which causes the headache).  It’s important to actively and physically address the muscle tension.  This is the time to contact a masseuse, physical therapist, athletic trainer or friend who is skillful in body work and massage to relieve the area in spasm.  The specific massage technique to use will vary according to your preference.  Massage techniques range from a light relaxing massage to a deep tissue massage or utilization of acupressure points.  This can also be an effective prevention strategy.
  • Foam roller.  The foam roller allows you to perform self-massage and tissue mobilization.  The foam roller is a wonderful tool to prevent muscle cramping and spasms.  Please refer to the following posts for more information:  Foam Rolling For Rehabilitation and 5 Ways to Improve Range-Of-Motion.  I highly recommend a foam roller to help aid in your recovery.
  • Other self-mobilization tools.  Many times, a friend or masseuse isn’t available to assist when you need the help the most.  A foam roller cannot effective reach places in the upper back or arms, so other self-mobilization tools may be necessary.  You can get creative and use a tennis ball or golf ball, but I like a specific tool called a Thera Cane Massager.  This tool allows you to apply direct pressure to a spasming muscle.  When held for a long enough period of time, the Thera Cane Massager will usually cause the muscle spasms to release and provide much needed pain relief!
  • Magnesium.  A deficiency in magnesium is often associated with headache symptoms and can also heighten the pain response.  Take magnesium orally (such as Mag Glycinate in pill form) or apply it topically in order to help mediate the pain response.
  • Topical agents.  Many topical agents can help to decrease and eliminate muscle spasms or mediate the pain response which can help to reduce headache pain.  You can apply a small amount of the topical agent directly over the headache pain area if it’s accessible and not near your eyes.  (Please use common sense.)  You may find that one product works better than another.  Some of my favorite products in my medicine cabinet include:  Biofreeze Pain Relieving Gel; Arnica Rub (Arnica Montana, an herbal rub); and topical magnesium.
  • Magnesium bath.  The combination of warm water with magnesium is very soothing and relaxing.  Magnesium is known to help decrease muscle pain and soreness.  Options include: Epsoak Epson Salt or Ancient Minerals Magnesium Bath Flakes.  I find that the magnesium flakes work better, but they are significantly more expensive than Epson salt.
  • Acupuncture.  I am personally a big fan of acupuncture.  It is very useful in treating all kinds of medical conditions.  It can be particularly effective in treating headaches, muscle trigger points, muscle cramps, spasms, and pain as it addresses the issues on multiple layers.  Acupuncture directly stimulates the muscle by affecting the nervous system response to the muscle while producing a general sense of well-being and relaxation.
  • Manual Therapy.  A physical therapist or chiropractor can use manual therapy techniques which can be beneficial in reducing pain and addressing some of the mechanical causes.  However, manual therapy is a passive treatment.  For long term treatment and prevention, an active approach needs to be taken.  I would encourage you to perform proper exercises to insure that you have adequate cervical and upper thoracic strength and mobility.  Also, address any precipitating factors (such as poor posture).
  • Medications.  Medications can be an effective short term solution to headache pain, but I strongly encourage you to transition off of medications over time.  In some cases, prescription medications may be used initially to help you tolerate the pain as you work toward prevention.  Please speak to your physician regarding prescription options.
  • Speak with your Physical Therapist (PT) or Physician (MD).  If you are suffering with headache and muscle tension/pain, there are options.  Please speak to your medical provider to determine if other causes are contributing to the problem.  Physical therapy is very good at assisting those suffering with these types of headaches.  The American Physical Therapy Association (APTA) offers a wonderful resource to help find a physical therapist in your area.  In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to hear your physician’s opinion as well).

Don’t give up hope!  Headache pain is difficult to manage, but with proper care most headache pain can be cured or effectively managed.  Begin by implementing one or two of these treatment tips, and then assess how well they worked for you.  If the technique helped, continue with it and then implement another strategy.

If you suffer from cervicogenic headaches, which treatments have worked the best for you? Please share below. 

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice.  No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.

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Prevention and Treatment Strategies for Tension Headaches

Approximately 15-20% of the population will suffer from headaches at any given time.  Headaches can range from mild to severe with symptoms varying wildly.  It’s one of the top medical ailments for which people seek treatment, and tension headaches are the most common type of headache.  Tension headaches are often related to tension in the muscles of the head, neck, and jaw and are frequently stress related.  The actual physical cause is still not fully understood, but it’s likely linked to how the brain and nervous system perceives muscular pain and stress.  The good news is that tension headaches are very treatable!

Young woman having migraine

Tension headaches are categorized as either episodic (meaning that you experience less than 15 headaches per month) or chronic (meaning that you experience more than 15 per month).  They are nearly as frequent in children and teens as adults.  Women tend to experience them more often than men by nearly two to one.

Tension Headache Symptoms include:

  • The pain tends to wax and wane in severity (sometimes, throbbing or pulsing occurs).
  • The pain is often described as pressure like and is typically felt on both sides of your head.
  • The pain typically impacts the whole head, but it may begin in the back of your head or above your eyebrows.  It’s typically painful around the temple area of your head and/or back of your head and neck.
  • Many describe the pain as a severe tightness (like a vise grip) around the forehead or like a cap or band-like sensation which encircles their skull.
  • The pain tends to come on gradually.  Even at maximum intensity, it isn’t typically incapacitating.  (Most people are able to continue with their daily activities despite the pain.)

Potential Triggers for Tension Headaches include:

  • Stress
  • Anxiety
  • Impaired sleep (fatigue)
  • Low blood sugar from improper eating
  • Hunger
  • Eye strain
  • Overexertion
  • Muscle strains and pain
  • Muscle tension
  • Cervical dysfunction (cervicogenic)
  • Poor posture
  • Hormonal changes and/or menses
  • Foods such as processed meats, gluten, red wine, and dairy
  • Environmental factors such as poor air quality, certain smells, and different chemicals that are inhaled or applied topically on the body.

Treatment for Tension Headaches

In most cases, effective treatment needs to be multifactorial as there are likely multiple triggers causing the headache.  In general, treatment needs to focus on both the prevention of the tension headache and methods of dealing with an active headache as both tend to interrelate.

Prevention for Tension Headaches:

To effectively manage (and ultimately, prevent) tension headaches, effective stress management and elimination of known triggers are primary treatment strategies.

  • Stress management.  Effective stress management should not be overlooked as an important treatment modality.  There are many different methods to help you manage stress more effectively.  Common methods include meditation, journaling, and yoga.  You may also need to reconsider certain friendships and relationships in your life.  The key to effectively managing stress is to find an enjoyable activity, and then stick with it.  This is a process–a journey (not a destination).
  • Eliminate food triggers.  Many foods can trigger headaches.  An effective management strategy will be to identify and then eliminate food triggers.  We may not even be aware of how negatively certain foods affect us.  If you choose to eliminate your trigger foods, you will be amazed about how well you start to feel in general.  Common food triggers include:  red wine, aged meats or cheese, dairy products, and gluten.  Addressing food triggers is a critical step in treatment.  I recommend that you take an IgG food sensitivity test.  IgG is an immunoglobulin antibody found in the body.  This test can help to determine if certain foods are causing your body to react in a negative way.  Addressing any sensitivities and possible gut or gastrointestinal issues can be very helpful in treating both tension and migraine headaches.  Please seek assistance from a functional medicine doctor who specializes in headaches and gastrointestinal issues if your symptoms are correlated with any food triggers.
  • Eliminate caffeine.  This can be very tough because caffeine tends to be helpful in reducing initial symptoms.  Chronic caffeine use (particularly in headache suffers) is known to cause rebound headaches (another sub classification of headaches).  Rebound headaches occur when the same substance that helps to reduce symptoms will also cause the next headache to happen.  Eliminating caffeine initially is difficult as it may trigger another headache.  However, long term elimination of caffeine from your diet can be very effective in preventing headaches.  Just watch out for over the counter (OTC) medications that contain caffeine as an active ingredient.
  • Focus on your posture.  Poor posture is a bane of modern society.  The most common example of poor posture is a forward head with rounded shoulders.  This causes excessive muscular tension throughout the cervical spine, upper trapezius region, and mid-thoracic area.  Over time, this also leads to muscle weakness in the cervical spine and upper thoracic area.  Proper posture allows for the optimal alignment of your spine.  Neurologically speaking, this allows for your muscles to down regulate by reducing tension. Poor posture is almost always associated with muscle knots and trigger points.  My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain is a downloadable .pdf file with my recommended stretches and exercises to address posture.  These simple exercises (with complete instructions and photos) will help you to improve poor posture and can be performed at home.

DOWNLOAD NOW: My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain

How to Treat when you’re experiencing a Tension Headache:

  • Fix your posture.  Poor posture is one of the most common causes of muscle spasming and pain.  This is particularly true if you spend a good portion of your day sitting.  If you’re already experiencing a headache or you feel like one might be starting, I highly recommend that you initiate my stretching protocol (as noted above).
  • Massage.  Many trigger points and muscle spasms will refer pain into the head (which causes the headache).  It’s important to actively and physically address the muscle tension.  This is the time to contact a masseuse, physical therapist, athletic trainer or friend who is skillful in body work and massage to relieve the area in spasm.  The specific massage technique to use will vary according to your preference.  Massage techniques range from a light relaxing massage to a deep tissue massage or utilization of acupressure points.  This can also be an effective prevention strategy.
  • Foam roller.  The foam roller allows you to perform self-massage and tissue mobilization.  The foam roller is a wonderful tool to prevent muscle cramping and spasms.  Please refer to the following posts for more information: Foam Rolling For Rehabilitation and 5 Ways to Improve Range-Of-Motion.  I highly recommend a foam roller to help aid in your recovery.
  • Other self-mobilization tools.  Many times, a friend or masseuse isn’t available to assist when you need the help the most.  A foam roller cannot effective reach places in the upper back or arms, so other self-mobilization tools may be necessary.  You can get creative and use a tennis ball or golf ball, but I like a specific tool called a Thera Cane Massager.  This tool allows you to apply direct pressure to a spasming muscle.  When held for a long enough period of time, the Thera Cane Massager will usually cause the muscle spasms to release and provide much needed pain relief!
  • Magnesium.  A deficiency in magnesium is often associated with headache symptoms.  Most people are deficient in the amount of magnesium they consume on a regular basis.  You can take Mag Glycinate in pill form or by eating foods higher in magnesium such as spinach, artichokes, and dates.
  • Topical agents.  Many topical agents can help to decrease and eliminate muscle spasms which can help to reduce headache pain.  You can apply a small amount of the topical agent directly over the headache pain area if it’s accessible and not near your eyes.  (Please use common sense.)  You may find that one product works better than another.  Some of my favorite products in my medicine cabinet include:  Biofreeze Pain Relieving Gel; Arnica Rub (Arnica Montana, an herbal rub); and topical magnesium.
  • Magnesium bath.  The combination of warm water with magnesium is very soothing and relaxing.  Magnesium is known to help decrease muscle pain and soreness.  Options include:  Epsoak Epson Salt or Ancient Minerals Magnesium Bath Flakes.  I find that the magnesium flakes work better, but they are significantly more expensive than Epson salt.
  • Acupuncture.  I am personally a big fan of acupuncture.  It is very useful in treating all kinds of medical conditions.  It can be particularly effective in treating headaches, muscle trigger points, muscle cramps, spasms, and pain as it addresses the issues on multiple layers.  Acupuncture directly stimulates the muscle by affecting the nervous system response to the muscle while producing a general sense of well-being and relaxation.
  • Medications.  Medications can be an effective short term solution to headache pain, but I strongly encourage you to transition off of medications over time.  Many over the counter (OTC) medications contain caffeine which can lead to another type of headache called a rebound headache.  This occurs when the medication wears off and triggers another one. This is common with medications such as Excedrin which contains caffeine.  Other types of medications include acetaminophen, aspirin, Ibuprofen, and Naproxen.  In some cases, prescription medications may be used initially to help you tolerate the pain as you work toward prevention.  Please speak to your physician regarding prescription options.
  • Speak with your Physical Therapist (PT) or Physician (MD).  If you are suffering with headache and muscle tension/pain, there are options.  Please speak to your medical provider to determine if other causes are contributing to the problem.  Physical therapy is very good at assisting those suffering with these types of headaches.  The American Physical Therapy Association (APTA) offers a wonderful resource to help find a physical therapist in your area.  In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to hear your physician’s opinion as well).

Tension headaches are a common and debilitating problem.  Although this is not an exhaustive list of treatment options, it offers many different and effective methods for you to consider.  In many cases, the techniques utilized to treat an active headache are also effective in prevention.

In nearly all cases, the frequency of tension headaches can be reduced and eliminated in general.  The key is to acknowledge that you are not powerless when addressing this type of headache.  However, there isn’t just one magic cure for the headache either.  Effective treatment will likely be multifactorial.  Begin by implementing one or two of the strategies, and then assess how well they worked for you.  If the technique helped, continue with it and then implement another strategy.  Create a plan with specific strategies for prevention in addition to knowing beforehand as to how you will treat an active headache.  This will empower you to recognize that you have control and are not destined to have headaches forever.

Can you share any prevention tips or treatment techniques that have worked for you when dealing with a tension headache?  Please leave your comments below. 

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice.  No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.

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14 Tips and Strategies to Self-Treat Muscle Pain

Muscle pain is common and often occurs after exercise or activity.  Although the pain is uncomfortable, most types of muscle pain are benign and quickly pass.  Muscle aches and pains can affect your ability to compete or train at a high level.  It also can affect your sleep and mood.  Discover the possible causes of muscle pain as well as prevention and treatment strategies.

Possible Causes of Muscle Pain include:

  • Delayed Onset Muscle Soreness (DOMS). This soreness typically occurs 24-48 hours after an exercise session due to micro trauma within the muscle tissue. It tends to be worse after eccentric biased exercise where the muscle is lengthened.
  • Muscle Strain. If you strain your muscle either by over lengthening or over exerting the muscle capacity, muscle tearing may occur. Depending on the size and location of the tear, it may range from minor to severe (potentially needing surgical intervention).
  • Myofascial Issues. Layers of the myofascia (the dense, tough tissue which surrounds and covers all of your muscles and bones) may become bunched or knotted up and result in pain. This is typically due to poor posture, repetitive motion injuries or over exertion.
  • Neurological Issues. Many neurological disorders, including pinched nerves, can cause pain. Other medical conditions, such as muscular dystrophy, cause muscle dystonia.
  • Illness. Muscle pain can occur as a symptom in colds, flu, Rocky Mountain Spotted Fever, and other viral or bacterial infections.
  • Disease. Many diseases, such as Polio, Lupus, and Lyme’s Disease, cause muscle pain.
  • Medications. Certain medications, such as statin drugs for cholesterol, have been strongly associated with muscle pain.
  • Fibromyalgia. This condition causes muscle pain, joint pain, and extreme fatigue.
  • Rhabdomyolysis. A serious condition, due to either direct or indirect muscle trauma, which causes pain. It can be life threating due to the potential for kidney failure. Common causes include extreme exercise, statin medication, severe injury or illicit drug use.
  • Compartment Syndrome. A serious condition in which excessive swelling and pressure build up in a confined space. It leads to extreme muscle pain and eventually, numbness and tissue death.

This list highlights some of the many potential causes of muscle pain.  Many are benign while others are true medical emergencies.  The most common reasons include: delayed onset muscle soreness (DOMS); muscle strains; myofascial related issues due to posture and/or repetitive motion injuries; and fibromyalgia.

In order to properly treat muscle pain, first identify the cause of your muscle pain.  Can you correlate the symptoms with a certain activity or exercise?  Are you suffering from a cold or flu like symptoms?  If you are unable to correlate a reason for the pain, then you may consider consulting with your medical physician to rule out other possible causes for muscle pain.

Young man experiencing neck pain against a white background

The following tips and strategies to treat muscle soreness specifically address mechanical causes related to DOMS, minor muscle strains, and myofascial issues.  Many of these strategies are also appropriate in helping to manage fibromyalgia symptoms.

14 Tips and Strategies to Self-Treat Muscle Pain: 

  1. Fix Your Posture. Poor posture is one of the most common causes of muscle spasming and pain. This is particularly true if you spend a good portion of your day sitting. Sign up to receive my weekly blog posts via e-mail, and I will share with you My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain. These simple exercises, with complete instructions and photos, will help you to improve poor posture and can be performed at home.
  2. Massage. Contact a masseuse, physical therapist, athletic trainer or friend who is skillful in body work and massage to relieve the area in spasm. The specific massage technique to use will vary according to your preference. Massage techniques range from a light relaxing massage to a deep tissue massage or utilization of acupressure points.
  3. Foam Roller. The foam roller allows you to perform self-massage and tissue mobilization. The foam roller is a wonderful tool to prevent muscle cramping and spasms. Please refer to the following posts for more information: Foam Rolling For Rehabilitation and 5 Ways to Improve Range-Of-Motion. I highly recommend a High Density Foam Roller to help aid in your recovery.
  4. Other Self-Mobilization Tools. Many times, a friend or masseuse isn’t available to assist when you need the help the most. A foam roller cannot effective reach places in the upper back or arms, so other self-mobilization tools may be necessary. You can get creative and use a tennis ball or golf ball, but I like a specific tool called a Thera Cane Massager. This tool allows you to apply direct pressure to a spasming muscle. When held for a long enough period of time, the Thera Cane Massager will usually cause the muscle spasms to release and provide much needed pain relief! I am also a big fan of the Thera-Band Standard Roller Massager. I particularly like that its firmness allows for a deep amount of pressure. If you prefer something similar, but more flexible for the boney regions of the thigh or lower leg, I recommend The Stick Self Roller Massager.
  5. Topical Agents. Many topical agents can help to decrease and eliminate muscle spasms. The method of action varies greatly according to the product used. You may find that one product works better than another. Some of my favorite products in my medicine cabinet include: Biofreeze Pain Relieving Gel; Arnica Rub (Arnica Montana, an herbal rub); and topical magnesium.
  6. Magnesium Bath. The combination of warm water with magnesium is very soothing and relaxing. Magnesium is known to help decrease muscle pain and soreness. Options include: Epsoak Epson Salt or Ancient Minerals Magnesium Bath Flakes. I find that the magnesium flakes work better, but they are significantly more expensive than Epson salt.
  7. Oral Magnesium. You can take Mag Glycinate in pill form or by eating foods higher in magnesium such as spinach, artichokes, and dates. Taking additional magnesium (particularly at night) can help to reduce muscle cramps and spasming. It is also very helpful in reducing overall muscle soreness and aiding in a better night’s rest. Most people are deficient in the amount of magnesium they consume on a regular basis. I recommend beginning with a dose of 200 mg (before bedtime) and increasing the dose as needed. I would caution you that taking too much magnesium can lead to diarrhea. Mag Glycinate in its oral form is the most highly absorbable. Although not as absorbable, Thorne Research Magnesium Citrate and magnesium oxide can also be beneficial.
  8. Stay Hydrated. The human body is primarily made of water, which is critical for all body functions. Your muscles are approximately 80% water. Dehydrated tissues are prone to injury and pain as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Stay hydrated by drinking water. Try to avoid beverages that contain artificial sweeteners or chemicals with names you can’t spell or pronounce.
  9. Eat Healthy. A healthy diet is critical to avoid injury, illness, and pain. Your body tissue needs nutrients to be able to perform at a high level. Avoid processed food as much as possible. Limit sugary food and add more protein and healthy fat in your diet. Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system. Adequate protein intake is necessary to support muscle health and development. Give your body the needed nutrients to combat illness and function at a high level.
  10. Move More! Not only has research proven that sitting for more than two hours at a time decreases your expected life span, but extended sitting also leads to increased muscle tension, cramping, and pain. If you sit most of the day, get up and walk. If you stand most of the day, frequently change your standing posture. To optimize health and joint function, you should take each joint in your body through a least one full range of motion (ROM) every day. If you are experiencing pain, I recommend performing more frequent ROM (every 1-2 hours).
  11. Stretch. Stretching is a wonderful way to help eliminate a muscle spasm. We instinctively stretch when we feel a spasm begin. Try gently stretching (lengthening) the muscle affected by the spasm. I recommend beginning with a short 30-60 seconds stretch, then repeating as needed. If the spasm or cramp is severe, you will likely need to continue stretching several times in a row, multiple times throughout the day. Stretching should always be part of a general fitness and lifestyle program. As we age, muscle and tendons tend to lose elasticity so stretching becomes even more important. I highly recommend a daily stretching routine or participation in a group class, such as yoga, which incorporates full body stretching.
  12. Acupuncture. I am personally a big fan of acupuncture. It is very useful in treating all kinds of medical conditions. It can be particularly effective in treating muscle cramps, spasms, and pain as it addresses the issues on multiple layers. Acupuncture directly stimulates the muscle by affecting the nervous system response to the muscle while producing a general sense of well-being and relaxation.
  13. Sleep and Rest More. Most people are not sleeping long enough or often enough to optimize health. Take a nap or go to bed earlier. Your body requires time to repair and heal as you sleep. Your body must rest in order to grow and develop. Training every day is not the best way to improve. It can lead to injury and burn out. Take a rest day and have fun. Participate in a Tai Chi or yoga class, take a leisurely bike ride or take a walk in the park.
  14. Speak with your Physical Therapist (PT) or Physician (MD). If your muscle pain cannot be correlated to a specific mechanical cause, please speak to your medical provider to determine if other causes are contributing to the problem. The American Physical Therapy Association (APTA) offers a wonderful resource to help find a physical therapist in your area. In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to hear your physician’s opinion as well).

Most muscle pain and soreness can be self-managed and self-treated if you are proactive.  These tips and strategies are highly effective in managing muscle pain.  A healthy lifestyle is a lifelong pursuit.  If you are injured or not enjoying an activity, you will not stay engaged or motivated in the long term.  Seeking advice specifically from a running coach, physical therapist or physician can be beneficial.

How do you manage your aches and pains?  Which tip or strategy will you incorporate into your treatment?  Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice.  No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.

Posted on

Muscle Cramping & Spasms – Treatment Options

The list of potential reasons for developing a muscle cramp or spasm is quite long and somewhat arduous.  Once the cramp or spasms begin, it’s often quite painful!  Therefore, we’re highly motivated to act quickly to eliminate the spasm.  What can you do to prevent muscle cramps and spasms? More importantly, how can you recover from experiencing one?  I will provide simple treatment options to quickly help aid in your recovery.

For discussion purposes, I will address a spasm which isn’t caused by a serious medical condition such as a fracture, muscle tear and/or injury, or other medical conditions which would require the immediate attention of a healthcare practitioner.  If you believe that the spasm is from a serious medical condition, please do not attempt to self-treat the condition–immediately seek competent medical advice.

Over training or overexertion is a common issue experienced by many of the clients who I work with.  It remains a very sensitive topic as no one wants to admit that he/she was physically unprepared for an event or activity in which he/she participated in.  Don’t worry!  The point of participating in competition and other difficult activities is to test your body and to have fun!  During a race or sporting event, you will likely overreach from your training plan.  The hope is that your body is physically prepared to handle this overreaching without injury.  If you experience muscle cramps or spasms before or during an event, modify your training routine for the next event.

Top Tips for Treating Muscle Cramping & Spasms:

  • Massage – Contact a masseuse, physical therapist, athletic trainer, or friend who is skillful in body work and massage to relieve the area in spasm. The specific massage technique to use will vary according to your preference. Massage techniques range from a light relaxing massage to a deep tissue massage or utilization of acupressure points.
  • Foam Roller – The foam roller allows you to perform self-massage and tissue mobilization. The foam roller is a wonderful tool to prevent muscle cramping and spasms. Please refer to the following posts for more information: Foam Rolling For Rehabilitation and 5 Ways to Improve Range-Of-Motion. I highly recommend a High Density Foam Roller to help aid in your recovery.
  • Other Self-Mobilization Tools – Many times, a friend or masseuse isn’t available to assist when you need the help the most. A foam roller cannot effective reach places in the upper back or arms, so other self-mobilization tools may be necessary. You can get creative and use a tennis ball or golf ball, but I like a specific tool called a Thera Cane Massager. This tool allows you to apply direct pressure to a spasming muscle. When held for a long enough period of time, the Thera Cane Massager will usually cause the muscle spasms to release and provide much needed pain relief! I am also a big fan of the Thera-Band Standard Roller Massager. I particularly like that its firmness allows for a deep amount of pressure. If you prefer something similar (but more flexible, for the boney regions of the thigh or lower leg), I recommend The Stick Self Roller Massager.
  • Topical Agents – Many topical agents can help decrease and eliminate muscle spasms. The method of action varies greatly according to the product used. You may find that one product works better than another. Some of my favorite products in my medicine cabinet include: Biofreeze Pain Relieving Gel; Arnica Rub (Arnica Montana, an herbal rub); and topical magnesium.
  • Magnesium Bath – The combination of warm water with magnesium is very soothing and relaxing. Options include: Epsoak Epson Salt or Ancient Minerals Magnesium Bath Flakes. I find that the magnesium flakes work better, but they are significantly more expensive than Epson salt.
  • Oral Magnesium – You can take Mag Glycinate in pill form or by eating foods higher in magnesium such as spinach, artichokes, and dates. Taking additional magnesium (particularly at night) can help to reduce muscle cramps and spasming. It is also very helpful in reducing overall muscle soreness and aiding in a better night’s rest. I recommend beginning with a dose of 200 mg (before bedtime) and increasing the dose as needed. I would caution you that taking too much magnesium can lead to diarrhea. Mag Glycinate in its oral form is the most highly absorbable. Although not as absorbable, Thorne Research Magnesium Citrate and magnesium oxide can also be beneficial.
  • Increase your Electrolyte Intake – You may need to increase your potassium, sodium, or calcium intake to your diet or consider supplementation. Sherpa Pink Gourmet Himalayan Salt contains the electrolytes you would expect as well as a host of other trace minerals. I have found this to be highly effective for cramps and muscle soreness. It also helps me to sleep more soundly. I highly recommend it to anyone who is suffering from chronic cramping or after participating in an athletic event. Drink a small glass of warm water, mixing in a teaspoon full of pink Himalayan sea salt, before bedtime.
  • Fix Your Posture – Poor posture is one of the most common causes of muscle cramping and spasming as well as pain. This is particularly true if you spend a good portion of your day sitting. Sign up to receive my weekly blog posts via e-mail, and I will share with you My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain. These simple exercises, with complete instructions and photos, will help you to improve poor posture and can be performed at home.
  • Move More – Not only has research proven that sitting for more than two hours at a time decreases your expected life span, but extended sitting also leads to increased muscle tension, cramping, and pain. If you sit most of the day, get up and walk. If you stand most of the day, frequently change your standing posture. To optimize health and joint function, you should take each joint in your body through a least one full range-of-motion (ROM) every day.
  • Stretch – Stretching is a wonderful way to help eliminate a muscle spasm. We instinctively stretch when we feel a spasm begin. Try gently stretching (lengthening) the muscle which is in spasm. I recommend beginning with a short 30-60 seconds stretch, then repeating as needed. If the spasm or cramp is severe, you will likely need to continue stretching several times in a row, multiple times throughout the day. Stretching should always be part of a general fitness and lifestyle program. As we age, muscle and tendons tend to lose elasticity so stretching becomes even more important. I highly recommend a daily stretching routine or participation in a group class, such as yoga, which incorporates full body stretching.
  • Acupuncture – I am personally a big fan of acupuncture. It is very useful in treating all kinds of medical conditions. It can be particularly effective in treating muscle cramps and spasms as it addresses the issues on multiple layers. Acupuncture directly stimulates the muscle by affecting the nervous system response to the muscle while producing a general sense of well-being and relaxation.
  • Speak with your Physical Therapist (PT) or Physician (MD) – If the above techniques are not helping or if the muscle cramps and spasms continue to come back regularly, speak to your medical provider to determine if other causes are contributing to the problem. The American Physical Therapy Association (APTA) offers a wonderful resource to help find a physical therapist in your area. In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to hear your physician’s opinion as well).

What are your top tips for dealing with muscle cramping and spasms?  Please post your comments below as we could all use a few more tricks to eliminate pain!

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!