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Healthbeat: A heads-up about common causes of headaches
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Editor’s note: This will be the last column by Jim Hlavacek.

Headaches are one of the most common reasons people see their primary care physician, and they account for 20 percent of outpatient visits to neurologists.

According to the National Headache Foundation, more than 45 million Americans suffer from chronic or recurring headaches. These headaches are generally grouped into two different categories: primary and secondary.

Primary headaches are the most common type and have a single cause which can include migraine, tension-type, cluster and others. Secondary headaches are classified according to their cause.

Examples of secondary headaches are those which are attributed to temporomandibular (TMJ) joint disorders and cervicogenic headaches, which are attributed to disorders of the neck.

Both are treated by various clinicians including dentists, massage therapists and physical therapists.

Headaches are often caused by a combination of factors including musculoskeletal, psychological and neurovascular issues as well as chemical imbalances in the brain. Thus, a thorough medical evaluation is necessary with any onset of a new or ongoing headache.

A thorough physical therapy examination attempts to determine the type of headache and to define the factors contributing to it. Muscle tension; joint dysfunction of the neck and jaw; poor posture; and stress are factors that can be addressed and treated.

The muscles of the face, head and neck may contain tight bands and knots called myofascial trigger points. Trigger points found in these muscles typically refer pain to the head, causing headaches.

Poor posture is another common cause of headaches.

Due to chronic, poor posture habits either during work, leisure or sleep, the soft tissues of the neck and shoulders can become shortened, weakened or overstretched. This is commonly seen in individuals with forward head postures or rounded shoulders.

Dysfunction to the joints and discs of the upper cervical spine is another cause often seen in patients with secondary headaches.

Physical therapy offers a wide range of options for patients who wish to treat their headaches without medicine.

Correcting postural dysfunctions can be done through postural education which includes instruction in proper work station set-up, sleeping positions or proper body mechanics for every day activities.

Postural retraining generally consists of developing a program focused on stretching shortened muscles, while strengthening weak muscles.

Physical therapists can also improve the mobility of the upper cervical spine through numerous hands-on techniques which can result in reducing the occurrence of headaches.

Jim Hlavacek MS, PT, DPT, is a physical therapist at The Rehabilitation Institute, 597 S. Enota Drive NE, Gainesville; 770-219-8200, www.nghs.com/rehab. His column appears monthly.

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