Causes Of Tension Headaches
As is officially the case with all of the ‘primary headaches’ the exact cause of tension-type headaches has not yet been proven or even been studied in any real depth. You can be sure that science will not conclusively ‘prove’ the causes of tension headache within our lifetimes.
Meanwhile, as is often the case with stubborn pain conditions those in the front line of pain treatment (clinicians) often are pretty clear on what most significant causes are, and feel pretty confident in managing them.
If you ask ‘us’, most tension headaches have their primary root cause in the soft tissues of the neck and skull, and also in habitual patterns of emotional tension held over time. There are very few of us who do not have any stress on our lives, and even fewer who don’t habitually ‘hold’ that stress in certain areas of our bodies.
Three of the most common muscle groups we habitually hold tension in are the upper neck, the jaw and the tongue, all of which can influence the likelyhood of headaches.
Old injuries to the head, neck and jaw are a common cause of tension headaches. Sports injuries, road traffic injuries and early childhood/birth injuries are all common historical factors in the tension headaches that show up in clinics that treat headaches.
Tension Headaches Caused By Birth Trauma
Human births are an extremely difficult and dangerous time. The width of a human babies shoulders and the size of it’s head relative to the size of a human mothers pelvis is dicey mathematics. Whilst many mammals of a comparable size to us can give birth in a matter of moments, human births are frequently a very slow and violent strangulation process for the baby. We are very aware of the frequent physical trauma sustained by mothers. Babies on the other hand ‘have no voice’ and bear the wounds of birthing more internally.
As a culture we woefully underestimate the potential damage newborns sustain to their necks and delicate skull cartilage. Even when newborns scream many hours a day for months on end the possibility is still often overlooked to this day.
The legacy of unchecked and unmanaged birth trauma can be stubborn patterns of stiffness and inflammation deep in the delicate neck tissues. These patterns of unresolved physical trauma are a factors in the tension headaches of many adults. If you had issues with ‘colic’ as a baby and/or ear drainage issues, and now have headaches as an adult you may be carrying birth related injury patterns in your neck to this very day.
Tension Headaches Caused By Childhood Injuries
When a baby antelope is born it can stand up and walk immediately, within a day or 2 it is an athlete. To get to the same point in our development it takes humans 3-5 years. After 2-3 days the antelope is able to sprint, and we are still months away from being able to lift and support the weight of our own head. This stark comparison is a glimpse into just how frail we are as a species during early childhood.
We start life as we mean to continue, with a very large skull and brain. Having an XL skull means we have to be born as soon as possible in order to still fit through the base of our mums pelvis. This ‘immaturity’ means we are extremely weak during early childhood compared to many if not all other mammals. Being weak is in many ways the same as being injury prone, especially for a neck that has to vertically support a very large head. If you have ever seen how easily a babies head flops around when it is not supported you have glimpsed this potential for neck injury at this precarious time of life.
Once we have completed the mammoth task of earning to effectively hold and support our own skull under gravity we then have to learn to walk and run. As demonstrated by the antelope it takes us years to do what they can do in days. A big part of the difficulty we have is learning to balance on 2 legs using a recently and only slightly modified ancestral 4 legged body design. Learning to stand, walk, run and jump on 2 legs opens us up to a whole new host of opportunities for neck injuries. If these neck injuries do not heal they can easily become tension headaches later in life.
Tension Headaches Caused By Car Crashes
Motor vehicle crashes frequently place enormous stresses on the human body, there are very few survivable moments in nature that involve the sort of forces unleashed by vehicle collisions. We just aren’t made for the kind of forces at play when vehicles collide with other large objects. Among the many long term issues that can arise after road traffic accidents are migraines, cluster headaches and tension headaches.
Sometimes an example or a story can paint the most effective picture of how things are. We met a young lady recently who had a story about being t-boned by a truck in her Toyota Yaris. The extremely large truck struck her tiny car at 100kmph. Her Yaris was a crumpled ball of metal after the impact.
In one of lifes ‘1 in a million’ type outcomes she was cut out of the vehicle, cleared of any major trauma including fractures and concussion then sent home from the hospital, all within a few hours. There was no mention of the possibility of whiplash type injuries, she was given the all clear and sent home with less than a weeks worth of pain killers. The following 5 years of her life had been nothing short of a living hell, with a severe pounding tension headache every moment of her walking life, until she finally found some treatment that started the process of healing the whiplash.
The modern emergency room is a marvel of the modern world, and one that we should all be pretty thankful for considering how few of us have had access to this kind of care in human history. The simple fact is though that as highly trained as emergency doctors are, they are not trained in rehabilitation. They are also far too busy literally saving peoples lives to worry about whether your quality life has been ruined by a whiplash injury. Expect ED doctors to save your life, not your quality of life. Saving qiualoity of life is the job of those who are extensively trained and experienced with chronic pain management.
Old whiplash and car crash injuries are a major cause of chronic migraines and tension type headaches. Headaches can even arise from 5kmph rear end collisions if you are unbraced and not expecting the impact. Why whiplash injuries and the like so often fail to heal themselves is up for debate. The likely hood is that modern lifestyle factors in combination with us having large, heavy skulls to support with our necks at the best of times are both factors.
Tension Headaches Caused By Sports Injuries
By far the most common sports injury is the ankle sprain. In addition to being super common, ankle sprains are also ‘high visibility’ when they occur. The lack of fat and muscle at the ankle leaves any swelling and injury highly exposed and obvious to the naked eye.
In contrast to an ankle sprain when we sprain out neck there are many layers of muscle and varying amounts of fat to obscure any swelling and inflammation. What can be more obvious though is the stiffness and pain, that at least tells us that something is wrong.
There are many ways that sports injuries can lead to headaches and migraines in the longer term, most of which relate to unresolved and unrehabilitated soft tissue injuries deep in the neck and jaw. It is of course also possible to develop longer term tension headache and migraine type symptoms as a result of concussion and brain injury, especially from contact sports like rugby and boxing. Beyond those obvious and habitual collisions there are many other opportunities for the type of neck injury that can lead to migraines and tension headaches, like heading balls and even poorly executed deadlifts.
One of the more difficult challenges commonly faced by those who develop stubborn headaches after sports injuries is distinguishing between damage to the brain and damage to the neck. We have met literally hundreds of people over the years who had assumed that their headaches, migraines, loss of attention span and chronic fatigue were all caused by brain injury; only to find that their symptoms were coming from an easily treatable whiplash injury that had not healed.
Tension Headaches Caused By Physical Abuse & Assaults
Many of the same rules that apply to headaches and migraines that come from sports injuries in the soft tissues of the neck also apply to injuries cause by physical abuse and assaults. Long after the immediate cuts bruises and tears have all vanished and dried up, deeper wounds can remain in the soft tissues and joints, much as they do in the heart and mind of abuse victims.
The human neck contains numerous very small and delicate joints known as facet joints, these are easily injured in instances of head trauma. If you have ever been knocked unconscious of been hit on the head ghard enough to leave a wound it is very likelh you have have suffered a facte joint injury at the same time. As is the case with sports injurie and car craches many people suffer neck injuries and later on are mis-diganosed with brain trauma due to stubborn headache and struggles with concentration etc.
An additional dimension with neck trauma and headache that stem from injuries sustained in abuse and assault scenarios is the unresolved emotional trauma. Injuries that are sustained in profoundly traumatic ways often do not heal as readily as injuries that are sustained in relatively less traumatic ways. Injuries sustained over time spent under chronically absuing conditions can be particularly prone to manifesting as chronic pain. It is not easy to know exaclty why and how emotional trauma suppresses healing and exacerbates chronic pain, but the fact is they do. Some of the worst tension headaches that show up in clinics are those that relate to chronic physical and emotional abuse. It should also be pointed out that less severe tension headache cases can relate to cases of historical emotional abuse in the absence of physical injuries and the like.
Tension Headaches Caused By Emotional Trauma
Emotional trauma is a notorious and scientifically well known cause of chronic pain conditions, and headaches are no exception to this rule. We don’t know with any certainty exactly what happens in the central nervous system in people who struggle with chronic pain that stems from emotionally traumatic events in their past. The current best explanation we have is called ‘central sensitisation’. Central Sensitisation basically means that trauma has triggered the brain centres that are responsible for processing pain into becoming hyperactive or hypersensitive.
If you suffer from headaches that relate to unresolved emotional trauma it is highly likely you will have stubborn pain in one or more other areas of your body too. Not everyone who suffers with headaches that stem from emotional trauma remember the trauma or connect it to their pain, in fact most don’t make the connection. One of the hallmarks of pain that is caused by trauma of this type is extreme sensitivity to touch. In milder cases there is less tissue sensitivity but pain is still generally stubborn and frequently resistant to attemots at treatment and pain relief.
The 2 most important things to know about headaches and pain that stem from a history of emotional trauma are that it is not ‘all in your head’ and that it ‘is treatable’. There is every reason for hope and optimism because many, many people have successfully managed to resolve this kind of pain with the right mindset and the right help.
Tension Headaches Caused By Neck & Jaw Clenching
The topic of neck and jaw clenching and tension headaches is basically in most cases inseparable from factors like occupational stress, interpersonal stress and sometimes also emotional trauma. A major part of what we experience as ‘stress’ and forms of ‘unhappiness’ is made up of our own tendency to habitually clench or tighten certain muscle groups in relation to particular ‘life themes’. Some of us tend to clench more around our solar plexus, some of us clench around our hips, some clench around our shoulders, others clench most often and most intensely around our neck and jaw.
Those of us who tend to clench around our neck and jaw the most are generally more prone to headaches, when this tendency is combined with stress it can be a very potent recipe for tension headaches, and migraines too for that matter.
Jaw clenching is far more well known than neck clenching… for a terrible but interesting reason. The reason so many people are aware that they clench their jaw is that they do it so loudly once they are asleep that it makes a grinding noise that disturbs their other half. The resulting noise leads to a household reputation for ‘teeth grinding’. The distressing thing about this is that EVERYONE who ‘grinds’ at night also clenches during the day but are almost never aware that they do because it has become such an entrenched habit it just feels normal. What happens at night is the conscious mind switches off and the subconscious clenching habit takes control and is magnified.
The subject of neck clenching is so common that it borders on universal as far as ‘busy’ people go. Neck clenching as a subconscious response to stress is rarely acknowledged and rarely felt consciously by those who do it. If daytime neck clenching made a noise like nocturnal jaw clenching you might find yourself wearing ear plugs to work.
Both neck clenching and jaw clenching are major causes of tension headaches. The only way to know if you are suffering from headaches caused by clenching habits is to be examined by practitioners who know what the signs and symptoms look like. We are frequently able to confirm for people whether it is habitual clenching habits that are causing their headaches. In other instances we treat people who’s clenching habits have been identified by their dentist.
Tension Headaches Caused By Occupational/ Interpersonal Stress
Inseparable from the clenching topic and sometimes from the trauma topics also is the connection between ‘life stress’ and headaches. Stress is universally known for being a reliable headache trigger, we would go one step further and refer to it as a ‘headache cause’.
When we ‘feel stressed’ a major part of that feeling is the muscle tension we hold when we are consistently experiencing things we don’t love. There is nothing wrong with a bit of stress and a bit of muscle tension. It’s when they build up over time with no release that stress and muscle tension become the type of problem that can create headaches.
The tension we hold in our neck and shoulders when we are stressed is a major source of irritation to the soft tissues deep in the neck. Over time spent habitually clenching and holding postural tension in response to stress the delicate neck tissues become stiff and inflamed. Stiff and inflamed tissues deep in the neck are a super reliable cause of headaches.
The traditional medical explanation of stress as a ‘trigger’ for tension headaches is worth questioning. There is no doubt that acute episodes of stress are a major trigger for tension headache sufferers. Stubborn patterns of stress may be a major underlying ‘root cause’ of the tissue irritation that leads to tension headaches as well. Naturally other factors like genetics and diet will play a role, we suspect from experience that they are actually far less important factors however.
The good news about tension headaches that relate to stubborn patterns of stress is that they are generally much easier to control and manage than the stress itself. If you can get on top of the ‘build ups’ of tension and inflammation in the soft tissues of the neck you may find dramatic improvements in your headache issues.