FACE OFF WITH HEADACHES
Recently I re-watched the classic movie "Face Off" with Nicholas Cage and John Travolta. Watching it again reminded me of how good of a movie it was, despite it's corniness.
But as fascinating as it was to watch the scientists of the movie remove Cage's face allowing Travolta to go undercover to stop a deadly terrorist attack - it is equally as fascinating to know that your face, more correctly the muscles of your face, can be contributing to your headaches.
Yes, you read that correctly - the muscles in your face can be relaying pain information back to your nervous system contributing to that nasty band of pressure that makes you feel like your head is about to explode.
Let's take a few steps backwards and explain.
Cervicogenic headaches are headaches where pain is referred to the head from either the bony structures or the soft tissue structures of the neck. Neck pain and cervical muscle tenderness are common complaints of those who suffer from headaches.
Neck pain causes headaches due to the fact that the sensory nerves of the head and face originate in the upper cervical spine. When these nerves get entrapped from improper joint function or increased tone of the muscles, pain will follow the distribution of that nerve. A common example of this is when the greater occipital nerve gets entrapped referring pain to the back of the head, which can travel up to the front of the face and behind your eye.
This is why when you come to physical therapy, we treat your neck in order to fix your head. But the neck may not be the only answer to decreasing frequency and intensity of headaches. The sensory nerves of the upper cervical spine are part of trigeminocervical nucleus, which is also where the sensory nerves of the face join the nerves of the neck.
What does this mean? It means even if we fix your neck, there can still be dysfunction of the muscles of facial expression, resulting in pain to remain present. Specifically of the corrugator supercilii and the procerus shown here:
Research from the journal of Plastic Reconstructive Surgery in 2007 specifically points to the corrugator supercilii as a chief culprit of headaches and "complete resection" of this muscle is necessary for "effective decompression of the supraorbital nerve and supratrochlear nerve branches in the surgical treatment of migrane headaches". So yeah, it seems pretty important.
Never heard of it before? Neither did we until we took Functional Range Release for the spine. More information on Functional Range Release courses can be found on their website: www.functionalanatomyseminars.com
In the mean time, try a few of these tricks and see if they help you decrease the pain and frequency of headaches in yourself and your patients.
Until next time, Happy Rehabbing.
Cervicogenic Headache: Mechanisms, Evaluation, and Treatment Strategies. The Journal of the American Osteopathic Association, April 2005, Vol. 105, 16S-22S.
Corrugator Supercilii Muscle Resection and Migraine Headaches. Plastic & Reconstructive Surgery: August 2000 - Volume 106 - Issue 2 - pp 429-434