It might not seem important to you what type of headache you suffer from when it hits you unexpectedly and you would rather focus on other things. However, to us therapists it is crucial to determine the type of headache we’re dealing with to be able to help in the most precise and effective way.

There are as many headaches as people who have them, and each of us, myself included, has our own story related to them. Traditionally, headaches are categorized in three major groups:

1. Migraine

2. Tension headache

3. Cluster headache
   

MIGRAINE

Migraines can have their onset since early childhood. Luckily for some people (like me), it isn’t uncommon to outgrow them. Unluckily, some people ( again, like me) might develop other forms of headache once the migraines are gone.

70% of people affected are women. Out of those, 70-80% might have a family member who also suffers from them. Migraines may be preceded by an aura — a period of time with nervous system symptoms - double vision, visual disturbances (seeing bright spots or flashes of light), pins and needles in arms and legs, numbness, and difficulty speaking. One or two days before the onset, the patient might feel constipated, or emotionally imbalanced,  going from depression to euphoria and back over the course of a day. There might also be neck tension or food cravings. Migraines may last from several hours to days. 

The pain is usually felt as severe throbbing, or pulsing, usually accompanied by nausea and/or vomiting, and sensitivity to light and noise. In many cases, the best relief comes from being alone in a dark room where these disturbances can be reduced to a minimum. For a lot of people the aura period is their only opportunity to treat it by taking medication; once the pain sets in, the only solution for them is to ride it out, in the dark, until it passes. 

Interestingly, in some people the only symptom of migraine is vertigo. They might not realize that they suffer from migraines as there is no headache at all, but the manual treatment for migraine might be extremely effective.

Triggers

Stress, bright lights (especially fluorescent), lack or excess of sleep, missing a meal, alcohol, excessive exercise, menstruation, and emotional overwhelm.

What might help?

There are several techniques in fascial and craniosacral therapy that might help with migraines. I would recommend:

Muscle releases

• The superficial muscles of the neck - Sternocleidomastoid (SCM) to improve the head position (moving it back where it can sit comfortably on top of the spine instead of ‘hanging forward’ with no support), Upper Trapezius and Levator Scapula to relax the shoulders.

• The deepest layers of the neck - the sub-occipital muscles including Rectus Capitis Posterior Minor and Major and Rectus Capitis Oblique Minor and Major. I would also release Splenius Capitis, which, when under tension, might produce symptoms exactly the same as migraine (this is known as the Splenius Capitis Muscle Syndrome)

• Releasing the second cervical vertebra (C2), which the spinal dura attaches to, for three reasons:

• C2 is the dynamic center of 136 muscles in the head and neck

• Tension located at C2 can affect the whole spine up to the second segment of the sacral bone

• C2 forms the myodural bridge, which is a connection between the myofascial and dural layers that anchors the spinal cord

Bony releases

• Decompressing the bones of the skull that are under tension. These might include sphenoid, temporals, frontal, zygoma, maxilla, palatines, mandible, ethmoid

• Releasing the sphenobasilar joint (more on that later)

• Releasing the eye socket and the eye muscles

• Releasing the vagus nerve

• Clearing the sinuses
  

TENSION HEADACHE

If you feel like your head has been put inside a tight vise, and you feel tension in your neck and shoulders, then you might be dealing with tension headache with steady (not throbbing) pain on both sides of the head. The areas of pain might be tender to touch. It is more common in women.

Tension headaches can appear in one’s life at any age. They come about any time of the day and there is no genetic correlation.

They can last from 30 minutes to several hours, appearing quite often, i.e., a person might suffer from them every other day.

Triggers

Stress, lack of sleep, depression, and difficult social situations that most of us would rather avoid. Oftentimes, headaches appear to save us from stressful social duties, or when there is a conflict between what we want to do and what is expected of us. Long-term and repetitive headaches may lead to chronic neck and shoulder tension, eye strain, and temporomandibular disorder (TMD).

How might we help?

• Precise treatment of the neck. We would especially focus on the sub-occipital region. Treating the muscles around the second cervical vertebra can induce deep relaxation of the whole body.

• Release of the atlanto-occipital joint located between the first cervical vertebra and the occiput

• Release of the jaw muscles to counteract the effects of stress

• Releasing the temporomandibular joint (TMJ)

• Decompressing temporal and parietal bones as well as checking the position and movement of the sphenoid and mandible

• Releasing the fourth ventricle of the brain
  

How you can help yourself?

• Talking, talking, and talking! Self-expression, opening up to your own feelings, being honest about things that are difficult or challenging, and getting things off your chest. If things are kept inside of our bodies, they tend to pile up until it is simply too much to cope with

• Some form of self-inquiry, i.e. meditation

CLUSTER HEADACHE

The first onset of a cluster headache is likely to appear in one’s twenties. We call them  cluster headaches because they occur in clusters. You might go through a period when you have them a lot and then they disappear. 90% of the affected population is male. The cluster headache is one-sided. Just like with the tension headache, there is no throbbing sensation. Instead, the pain might feel burning or piercing. Some people describe it as being stabbed with a knife.

Cluster headaches are sometimes referred to as ‘clock’ headaches - this means that they tend to start at the same time of the day or night. You might get them precisely two hours before you normally wake up and/or two hours before your usual bedtime. 

They might bring tearing of one eye, blocked sinuses on one side, and sweating on one side of the body.

Cluster headaches might last from a few minutes to a few hours. They are distressing because often they don’t follow a pattern, and feel like they might never ease off.

Triggers

The most common triggers include alcohol or smoking. Often the symptoms appear within minutes of lighting a cigarette or having a drink.

How we might help?

• Clearing tension from the sub-occipital muscles

• Releasing the mandible and maxilla (lower and upper jaw and teeth)

• Releasing the lateral pterygoid muscles

• Releasing the eye sockets and the optic nerve

• Decompressing the temporal and zygomatic bones
  

How you can help yourself?

• Avoid alcohol, especially red wine

• Avoid fatty, heavily spiced, or sugary foods that might clog up your liver

• Find time for regular rest

• Find time for introspection, i.e., meditation

HEADACHES AS A RESULT OF SPHENOBASILAR JOINT (SBJ) DYSFUNCTION

You might well go through your life not even knowing about the existence of the SBJ, and nobody could blame you for it. After all, it isn’t in a place that a normal person has a lot of opportunity to notice. However, if you are subjected to trauma, whether physical (a hit to the head due to domestic violence or a boxing match; falling down and hitting your head, a car accident, and so on), or emotional (severe shock, loss, grief), your SBJ might be affected and can cause all sorts of trouble, a lot of which might not even appear to be related to anything being wrong with your head. 

The SBJ connects the sphenoid - the bone in the middle of the skull that I would love to write several blog posts about - and the basilar portion of the occipital bone, at the back of the skull. Because the sphenoid is connected to almost all other bones in the skull (12 of them, actually, to be nerdy and precise), distortions (a.k.a. ‘fault patterns’) involving the sphenoid can affect us in the most profound ways.

The eight most commonly recognized fault patterns of the SBJ can be separated into two groups. The first four are just exaggerations of the normal configuration of the bones of the skull, any and all of which need to be balanced with the others if headaches or other symptoms are present. The last four are the result of severe physical, emotional, or spiritual trauma that can also present with headaches or other, more severe symptoms.

1. Flexion Lesion

In this fault pattern, the sphenoid and occiput move further and easier into flexion. It might cause the patient to experience a simple dull headache located at the front of the head

2. Extension Lesion

In this pattern, the sphenoid and occiput move further and easier into extension. The patient might experience more severe headaches, especially migraines that can last quite a long time.

3. Torsion Lesion

In the torsion lesion, the sphenoid moves up and towards one side and the occiput moves in the opposite direction — imagine wringing out a wet towel and you have a picture of torsion right there! The patient might experience head pain accompanied by neck and lumbar pain, dyslexia and difficulty with focusing the eyes, for example, when reading a book.

4. Side-bending Lesion

In this pattern, the sphenoid and occiput like to side-bend to the same side, leaving a gap on the opposite side of the joint. This might cause severe cluster headaches (remember when I described it earlier as having your head squeezed in a vise?) This might also be accompanied by neck hypermobility, mild personality changes, and ambivalence.

5. Lateral Strain or Shear

Here, the sphenoid and occiput might be compared to two tectonic plates that slide past each other in opposite directions at the SBJ. This often produces chronic cluster headaches that just don’t stop. This type of lesion is usually the effect of an accident where one is hit on the side of the head (especially if the impact wasn’t expected).

6. Vertical Strain or Shear

If a person gets hit on the head from the below (think uppercut in boxing), the sphenoid and occiput might travel upwards from the impact, resulting in a vertical strain or shear lesion. In such case, cluster headaches might be accompanied by difficulty concentrating, focusing the mind, and manic depression.

7. Lateral flexion Lesion

If both the sphenoid and occiput are pushed up forcefully on one side, this might result in a latero-flexion lesion. This often causes persistent low-grade headache, as well as a sense of withdrawal from the world, feeling separated from everything as if watching the world go by from behind a pane of glass. In fact, many patients report a feeling as if a pane of glass were going through the middle of their skulls. This might be accompanied by amorphous pain in other, completely random parts of the body; or pain that is difficult to track or pin down, and/or moves around.

8. Compression Lesion

The worse possible scenario is where all the movement of the skull stops. This causes severe headaches that might be accompanied by dreams of death, or suicidal depression. This lesion is the result of severe head trauma, for example, beatings that began in childhood.

Headaches can be debilitating companions in our life. What we find in our clinic is that in many cases, releasing the muscles and bones of the head and neck can help resolve the underlying causes. If you suffer from headaches, book an appointment and let us help you to move towards relief and a pain-free life.