Updated: Jul 16, 2021
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All of us have experienced it at one time or another-working all day on the computer only to end up with a stiff neck and headache. Most of the time even over- the-counter pain relievers do not do the trick. The discomfort is nagging and you just cannot get comfortable no matter what you do!
What Causes Neck Pain with Headache?
There are a variety of causes of headache, however when a headache comes on with associated neck tightness or pain, then most likely the cause is the upper trapezius muscle pulling on the skull.
The trapezius muscle is a large muscle which spans over the back of the neck and upper back. It is divided into 3 sections: upper, middle, and lower fibers. These fibers act to move the shoulder blades and the head.
The upper fibers are the primary culprit in headaches associated with neck pain. The reason for this is the upper fibers start at the base of the skull where you can feel two bumps (this is called the occiput) and flow down over the top of the shoulders. It is the attachment at the occiput that causes the issues.
When we sit or move with forward head posture for prolonged periods (reading, computer work, etc) hike our shoulders up with stress (shrugging our shoulders), or overuse our arms doing overhead movements (repetitive overhead reaching or push/pulling) these upper fibers can become stiff, tight and painful.
This will cause the fibers to shorten which in turn causes a pulling on the areas where the ends of the muscles attach to the bones. Since there is an attachment up at the base of the skull, any pulling or tension here will contribute not only to neck pain but headaches, as well.
Hence the name-tension headaches!
What Can I Do To Get Rid of Neck Pain with Headache?
Fortunately, there are some things that you can do to alleviate this discomfort.
First, you want to be mindful if you are participating in any of the above postures which can be stressful to the muscle itself and obviously change that!
1. Trigger Point Release
The next thing you can do to relieve neck pain with headache is to release the tension in the muscle itself. There are some specific areas where the muscle becomes restricted as seen here:
You can release this tension by applying pressure to these spots (known as trigger points) which will cause them to release. Please note: this will be uncomfortable at first, but the discomfort will subside as the muscle releases, so just keep as much pressure on the spot as you can tolerate without tensing up against the discomfort.
You can use release the fibers by using a tennis ball or golf ball under a towel, placing it under the trigger point and either lying on it or leaning up against a wall against it in order to apply pressure.
My favorite tool for this is called a massage hook. This is a hook with knobs on it that allows you to apply sustained pressure using the knobs over the painful areas. You can check out a massage hook here, see a video of how it works, and get one for yourself. You want to hold the pressure until you start to feel the pain subside. As the tension in the muscle relaxes, so will the headache.
Now that you have released the fibers, you want to elongate them so they do not tighten back up again and contribute to another headache. I recommend stretching two muscles: the upper trapezius itself and the pectorals (front of chest). When the pectorals are tight (and they are on most people) they will contribute to the head being pulled back into a position which stresses the trapezius. Therefore, you want to stretch it as well to ensure that the pecs do not contribute to the return of a headache.
When stretching you will hold each stretch for 30 seconds while breathing (do NOT hold your breath) and gently relax off each stretch. Do each stretch 3 times on each side.
To stretch the upper trapezius, you will sit on your right hand.
Bring your left hand over the top of your head and use it to gently pull your left ear towards your left shoulder until you feel a comfortable stretch anywhere on the side of your neck or top of shoulder.
Relax slowly off the stretch and switch sides by sitting on your left hand.
To stretch the pectorals, put your right hand up on a door frame with forearm flat on the frame.
Step forward with your left leg and keeping your chest upright, lean forward into the doorway until you feel a gentle stretch at the front of your right chest.
Relax slowly off the stretch and switch arms and feet.
You can do these stretches 2-3 times per day, as needed.
3. Using Heat or Ice
The majority of time heat will be the most helpful to relieve neck and headache discomfort, unless your headache is very strong, then you want to use an ice pack, bag of peas, or ice cubes in a Ziploc and apply it to the back of your head (at the occiput).
This ice pack is perfect for neck and headache pain, as it has a high collar which gets the cold higher up where the upper trap fibers attach.
Apply for 10 minutes and ensure that you have a thin layer of fabric (if using an ice pack without its own cover) between your skin and the ice, so that you do not burn yourself.
Heat can be used relieve neck and headache pain particularly if you are experiencing stiffness at your neck. Using a heating pad of the back of your head as described above, as well as on the top of your shoulder. This can be very helpful in increasing circulation to the muscle and relaxing the muscle fibers.
You can make a quick and easy hot pack by filling up a sock with rice, tie a knot at the top and place it in the microwave for 1-3 minutes (depending on your microwave). Place the pack over the back of your skull and lie on it for 10 minutes. You can also reheat it and place it over the top of your shoulder, as needed, as well.
Note: you will not hurt yourself by using ice or heat, rather use which one gives you the most relief. You may find alternating between the two is helpful as well-heat in the morning if you are feeling stiff and ice later in the day if you are feeling more sore.
4. Proper Sleeping Position
Finally, you want to ensure that you are not putting more stress over the upper trapezius when you are sleeping. One of the most common ways I see people place undue stress on their neck is by reading/watching television in bed with several pillows under the head. This puts extreme tension over the trapezius and promotes pain, inflammation, and stiffness.
You want to have your upper back propped up, not your neck. With reading, have the book resting on another pillow on your lap, so that you are not excessively looking down.
When you go to sleep you want to ensure that you head is line with your body. That means you do not want your head up too high or dropped back too low. This will prevent passive stress on the muscle while you are sleeping and relieve return of headaches due to neck pain.
If you feel you need more support at the back of your neck, you can roll a towel up and place it inside your pillow case. This will allow the curve of your neck to rest on the roll while still using your own pillow.
Ultimately, reducing the cause of tightness at the upper trapezius will have the most impact on reducing neck pain with headaches. However, if you continue to experience them, you can use these tips to alleviate your neck pain with headache and get yourself feeling better in no time!
Stay Well & Feel Good,
Always consult your physician before beginning any exercise program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. Consult with your healthcare professional to design an appropriate exercise prescription. If you experience any pain or difficulty with these exercises, stop and consult your healthcare provider.
Hi! I am Dr. Kim MacDonald. I am a physical therapist who specializes in empowering my patients to optimize how they move their bodies and improve their ability to do the things they love regardless of age, experience, or capabilities.
My experience in the health care field allows me to teach the tools you need to ensure that you are working safely to improve your pain and maximize your physical potential.
If you would like to know more about how you can help yourself be healthier and live a more active lifestyle, join me here.