Preventing Tension Headaches

By E Douglas Kihn, OMD, LAc, CPT

According to Chinese Medicine, there are four types of headaches commonly found in the U.S. They are caused by qi stagnation, heart & liver heat rising, liver fire, and spleen damp. A tension headache, the most common kind of headache in North America, fits into the category of qi stagnation. All of these headaches can be prevented and banished for good. Here we will focus on preventing and banishing tension headaches.

When the head hurts, it’s a message from the body demanding that we stop using the head, both physically and mentally. A headache means we didn’t listen to all the little indications from the body warning us that a headache was on the way and advising us to rest the head.

Preventing headaches requires a basic understanding of the dynamics of your particular headache pattern, and then listening to your body and picking up on those early cues so that proactive steps can be taken and pain avoided.

Let us now take a brief look at the four types of headaches. While tension headaches do not necessarily cause other types of headaches, the condition of qi stagnation which caused the tension headache, if ignored, can lead to other kinds of headaches as well as many other serious medical problems.

Afterward, we will explore some preventative actions that can be taken for qi stagnation headaches.

Qi Stagnation: one-sided headaches with dull pain (tension headache)
Accompanying symptoms:
· tight neck & shoulder muscles
· poor posture and/or chronic anxiety
Other qi stagnation traits:
· obsessive thinking and worrying
· jerky uneven movement, including driving with sudden stops and starts
· irregular menstrual cycle
· pre-menstrual symptoms
· irregular bowel movements
· shallow breathing with sighing
· stammering or halting speech
· any kind of physical ailment (the variety is endless) that is brought on or worsened by anxiety

Heart & Liver Heat Rising: One-sided headaches with throbbing pain
Accompanying symptoms:
· tight neck & shoulders
· aversion to heat, preference for cool
· irritability and impatience
· restless sleep
Other heat rising traits:
· sleep-deprived (and proud of it)
· over-scheduled (and proud of it)
· drive fast, talk fast, walk fast, work fast, everything fast (and proud of it)
· sweating easily
· reddish coloring
· recurrent sinus, eye, or ear problems
· strokes

Liver Fire: Incapacitating headaches with a need to retreat to a dark, cool, and quiet place
Accompanying symptoms:
· sharp headache pain at the top of the head or inside the head
· chronic rage that is suppressed
Other liver fire traits:
· any of the heat and stagnation symptoms mentioned above
· sudden severe eye problems (stys and conjunctivitis, for example)
· sudden dizziness, deafness, nosebleed or similar head problems
· strokes and embolisms

Spleen Damp: Frontal headaches often involving sinuses
Accompanying symptoms:
· sinus drainage
· heavy stuffy feeling in the head (“brainfog”)
· little or no hunger (but possibly a strong appetite)
· excess body fat
Other spleen damp traits:
· fatigue, low thyroid function
· a feeling of heaviness and bloat
· food allergies and intolerances
· food obsession (“right foods,” “wrong foods,” and food “remedies” for every problem)
· nausea
· swellings and growths

Often, different types of headache will be combined, in which case, a number of preventative actions must be taken.

Preventing qi stagnation headaches

Whenever muscles are kept unnaturally tight for extended periods of time, circulation is decreased. The body’s first message is muscular fatigue. The second message is muscular tightness. If these communications are ignored, the next message is pain. When the fatigue and tightness is in the neck and shoulder region, the qi will typically get stuck at the base of the skull, creating pain along one side or both sides of the head, even extending into the temple region.

Poor posture

Muscles in the neck and shoulder region tighten up from two causes, which are often combined. The first is poor posture. Poor posture is an epidemic in the U.S. People were not designed by nature to sit in chairs all day or to stand for hours on end. We are not built for hunching over while writing, computing, driving, or standing in line. The muscles that hold up the spine are small muscles whose function is to adjust for balance. When they are called upon to hold up the heavy head and upper body for long periods of time, they become overworked, chronically tight, and very unhappy.

For a while you will need to be constantly aware of your posture. Sit straight, stand tall, and walk with measured steps. Incline your head a little if necessary, but do not incline your upper body. If you have trouble seeing your work, wear glasses (or correct your vision naturally – a subject for another time and one that relates directly to neck tightness).

When you first start changing your posture, you will probably be aware of people looking at you more than before. You will stand out in a crowd. You will have to get used to this. Not being able to hide is the psychological price you must pay for preventing tension headaches. As long as you are friendly, people will see you as charismatic, not arrogant.

At the first indication of neck fatigue or tightness, stop what you are doing. If your health is more important to you than anything you are currently working on, if you really hate headaches, then you will take short breaks. The basis for good health in all living creatures is self-trust.

Neck fatigue and tightness will require you to relax your neck and back muscles for a minute or two. Sit back in the chair, relax on a sofa, or lay down for two minutes. Close your eyes and breathe. When the neck and shoulders feel refreshed, you can return to the task at hand, with good posture. At first, you may need to take a break every fifteen minutes. Gradually, as postural habits improve, your rest breaks will occur less frequently, but the need for them will never go away as long as you are sitting or standing for long periods of time.

Driving is a major cause of tension headaches. I recommend that you incline the back of your seat far enough to rest your back and even neck on the seat back while keeping your hands firmly on the steering wheel. Keep the shoulders relaxed. Don’t drive fast. It will only tense you up and endanger your life. Play some relaxing music or listen to a book on audio and leave a little early instead.

Improper use of the keyboard and mouse can also cause tension headaches, as well as wrist and elbow problems. Make sure your seat is high enough so that your elbows are higher than your wrists. This will discourage the shoulder and neck muscles from rising ever so slightly while working the forearms and wrists, thus eliminating shoulder and neck strain.

Anxiety

The second cause of tension headaches is anxiety. I use the term anxiety to cover a multitude of synonyms such as stress, dread, worry, resentment, and so on.

The emotional basis of all forms of anxiety is fear. Whenever animals and people feel fear, the natural reaction is a tightening of muscles in preparation for fighting or fleeing. Animals will tense up only for the time it takes to successfully fight or flee. People, especially those of us who live in modern anxiety-plagued cities, often feel trapped in positions from which there seems to be no successful fighting or fleeing. And so we stay tense and tight for long periods of time.
This type of qi stagnation is called liver qi stagnation because it involves stagnant emotions and obsessive thinking. It’s the responsibility of the Chinese liver (gan) to maintain spontaneous and free-flowing emotions.

Any muscle in the body can develop a pattern of chronic tension in response to chronic anxiety. When this tightness involves internal organs, the result can very serious, even life-threatening. Asthma, heart disease, stomach problems, Crohn’s disease (small intestine), colitis, irritated bowel syndrome, pre-menstrual syndrome, fibromyalgia, difficult urination, urinary incontinence, sexual impotence, infertility – the list is endless – are all conditions that are partially or wholly caused by anxiety and muscular tightness.

This is the same list of complaints, by the way, that responds well to placebo treatments and faith healing of all sorts. Trust for the procedure or the healer causes a relaxation effect and a resultant lessening of pain and other symptoms.

A very common place for Americans to tense up is the neck and shoulder region. Often, the dominate side will tense up the worst.

Eliminating anxiety as a major factor in one’s life is a huge challenge and a 6,000 year old human quest. Before that time, our forager-hunter ancestors normally lived spontaneous lives in well-fed egalitarian clans. Now, as we approach the end of this turbulent age, anxiety is at record levels all over the world and increasing. Nevertheless, it’s important not to blame the world for our internal environment, since we cannot change the world just like that, but we can change our internal environment instantly.

In a certain sense, external stress does not cause stress headaches. Not taking responsibility for our mental and physical health is what causes stress headaches.

There are a gazillion ways of replacing anxiety with calmness. Cognitive/behavioral therapy (CBT), meditation, Taoist philosophy, hatha yoga, physical exercise, massage, acupuncture, Chinese herbal formulas such as xiao yao wan, frequent breaks, slowing down, and getting plenty of sleep are just some of the prescriptions I favor that have worked for me and my patients.

But the most important remedies are awareness and breathing. If you are tensing your neck and shoulders in response to anxiety, you must tune in to your body while it is happening, so that you can stop what you are doing, relax, and breathe. Ten slow deep breathes with body awareness will relax both muscles and mind.

Until you can find the confidence that will allow you to calm the fear and turn off the overthink machine, you will want to use breathing breaks to dispel physical and mental anxiety, perhaps many times per day.

Complications from tension headaches

Many people live their whole lives with tension headaches that do not develop into anything more serious than headaches. However, there is the potential for the development of some very serious problems indeed when a pattern of tension headaches is allowed to continue.

Tumors in the head, both benign and cancerous, are usually partially or wholly the result of chronic neck tension that is not addressed. Several years ago, I treated a patient with chronic tension headaches who had been blinded by a benign tumor that was pressing on the area of her brain that enables sight. That area for sight lies just to each side of the bump that sticks out on the back of your head, called the “external occipital protuberance.”

I’ve treated patients with tension headaches whose chronically tight neck muscles managed to shut off the nerve supply to one ear, causing deafness on that side. In these cases, a course of acupuncture/acupressure treatments can perform “miracles,” but it won’t resolve the underlying problems of fear or poor posture.

There are healers who train people to see naturally and reduce or eliminate their eyeglass prescriptions. They maintain that tension headaches and squinting cause the eyes to lose focus, prompting many to wear glasses who normally would have no vision problems.

The tension trapped in the neck and shoulder region can also cause “mysterious” injuries to the arms, hands, and fingers. Qi stagnation will pinch down on the nerve and blood channels leading from the spinal column to the upper extremities, causing weakness, pain, and numbness in fingers, hands, and arms.

While tension headaches may seem common and of minor importance, they deserve our respect and attention, and will generally remain predictable and preventable.