A myofascial trigger point (TP) is a hyper-irritable area in skeletal muscle that is commonly detected by palpating (feeling with the fingers). Although more sophisticated ways exist for locating TPs—ultrasound, microdialysis, electromyography, infrared thermography, and MRI—palpation remains the most utilized due to its simplicity, efficiency, and low cost. For patients with migraine and tension-type headaches, TPs are commonly found at the base of the skull/upper neck, paraspinal neck muscles, the upper trapezius, and/or the levator scapulae musculature.
In one study that included 34 headaches sufferers (20 had migraine headaches without aura and 14 had tension-type headaches) and 34 non-headache controls, researchers looked at what happened when they used a specific technique to recreate the effect of a trigger point on muscles in the upper neck and in the arm.
When the researchers stimulated the upper neck, 8 of the 14 (57%) members of the non-headache control group, all 14 TTH subjects, and 19 of the 20 migraine sufferers reported headache-related symptoms. On the other hand, when the same technique was used on the arm of each participant, none reported headache-like symptoms.
The authors concluded that the high incidence and accuracy of headache reproduction from upper neck stimulation supports the importance of evaluation and treatment of trigger points in the upper neck region in those with TTH and migraine headaches. Doctors of chiropractic commonly perform manual techniques to the upper neck region and train their headache patients in identifying and self-managing TPs located in the upper neck muscles.
Several methods can be used to self-treat TPs in the upper neck region. Perhaps the easiest approach is to reach back with your thumb to the muscle attachments along the base of the skull and apply deep (but tolerated) pressure, feeling for areas that are most sensitive and sliding the thumb up/down and across the sore TP until it becomes less tender. Work the left side with the left thumb and vice versa. Doing the same with small head movements—up/down, left/right rotations, etc. helps.
Another method is to sit in a straight-back chair, slide down so that you cradle your upper neck over the top edge of chair back and then roll your head left to right. When you find a sore TP, add a nodding type of head motion while “digging in” over the chair-back edge (within tolerance) until it loosens and hurts less.
If you suffer from headaches, your doctor of chiropractic can train you in these and other effective exercises and render treatment to improve cervical function that can be highly effective at reducing both the frequency and intensity of headaches.
