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Page reviewed July 2005
2. TENSION HEADACHE
As I suggested in "Migraines", tension headaches can be more difficult to get rid of than migraines and may take longer.
Tension Headaches are just that. Headaches caused by tension of the muscles of the scalp and/or the muscles of the upper back and neck. Tension in this latter area then works forward until you end up with a severe pain just above the eyes. Interestingly the pain usually starts to disappear from the neck and shoulders first and the pain above the eyes may be the last to disappear. Many clients also complain of a band like constriction around the head.
Inappropriate chronic bracing of the muscles (dysponesis) and thoracic, rather than diaphragmatic, breathing are usually the cause and so these are the two components we need to especially look at.
The general protocol is the same as for migraine. After helping the student to become more self aware, especially with regard to this inappropriate bracing and thoracic breathing, training begins by correcting breathing patterns, teaching the student to change to slow, relaxed diaphragmatic breathing. We then go on to use myographic biofeedback (muscle) and finally temperature feedback of the hands and feet as an indicator of a reduction in general sympathetic nervous system activity. All of these are augmented with general relaxation training, the biofeedback being used to check that quite specific criteria are being reached.
Thus a self-help-training programme would include:
- Diaphragmatic breathing to counteract the chronic tensing of the trapezius muscles during thoracic breathing.
- Relaxing the muscles of the head, neck and shoulders using myographic biofeedback to check this has been accomplished.
- Learning to dilate the blood vessels in the hands and feet, using mental techniques, in order to reduce general sympathetic nervous system arousal.
- Becoming aware of, and correcting, habitual patterns of raising the shoulders, frowning etc.
- Looking at precursing thoughts and behaviours that might trigger the tension. This last one may be more important than you think.
When I was working at Bristol University we had a visit from the Vice Chancellor. I was asked to give a demonstration of using biofeedback to teach one of the secretaries to reduce muscle tension while typing - she suffered from tension headaches and yes, the same biofeedback, different position, can be used to alleviate RSI. I had used myographic biofeedback to check that the typewriter and chair were at the correct heights and to teach her how to relax her shoulders when typing. As the VC came round the room I could see from the machine that she was tensing her muscles without showing any sign of movement. The closer he came, the higher the degree of muscle tension shown.
The Myograph measures the signal from the brain, down the spinal cord, to the muscle. The greater the signal the tenser the muscle. It is possible to have little or no signal at the end of training (i.e. the muscle is relaxed) and still have a knotted muscle and considerable pain. We thus need massage to unknot the muscle and reduce the waste products of muscle contraction, mainly lactic acid. The training will then ensure that the problem doesn't recur!
I tell my students that the massage will unknot the muscle and I'll teach them how not to do it again.
The same sort of procedure works on any muscle that you have problems with and we'll talk about it again when we talk about obstructed defecation.
DISORDER FILE MIGRAINE PANIC ATTACKS
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