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Heating or cooling can really help with tension headaches, but you have to be a bit careful with this. Cranky neck muscles usually prefer heat — but in the case of headaches, heat can sometimes contribute to an uncomfortable flushed or congested feeling that makes the headache worse. Trust your instincts: what will work in the case of a headache is whatever feels soothing to you. If cool washcloths feel soothing, do that. If steaming washcloths sound better to you, use those instead. It may vary from one time to the next. Sometimes alternating back and forth feels great. Experiment with temperature and location.
For lots of ideas about hydrotherapy, see Hydrotherapy, Water powered rehab. For more about choosing between hot and cold, see The Great Ice vs.
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Heat Confusion Debacle. Exercise is good medicine for many musculoskeletal conditions, but attempts to prove a benefit for headaches specifically have been unimpressive. I recommend a long-term, patient exercise program, targeting not just the neck muscles but also the jaw muscles because of their frequent involvement in headaches. Skip ordinary stretching unless you just enjoy it , 80 and begin with lots of pain-free range of motion and mobilizations.
Progress to endurance exercises , and then finally strength training. Although you will probably need to be disciplined and patient, strength training is remarkably efficient. A trendy neck pain treatment method in the physical therapy world is a strengthening program just for the "deep cervical flexors," a group of several tiny muscles on the front of the cervical spine.
The "scientific" rationale for this method is appallingly thin, but it's an interesting topic.
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General exercise is the single most important component of another treatment goal: see reducing systemic vulnerability below. Rubbing trigger points seems to ease them.
No one knows how well it actually works, or even if it works at all. Grope around your shoulder with fingers and thumbs and find acutely sensitive, aching spots in muscle tissue. You may or may not feel a slight bump or twitch, but those are inconsistent and unreliable signs. See below for several more specific places to look for headache-related TrPs. What tools?
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When you find a sore spot, either simply press and hold for a while 10— seconds , or apply small kneading strokes, either circular or back and forth. A good first self-massage experiment should take several days, two or three sessions per day, with a few minutes of exploration each time. Massage of practically any part of the head, face or neck will usually feel soothing to headaches, but by far the best place to look for TrPs is the suboccipital region under the back of the skull.
And there are some other high-priority locations. While any vigorous massage has the potential to aggravate nearly any condition, the risk is highest with headaches. Strong massage also has the potential to make you feel kind of gross and wiped out for the rest of the day or even longer.
This phenomenon is called post-massage soreness and malaise , and headache is a particularly consistent symptom of PMSM. In fact, PMSM is probably a mild form of a muscle crush injury called rhabdomyolysis which traumatically forces proteins out of damaged muscle cells into the bloodstream, which then clog up the kidneys.
Its signature is brown urine … and headaches, malaise, and feverishness. For more information, see Poisoned by Massage. Massage therapists also often move the neck around.
Although this is rarely done as vigorously as a typical chiropractic adjustment, it can come close, and that is dangerous for some vulnerable individuals — and headache is one of the warning signs of that vulnerability. See the next section for more about the risks of neck manipulation.
There are several other major types of trigger point therapy. Not one is promising for the average headache patient, but all are worth considering when you get more desperate.
Here are the other approaches, quickly summarized. Again, every topic here is explored in much greater detail in my book. It might work about the same way that stretching out a calf cramp works: you win the tug-of-war with contracting muscle, just on a tiny scale. As with massage, people believe it helps, including some experts. Unfortunately, there are major problems in both theory and practice. How can we pull apart a powerful contraction knot — a tiny segment of muscle fibres in full spasm — with anything less than pliers, a vice, and a glass of bourbon?
Stretch with … spraying? A coolant spray, that is. Janet Travell famous for her study and promotion of trigger point therapy in the s and 80s. It is obscure, rarely practiced today, and unvalidated scientifically — but probably worth a shot if you can find someone who does it. Maybe stabbing will help!