Most of us have had a headache at one time or another except for the very lucky few who never experience one.

What you may not know is that there are many different types of headaches and the appropriate treatment for your headache depends on which type you suffer from. Some people may suffer from more than one type of headache or experience mixed headaches, meaning their symptoms display a mix of 2 types.  

Here we discuss some of the more common types of headaches and how osteopathy can help you to relieve them. 

Tension-Type Headache

What it feels like:
– often described as “squeezing” or like a “tight band” across the forehead or around the head
– dull, non-throbbing pain
– mild to moderate intensity
– usually felt on both sides of the head
– tightness in the neck and shoulders is common
– associated symptoms may include trouble concentrating and sleeping, nausea and indigestion

Who it affects:
– can occur at any age although it is most common in adults
– often associated with periods of stress, anxiety or depression
– can also be triggered by muscular tension eg. Poor posture or jaw clenching

Cervicogenic Headache

The term cervicogenic means that the headache is being caused by referred pain from the upper neck.

What it feels like:
– pain often starts in the neck and travels to one side of the front and side of the head
– dull, non-throbbing pain
– mild to moderate intensity
– neck movement is usually reduced and painful

Who it affects:
– can occur at any age although it is most common in adults
– may be associated with tension in the upper neck, injury such as whiplash or degenerative disorders such as arthritis.

Migraine

What it feels like:
– severe, throbbing pain often made worse by movement
– pain usually occurs on one side over the forehead, temple region and around the eye.
– often associated with nausea, vomiting and/or light/sound sensitivity
– lasts for 4-72 hours

There are many types of migraine but the most common are:
Classical migraine (migraine with aura)
Common migraine (migraine without aura)

Aura consists of neurological symptoms that occur before the onset of the headache, most commonly visual disturbances such as bright zigzagging lines, flashing lights or blind spots.

Who it affects:
– can affect children through to middle age adulthood
– you are more susceptible to migraine if you have a family history of it
– more common in women than men (due to hormonal triggers)

Triggers
Migraines are usually set off by identifiable triggers, however there are many things that may trigger a migraine and they are different for everyone. Some of the more common ones are:
– certain foods, missing meals or dehydration
– hormonal fluctuations
– insufficient sleep or oversleeping
– back or neck pain
– illness

How Osteopathy can help

Our osteopaths will take a thorough clinical history, perform a complete assessment and determine a diagnosis of your headache, including referring you for further investigations if necessary.

Osteopathic techniques including soft tissue massage, joint articulation, muscle stretching and mobilisation may be used to help reduce muscle tension in the neck and shoulders. 

We will help you to identify triggers for your headaches and chat about changes you can make to your daily routine to help avoid triggering a headache

We can advise you on an exercise program specific to you and your type of headache 

Seek prompt medical care if you experience any of the following: 

• a sudden onset, severe headache known as a thunderclap headache 
• headache with a stiff neck 
• persistent headache after a head injury 
• confusion or loss of consciousness
• headache that is not relieved by medication
• headache with fever
• convulsions 
• headache that interferes with day to day activities 

Whiplash is a general term used for head and neck injuries where a person’s head moves backwards and then forwards suddenly with great force. We commonly see whiplash in motor vehicle accident patients but it can also result from physical abuse, sports injuries or falls. 

The acceleration-deceleration mechanism of energy transfer to the neck in a whiplash incident causes irritation to the structures of the neck and may not be noticed for 12-24 hours, sometimes longer. 

Symptoms can include but are not limited to decrease neck and shoulder movement, swelling, neck and back pain, headaches, dizziness, ringing in the ear and shoulder and/or arm pain. 

Whiplash affects everyone differently, so it is important to get a correct diagnosis following the incident. While serious incidents may require medical assistance from a GP/hospital, minor whiplashes can be well managed conservatively and with osteopathic treatment.

Osteopathic treatment for Whiplash

• Your osteopath will perform a complete assessment and determine a diagnosis of your pain
• Develop a treatment and management plan going forward, including any take home advice for the first few days
• Osteopathy may help reduce muscle tension and spasms around the neck and shoulder joints and help improve range of movement and decrease pain
• Osteopathic assessment and treatment will include the thoracic and lumbar spine, hip and pelvic areas to address any other strains or injuries. 
• Treatment may help promote blood and lymphatic flow, helping reduce pain and inflammation.
• Once initial acute pain and tissue strains/sprains have improved, treatment can then progress to exercises and rehabilitation to restore mobility 

Cork ball massage to relieve pain and postural strain in the upper back, shoulders and base of neck

• Place the cork ball against the wall, rest your upper back against it.
• The ball should be in contact with the space between the shoulder blade and spine.
• Move side to side, up and down allowing the ball to roll against your muscles.
• Pause on any tender spots and let the ball sink in slightly to release.
• Repeat on the opposite side

Improve your head, neck, shoulder and back alignment and posture with this simple ‘stacking’ exercise.

Here is an easy practice to help you try to prevent shoulder, neck and back issues. The aim of this stacking exercise is to reduce the tension in the muscles and create more even effort in the muscles that assist in keeping you upright.

Here are some basics:

• Start from the ground up – make sure your weight is balanced evenly between the left and right foot
• Now check to make sure your weight feels evenly distributed between the heels and the toes of each feet.
• Check in on your knees and ensure they are not ‘locked’ straight but rather softly bent.
• Allow your tailbone to drop down towards the back of the heels and the pubic bone to lift slightly. You should feel a slight drawing in of the lower belly when you do this.
• Stand/sit tall, imagine you are being pulled up by a string through the top of your head
• Keep your chin parallel to the floor
• Keep a gentle curve in your lower back and neck
• You should feel the chest open up at the front as the shoulder blades slide together and down your back slightly

Now most importantly, RELAX!
These tips are meant as a guide to help you achieve a good posture but remember not to hold yourself in a rigid position, too much tension in your body is more likely to cause injury than prevent it.
It takes time to practice good posture so be patient with yourself.

What is a cervical spine disc injury

Many people are familiar with a “disc bulge” or “slipped disc” in the lower back but did you know it can also occur in your neck?

Your spine is made up of three sections – “lumbar” in your lower back, “thoracic” in your upper back and the “cervical” spine in your neck.

Like the rest of your spine, your neck is made up of bones (vertebrae) stacked on top of one another, joined together by intervertebral discs (IVD). The IVD is made up of an outer ring of strong cartilage and a nucleus in the centre of a soft gel-like consistency. The IVD acts as a shock absorber in the spine.

As you get older or with wear and tear this disc may deteriorate and the outer ring can tear, allowing the soft gel nucleus to be pushed through the ring of cartilage giving the appearance that the disc is “bulging” or has “slipped”.

If the disc bulge is severe it may press on nerves as they exit the spine and cause symptoms such as severe pain, pins and needles and numbness in the neck, shoulders, arms or hands. This is because the nerves that come from your neck travel down your arms and into your hands.

A cervical disc bulge is more common in people over 40 years of age and is often a result of wear and tear over time. Some people with jobs that involve a lot of heavy lifting or people who participate in sports such as weight lifting may be at greater risk. 

If you have symptoms of a cervical disc bulge, it can be confirmed by MRI scan. However, we know that correlation doesn’t always equal causation when it comes to disc bulges and a small percentage of people may have a disc bulge in their neck with no pain. 

The majority of people with a cervical disc bulge will see improvement in their symptoms and substantial recovery without needing surgery in 4-6 months while complete recovery can range up to 2 years. 

Osteopathy and Cervical disc injury

• Our osteopaths will perform a complete assessment to determine a diagnosis of your pain and refer you for an MRI scan or to another health care professional if necessary. 
• Osteopathic techniques including soft tissue release, joint articulation, muscle stretching and mobilisation can be used to help reduce tension and inflammation.
• We will advise you on how you can avoid aggravating the symptoms including occupational, postural and sleeping modifications. 
• When appropriate we will guide you through some exercises to help you manage the symptoms and get on the path to recovery. 

Our wrists, hands and fingers are capable of many fine, controlled and complex movements, whether it is playing a musical instrument, a sporting activity, your occupation or just one of the tasks of day to day life.

 
Many of the muscles which control these movements come from our forearm and these muscles are attached to the bones of our hand and fingers via tendons. Where these tendons pass over the wrist, they travel inside little lubricated sheaths. Some of the more common tendinopathies are caused by irritation at this point, often due to overuse or repetitive use causing friction.

Tendinopathy can occur when these tendons become overused or overloaded, often due to an unaccustomed activity or an increase in the amount of an activity you already do. Maybe you’ve started a new desk job with a lot of computer work, have had a baby and now spend a lot more time lifting and carrying them or are playing a lot more tennis. So the affected tendon is placed under greater load or is being used more repetitively than it is used to and this can lead to pain.
Here we will discuss some of the more common types of tendinopathy that occur at the wrist and hand:

Wrist tendinopathies

Tendons may be affected at the front or back or either side of the wrist, depending on which action or activity is aggravating them. For example, golfers and tennis players are more likely to experience pain at the back of the wrist whereas rock climbers are more likely to experience pain at the front of the wrist.
Signs and symptoms:
- pain and tenderness in the region of the wrist
- increased pain during particular movements of the wrist (eg. bending forward or backward)
- feeling of weakness in the wrist when trying to lift an object or weight-bear (eg. when doing a push-up)
- difficulty doing everyday things like turning a door knob or lifting the kettle

de Quervain’s Tenosynovitis

This involves the tendons on the thumb side of the wrist. It is more common in women than men and is commonly seen in workers (eg. cashiers) and new mothers (due to repetitively lifting a baby).
Signs and symptoms:
- pain and tenderness over the thumb side of the wrist
- increased pain when clenching the thumb in a fist and deviating the wrist sideways, away from your thumb
- may cause swelling

Trigger finger (Stenosing tenosynovitis)

This condition occurs when one of the little lubricating sheaths in the fingers or thumb becomes thickened and the tendon gets “stuck” when it tries to glide through. The finger may get stuck in a bent position and be difficult to straighten. It is more common in women than men, if you have diabetes, rheumatoid arthritis or do heavy gripping activities.
Signs and symptoms:
- pain when bending or straightening the finger or thumb
- there may be a painful pop or click or a locking sensation when straightening the finger
- there may be swelling over the area
- you may feel a lump on the inside of your finger

Osteopathy and tendinopathy of the wrist and hand

– Our osteopaths will perform a complete assessment and determine a diagnosis of your pain. 
- Our osteopaths will differentiate which type of tendinopathy you may have and tailor a treatment and management plan accordingly.
- Osteopathic techniques including soft tissue massage, stretching, joint articulation and gentle joint mobilisation may be used to help reduce joint restrictions and muscle tension in the forearm and hand. 
- We may chat about some small modifications you can make to your daily routine to avoid aggravating the symptoms.
- We will advise you on appropriate exercises to slowly and correctly re-load the tendon to ensure optimum recovery.

Feeling stiffness and soreness in your hands and fingers? Osteoarthritis is a common condition in these areas. It is where, over time the protective cartilage on the ends of your bones slowly starts to break down. This leads to rubbing of ‘bone on bone’ and can cause tissue inflammation and pain  

Picture credit: Healthlink BC – https://www.healthlinkbc.ca/health-topics/zm6124

The most common place for osteoarthritis in your hands are: 

1. the base of the thumb
2. the joints closest to the fingertip 
3. the middle joint of the finger. 

Symptoms may include: 

• Pain and swelling
• Grating or grinding of the joint (known as crepitus) 
• Loss of strength
• Pain maybe worse in the colder weather

As Osteopaths we can help reduce inflammation but releasing tension in and around the symptomiuc area as well as provide tips to reduce pain moving forward. For more information or if you are struggling with hand pain, book an appointment with one of our osteopaths today (see link in bio)

Sick of that numbness and tingling in your hands with repetitive activities? It might be Carpal Tunnel Syndrome. Here is what you can do.

Carpel tunnel syndrome (CTS) is a painful common condition of the hand where there is pressure on the median nerve as it runs within the carpel tunnel of the wrist. The carpel tunnel is a narrow passageway on the palm side of your wrist that is made up of your ‘carpel’ bones and ligaments.

The main symptoms include:

• Numbness and tingling in the hand
• A dull and aching pain in the hand or wrist. Usually the areas supplied by the median nerve, so the first and 2nd fingers however it is not always ‘text book’ symptoms. It can affect the whole hand. 
• Can be associated with weakness or the feeling of clumsiness
• Pain in often worse at night
• Relief may come from changing hand positions or shaking the hand. 

What are the causes and risk factors?

• Repetitive actions of the wrist, manual work. 
• Pregnancy
• Diabetes
• Hypothyroidism,
• Obesity, 
• Past wrist fracture

Osteopathy and CTS

Osteopathy can provide a conservative treatment option for CTS by:

• Our osteopaths will provide a full assessment and diagnosis
• Advise on rest and possible splinting. Discuss referral options if splinting is needed 
• Osteopathic techniques like soft tissues, joint mobilization and stretching can help reduce muscle tension around the hand and wrist. 
• Osteopathic treatment may help promote blood flow and lymphatic drainage to help reduce local inflammation and irritation. 
• Prescribe some basic exercises to help with hand and wrist strength 

References: 

• Carpal tunnel syndrome: primary care and occupational factors

• Better health 

Is sitting at your desk all day making your elbows sore? While using your mouse isn’t an extreme sport, over time it can cause the muscles in your forearm to be overused and unhappy. Repetitive strain injuries (RSI’s) aren’t just for the super active and weight lifting folk. Repetitive, overuse of the wrist can lead to tendon pain in the forearm muscles that run from the wrist to the elbow. How can we avoid desk related elbow pain? 

• Mouse pads with gel supports can be helpful
• Check your keyboard and mouse position 
• Strengthen your muscles. We aren’t made to sit down all day holding a tiny electrical mouse.  It is important that you are strengthening your upper body away from work to help create stronger muscles that can take the repetitive load. Example –  Try holding some little 1-2kg weights and doing some wrist movements or squeeze a tennis ball 30 times. 

For the rundown on elbow pain see our elbow pain blog here and for all your workstation ergonomic information see here

Elbow bursitis is an inflammation of the bursa at your elbow and the most commonly affected is the olecranon bursa, which sits over the pointy part of your elbow.

A bursa is a small fluid-filled sac which acts like a cushion between the bony parts of your elbow and the muscle tendons that run across it.

When this bursa gets irritated by something it can become swollen and very painful! It may be irritated by a traumatic fall, direct pressure, a repetitive motion or it can also be associated with infection.

What are the symptoms?

• Obvious swelling at the point of the elbow
• Pain with movement of the elbow or putting pressure on it
• If the skin over the elbow is red and hot (you may also have a fever) PLEASE SEE YOUR DOCTOR as this indicates the bursa might be infected. 

Who is at risk?

• The most common cause is a hard fall on to the elbow, so athletes like footballers and basketballers are more likely to sustain this injury.
• People who play sports with a lot of throwing/pitching actions may be susceptible due to repetitive trauma to the bursa.
• It can also be common in desk workers or students who sit for long periods of time with their elbow resting on a hard desk.
• People with certain occupations such as plumbers and electricians may be more likely to get elbow bursitis because they spend a lot of time crawling under houses putting pressure on their elbows.
• People who suffer from conditions such as gout and rheumatoid arthritis may also be more likely to get elbow bursitis.

How can Osteopathy help?

• Our osteopaths will perform a complete assessment and determine a diagnosis of your pain. 
• Osteopathic techniques including soft tissue massage, stretching, joint articulation and mobilisation may be used to help reduce pain and muscle tension around the elbow.
• These techniques may help improve blood flow and lymphatic drainage from the area to help reduce inflammation and swelling.
• Applying ice can help ease inflammation and swelling of the bursa.
• Our osteopaths can advise you on how to avoid aggravating your bursitis and tailor an exercise program to rehabilitate your condition.