Cervicogenic Headache: Neck Headache

Neck Headache, or as it is known medically - Cervicogenic Headache, is a secondary headache disorder. In other words, your headache is caused by a neck joint problem.

The good news is that by fixing your neck problem, your neck headache can be alleviated. Researchers feel that neck headache accounts for between 4% to 22% of all headaches seen clinically. (Racicki et al 2013; Watson 2014)

What's Causes Your Neck Headache?

Your neck headache can originate from a variety of musculoskeletal and neurovascular structures in your upper neck; including the upper three neck joints, C2/3 disc, spinal cord coverings and neck muscles. A dysfunction in these areas can trigger pain signals that travel to your trigeminocervical nucleus (TCN) in your brainstem. This information is then transmitted into your brain and interpreted as a headache (Bogduk 2003).

Upper Neck Joints

The most likely sources of your neck headache is dysfunction of either your upper neck joints, neck muscles or nerves, which trigger pain signals that travel to your trigeminal nucleus in your brainstem, where you interpret the pain signals as a neck headache.

The most common cause of neck headache is dysfunction of your upper three neck joints. The most common neck joints involved are your:

• Atlanto-occipital joint (O-C1), 
• Atlanto-axial joint (C1/2), and 
• C2/3 cervical spine joints.

In simple terms, your neck joints can cause a neck headache or pain if they are either too stiffor move too much (eg wobbly and unsupported by weak muscles) or are locked in an abnormal joint position eg. locked facet joint or poor posture. 

Once your neck joint becomes stressed and painful, the pain signals are referred to the trigeminocervical nucleus in your brainstem... and you start to feel a neck headache or, in some cases, face pain!

Your physiotherapist is expert in the assessment and correction of neck joint dysfunctions that result in neck headache. Their professional diagnosis and treatment is essential for neck headache sufferers.

Neck Muscles

Your neck and shoulder blade muscles that originate from your neck will cause pain if they are overworking, knotted or in spasm. 

Some of your neck muscles overwork when protecting injured neck joints. Other neck muscles become weak with disuse, which places further demand on your overworking muscles resulting in muscle fatigue related symptoms. 

Your neck muscles work optimally when they have normal resting tension, length, strength, power and endurance.

Your physiotherapist is expert in the assessment and correction of muscle imbalances that result in neck headache.

Cervical and Occipital Nerves

Nerves in your upper neck may be directly pinched by extra bony growths eg arthritis, disc bulges or swelling. The results can result in nerve irritation or a reduction in neural motion known as neuromechanosensitivity or abnormal neurodynamics. 

Irritation of your upper neck structures refer pain messages along the nerves and cause your headache.

In simple terms, your neck is the "switch", nerves are the "power cords" and your headache is where the "light" comes on.

What are the Symptoms of Neck Headache?

Neck headaches can often be misdiagnosed or confused with other sources of headache, including migraine, since the head pain is typically felt in the same area as a migraine. 

It is really the interpretation from your headache physiotherapist of the whole combination of your symptoms plus the findings of your physical examination that will confirm a neck headache diagnosis

Commonly, neck headache sufferers will usually notice:

• Tenderness at the top of their neck and base of the skull. 
• Neck stiffness or a mild loss of movement, although this is sometimes is only subtle and needs to be confirmed during your physiotherapist's physical examination.

One of the main differences between neck headache and migraine is that physiotherapy treatment of your neck is able to alter or relieve your headache immediately.

Common Characteristics of a Neck Headache?

The following symptoms are characteristics of a neck headache. You may experience any one or several of these symptoms:

• Your headache may seem to radiate from the back to the front of your head.
• Your headache is provoked or eased by a neck movement, a sustained posture, stomach sleeping or with your head turned to one side.
• Your headache normally appears to be worse on one side of your head. The side is normally constant and does not swap sides.
• Your headache appears to temporarily ease up when you apply pressure or you massage your neck or the base of your skull.

If you experience any of the above symptoms, you are more likely than not to be suffering a neck headache. Please inform your physiotherapist and they will assist you.

What if Your Neck Isn’t Sore?

Even if your neck isn’t sore or painful, you can still experience neck headaches. It is important to remember that your neck joints may NOT be sore at REST, but they may be tender to touch or painful on movement. 

Neck joints that are sore at rest will normally be very tender to touch and painful at the extreme of movement. Obviously, this scenario is a more severe neck headache.

If your headache or a migraine has been present for years and your neck has not been examined, then a thorough neck examination is recommended and is appropriate to eitherconfirm and treat your neck headache or exclude a neck disorder as the cause of your headache.

How is a Neck Headache Diagnosed?

Accurate diagnosis is important to guide the correct treatment and management your neck headache. Headache and head pain can have many causes, not just neck headache or migraine. Correctly identifying the cause will lead to better treatment.

This article originally appeared p physioworks.com.au and was written by John Miller.

Photo by Jacob Morrison on Unsplash

Depression is a physical illness which could be treated with anti-inflammatory drugs, scientists suggest

Depression could be treated using anti-inflammatory drugs, scientists now believe, after determining that it is a physical illness caused by a faulty immune system.

Around one in 13 people in Britain suffers from anxiety or depression and last year the NHS issued 64.7 million prescriptions for antidepressants, double the amount given out a decade ago.

Current treatment is largely centred around restoring mood-boosting chemicals in the brain, such as serotonin, but experts now think an overactive immune system triggers inflammation throughout the entire body, sparking feelings of hopelessness, unhappiness and fatigue. 

It may be a symptom of the immune system failing to switch off after a trauma or illness, and is a similar to the low mood people often experience when they are fighting a virus, like flu.

A raft of recent papers, and unexpected results from clinical trials, have shown that treating inflammation seems to alleviate depression.

Likewise when doctors give drugs to boost the immune system to fight illness it is often accompanied by depressive mood - in the same way as how many people feel down after a vaccination.

Professor Ed Bullmore, Head of the Department of Psychiatry at the University of Cambridge, believes a new field of ‘immuno-neurology’ is on the horizon.

“It’s pretty clear that inflammation can cause depression,” he told a briefing in London to coincide with this week’s Academy of Medical Sciences FORUM annual lecture which has brought together government the NHS and academics to discuss the issue.

“In relation to mood, beyond reasonable doubt, there is a very robust association between inflammation and depressive symptoms.  We give people a vaccination and they will become depressed. Vaccine clinics could always predict it, but they could never explain it.

“The question is does the inflammation drive the depression or vice versa or is it just a coincidence?

“In experimental medicine studies if you treat a healthy individual with an inflammatory drug, like interferon, a substantial percentage of those people will become depressed. So we think there is good enough evidence for a causal effect.”

Scientists at Cambridge and the Wellcome Trust are hoping to begin trials next year to test whether anti-inflammatory drugs could switch off depression.

“There is evidence to suggest it should work,” added Prof Bullmore.

The immune system triggers an inflammatory response when it feels it is under threat, sparking wide-ranging changes in the body such as increasing red blood cells, in anticipation that it may need to heal a wound soon.

Scientists believe that associated depression may have brought an evolutionary benefit to our ancestors. If an ill or wounded tribal member became depressed and withdrawn it would prevent a disease being passed on.

However a link has taken so long to establish because until recently scientists believed the brain was entirely cut off from the immune system, trapped behind a ‘Berlin Wall’ known as the blood brain barrier.

But recent studies have shown that nerve cells in the brain are linked to immune function and one can have an impact on the other. Around 60 per cent of people referred to cardiologists with chest pain do not have a heart problem but are suffering from anxiety.

One in 13 people in Britain suffers from depression CREDIT: ANNA GOWTHORPE 

Figures also show that around 30 per cent of people suffering from inflammatory diseases such as rheumatoid arthritis are depressed - more than four times higher than the normal population.

Likewise people who are depressed after a heart attack are much more likely to suffer a second one, while the lifespan for people withcancer is hugely reduced for people with mental illness.

“You can’t separate the mind from the body,” said Prof Sir Robert Lechler, President of the Academy of Medical Sciences.

“The immune system does produce behaviour. You’re not just a little bit miserable if you’ve got a long term condition, there is a real mechanistic connection between the mind, the nervous system and the immune system.

“Our model of healthcare is outdated. We have a separation. Mental healthcare is delivered by mental health professionals, psychiatrists, mental health nurses and so on, often in separate premises from where physical health care is delivered and that is simply wrong and we need to find ways to ever more closely integrate and train amphibious healthcare professionals who can straddle this divide.”

Research has also shown that people who have suffered severe emotional trauma in their past have inflammatory markers in their body, suggesting their immune system is constantly firing, as if always on guard against abuse.

This article originally appeared on www.telegraph.co.uk and was written by Sarah Knapton.

Photo by: Photo by Nik Shuliahin on Unsplash

Yoga Now Standard Treatment for Vets with PTSD

Yoga's not usually the first thing that springs to mind when thinking about treatment for post traumatic stress disorder in veterans. But from the Veterans Administration to the Pentagon, yoga classes are becoming not just commonplace, but in some rehabilitation programs mandatory.

One of the places in the forefront of change is the Newington Yoga Center, in Newington, Connecticut.

About 20 veterans train to become yoga teachers. Suzanne Manafort of the Veterans Yoga Project, said what began as a small project has burgeoned into programs across the country. Manafort taught yoga for years before using it as a treatment for PTSD. She said she had no idea she might need to make adjustments to her teaching, until she made mistakes.

"Touching is a mistake. In yoga classes we touch all the time. But to somebody whose been sexually assaulted that's a huge violation. Walking behind them is a huge mistake because it feels like they have to pay attention to what's going on in the room instead of just practicing their yoga practice," Manafort said.

She said ultimately it was veterans themselves that guided her, in some cases just by the courage it took simply to stay in class.

"Some of the men and women that I work with are Vietnam Veterans so they've been at home suffering for 40 years," said Manafort. "And when they come into this treatment program and they're told they have to do yoga, 'they're like are you kidding me?'"

"I thought it was a joke," said Vietnam veteran Paul Gryzwinski. "And I remembered actually laughing out loud and they said no we're really not kidding you're going to be going to yoga."

Gryzwinski is training to teach yoga to veterans. Many years after returning from the war, PTSD hit him hard. He ended up turning to the VA. Where he first encountered yoga.

"And I just thought of myself in like, tights with you know a bunch of women. And I know that sounds sexist — and I'm not, so forgive me — but it was such an alien concept to me," Gryzwinski said with a chuckle.

And Gryswinski's early misperceptions are one reason that Dan libby, a co-founder of the Veterans Yoga Project, said the 12 week yoga training for treating vets with PTSD tries to strip all the new-agey stuff out.

"We really emphasize, 'leave all the Sanskrit names at home, right. Leave the candles at home, don't talk about you know moonbeams and chakras and all these things,'" he said. "It's really just about learning about your body and your experience; learning to breathe."

Lt. Col Melinda Morgan deployed right after 9-11 and started teaching yoga to those who had served and those who were preparing to go to Afghanistan.

"So I started teaching veterans 10 years ago and one of those veterans that I taught became an instructor himself. And so in 2007 when he was in Iraq and I was in another location, he writes me a note that said, 'I have to teach yoga and I don't think I can.' So I'm like, 'yes you can.' I wrote it down all of the poses, emailed it to him and helped him on his way to become a certified teacher," Morgan said.

Today, Morgan teaches at the Pentagon, and she said classes once sparsely attended are now full every day. But despite an increased demand for yoga paired with a growing number of alternative treatment programs in the military and the VA, there's scant hard science about why yoga or most of the other alternative programs work.

Yoga instructor Dan Libby hopes the government does some studies soon, because without more data, returning troops won't take the programs seriously.

This article originally appeared on pri.org
Host Marco Werman
Reporter Susan Kaplan

Links

• VetsYoga
• Veterans Yoga Project
• Give Back Yoga

9 Things That Happen To Your Body When You Stretch Everyday

Not many people consider stretching to be a form of exercise, probably because it is something we do a lot without apparent effort, unlike strength training or aerobics. The effects of stretching aren’t all that apparent either; it doesn’t help you break a sweat or lose mega pounds. Stretching doesn’t give you six-pack abs or release growth hormones (HGH) known to have many fitness benefits. However, this relatively gentle form of exercise can keep you staying healthy and fit and is good for both your body and mind. 

1. Stretching increases flexibility

Sports trainers have always insisted that athletes give much importance to stretching, both before and after training sessions. That’s because stretching increased the flexibility of the body and reduced injuries in the field. Cats know that it is not ‘nine lives’ that help them land on their feet, but their great flexibility. And how do they keep their body flexible but by stretching it every now and then in between their long siestas.  In fact, you will see all animals stretching at one time or another during the day. 

2. Stretching exercises help lower blood sugar levels

Stretching definitely makes you more flexible, but the number one reason to stretch actually comes from an exciting new study which has found that it reduces blood sugar levels. You might already know that intense exercise increases insulin production and the utilization of the hormone to push glucose from the blood into tissues.

Contrary to expectations, a 30-second stretch and hold routine has been found to be just as effective in lowering glucose levels in the blood. Surprisingly, the effect doesn’t come from increased insulin production, but from capillaries in the muscle tissue opening up, facilitating the movement of glucose into the cells.

People with diabetes have a perennial problem with high blood sugar either because their pancreas gland is not producing insulin, as in Type I Diabetes, or because their insulin production has reduced over the years, as in Type II Diabetes. In people with insulin resistance, the hormone is present, but it cannot be utilized due to the insensitivity of insulin receptors.

Elevated sugar levels can damage blood vessels and nerves and adversely affect almost all other organ systems of the body, severely damaging kidneys, liver, heart, and the nervous system. Diabetes is rated as the no. 7 killer, but it is an underlying cause of many other potentially fatal diseases, including high blood pressure, atherosclerosis, heart disease, and stroke.  

High blood glucose level is not a problem exclusive to diabetics. In non-diabetics, high carbohydrate diet can cause high blood sugar for 1-2 hours after a meal. Although their insulin production will eventually bring down the sugar levels, frequent episodes of elevated blood sugar can do almost as much damage as full blown diabetes.

Elevated blood sugar can also cause overproduction of insulin, which gradually desensitizes the insulin receptors, resulting in insulin resistance. This can set into motion a series of metabolic problems that can potentially lead to Type II Diabetes.

Stretching helps reduce blood sugar by increasing the flexibility of the blood vessels supplying the muscles, which in turn allows more blood flow to the muscle tissue where the glucose can be utilized.  

3. Stretching helps reduce high blood pressure and its ill effects

Blood pressure is the force exerted on the arteries as the blood gets pumped through them. There may be several reasons such as obesity, diabetes, mineral imbalances, and stress hormones that may elevate a person’s blood pressure above the normal of 120/80.

The stress-busting effect of gentle, slow-paced stretching exercises can contribute directly to the lowering of blood pressure. It is not surprising since we already know that the stress hormone cortisol can raise blood pressure.

Increased pressure on the arterial walls damages them and makes them stiffer. But stretching can counteract the artery-stiffening effect of hypertension and protect you from many life-threatening conditions associated with high blood pressure, including atherosclerosis, kidney failure, and heart disease.

4. Regular stretching routine can reverse atherosclerosis

Atherosclerosis is another progressive disease condition which, like diabetes, has a wide-ranging effect on several organ systems. It starts with the buildup of plaque on the inner walls of the arteries that carry oxygenated blood from the heart to different organs and tissues of the body such as kidneys and heart muscle.

Plaque consists  mainly of cholesterol and calcium, and their accumulation on the arterial walls results in the narrowing of these blood vessels. This naturally reduces the blood flow to the respective organs, lowering their efficiency. For example, atherosclerosis in the coronary artery supplying the heart muscles can result in partial blocks that causes heart pain or angina, or a complete block that can result in a heart attack.

Atherosclerosis in the carotid artery that carries blood to the brain increases the risk of stroke. Narrowing of peripheral arteries reduces the blood supply to the hands and legs, causing pain and numbness. When renal arteries are affected, chronic kidney disease develops, which eventually culminates in kidney failure.

Besides narrowing the lumen of the blood vessels, atherosclerosis stiffens the arteries. We have seen that stretching exercises can increase the flexibility of blood vessels and improve blood flow. It has also been observed that regular practice can gradually reduce the plaque in the affected arteries.

5. Stretching exercises keep the muscles healthy

Muscles develop or atrophy based on the use and disuse theory. Those muscles we work more often become well developed while the least used ones tend to breakdown. When you sit around for extended periods, your thigh and calf muscles and glutes remain inactive, while certain other muscles in the lower back and around the knees become overstrained and sore. Stretching can prevent muscular atrophy of the glutes and other underused muscles and relieve pain in the strained ones.

We have seen how stretching improves blood circulation to the muscles. With increased blood supply comes extra oxygen and other nutrients to the muscles. Removal of metabolic waste from the tissues also becomes more efficient.

6. Stretching can increase the range of motion (ROM) of joints

Muscles are attached to the bone joints by tough, yet flexible, tendons. A similar type of tissue between the bones in a joint allows joint flexibility. Unless these tissues are kept in good condition with frequent stretching movements, the connective tissue protein collagen weaves a network of fibers. It causes them to stiffen up, reducing their capacity to remain flexible. When that happens, the range of motion (ROM) of the joints becomes greatly reduced. Stretching helps break up the collagen network and keeps the tissues flexible, allowing greater ROM.  

Aging naturally stiffens the tissues and reduces ROM, but in diabetic people, high blood sugar levels cause collagen to become glycated, forming a tougher, much less flexible tissue. That is one reason why ‘frozen shoulder’ is a common problem in diabetics. Along with aerobic exercises and resistance training, stretching exercises hold extra importance for diabetics.

7. Stretching helps correct structural imbalances and improves posture

Our body has a bilateral symmetry in the musculoskeletal framework, and the S-shaped curvature of the spine helps with balance. When we repeatedly do tasks that cause imbalances, such as carrying weight––a baby or a shoulder bag––on one side, some muscles gets over stretched while their counterparts remain contracted. The same thing happens when we use one hand or one leg exclusively for heavy and repetitive work or activity.

Similarly, when we spend a lot of time crouched in front of the computer screens, our shoulder muscles overstretch inwards, while the chest muscles remain contracted. You can see the opposite condition in pregnant women who bend backward in an effort to balance the weight of the enlarged tummy.

Stretching exercises help relieve the tension in both the overstretched and  contracted muscles and restore the structural integrity of the body.  

8. Regular stretching keeps your back safe

Back problems can be triggered by lifting heavy weights or by sudden twisting movements, especially in those who have not been maintaining the flexibility of their spine with sufficient stretching activities.

The vertebrae that form the spine are held in place by the surrounding muscles. 23 pairs of vertebral discs made of cartilaginous tissue keep the bony vertebrae separated from each other and from the spinal cord that runs through the spine. Their slightest displacement can injure the spinal cord, resulting in mild to acute pain.

Lack of exercise can make the cartilage tissue stiff and inflexible. When that happens, sudden twisting and straining can cause tears in the cartilage. Sitting for long hours without stretching makes the spine stiff and cause backache. Tight hamstrings also can cause low back pain.

Stretching exercises involving bending and rotational movements help strengthen the core muscles surrounding the spine and keep the discs flexible. Exercises stretching the hamstrings as well as getting up from the seat every 20-30 minutes for a few minutes of general stretching can keep your back in good condition. And don’t wait for any back pain to get you started on this. 

9. Stretching improves mental health

We’re not stretching the facts here, but people who do stretching exercises regularly report improvement in sleep quality, mood, and self-esteem. Don’t dismiss it as subjective data because there are plenty of sound scientific reasons to support their claim. For one, stretching triggers the release of dopamine, the feel-good neurotransmitter associated with positive feelings and good sleep. Dopamine can improve attention, learning and memory too.

The positive effects stretching have on blood sugar levels, blood pressure, and general cardiovascular health also can improve mental wellbeing because the above conditions are associated with depression and mood swings.

Stretching should be ideally done at an easy pace, accompanied by correct breathing techniques. A stretched position should be held for a minimum of 20-30 seconds to derive optimum results. Yoga and Pilates can be good stretching routines, but make sure that you involve all muscle groups, repeating it 4-5 times a week.

This article originally appeared on naturallivingideas.com and was written by Sierra Bright.