Any headache sufferer knows that headaches can be frustrating and debilitating. When headaches develop, they often interfere with or prevent us from performing many of our most basic daily activities, such as using the computer, reading, carrying on a conversation, and even thinking. Studies show that headaches top the list of conditions for which patients are most dissatisfied with their care.

Now for the good news: a new treatment technique known as Active Release Techniques® (ART®) is proving to be a very effective method for treating many common types of headaches. Through ART® treatments, many headache sufferers are able to finally get back to living their life. But before we talk about why ART® works so effectively, we’ll explain how headaches develop.

There is a common perception that the cause of all headaches is in the head itself, which seems like a logical assumption since that is where the symptoms are. However, scientific evidence suggests that many of the most common types of headaches may be generated in the muscles, joints, and nerves of the neck.

When talking about the neck, we are actually talking about the upper portion of the spinal column– the cervical spine. The cervical spine consists of seven small bones called vertebrae that are stacked on top of each other. By themselves the joints of the cervical spine are not very stable, so to protect the region, a complex system of muscles surrounds the spinal column to control movement and protect the area from injury.

Not only do these muscle need to move and protect the cervical spine, but they also must control the weight of the head. The head and neck have a unique anatomical relationship in that the larger, heavier head, which weighs about ten pounds, sits atop the thinner neck. The natural tendency would be for the heavier head, which represents the top of an inverted pendulum, to topple over. This places a high demand on the neck muscles, which have to support and control the weight of the head, at the same time ensuring adequate movement and stability of the joints of the cervical spine. This complex process requires each muscle to be adequately strong, flexible, and coordinated, and as long as this is the case, the neck remains protected and healthy, and will not cause headache symptoms.

The interesting fact is that muscle and joint dysfunction in the cervical spine has been shown to cause headaches through a process known as referred pain. The referred pain phenomenon is a complicated neurological process, but simply stated, it causes pain to be felt at a location other than where the problem is occurring. Referred pain can be experienced during a heart attack, when the pain is felt in the left arm, or with a disc herniation in the low back, which causes pain to be felt down the leg.

Scientific studies have shown that when problems in the muscles and joints of the neck occur, they often refer pain to the head, causing symptoms such as aching, throbbing, pressure, burning, and even stabbing pain. In many cases an ache or tension in the neck is felt along with the headache symptoms, but in many cases there are no noticeable symptoms in the neck at all.

Many situations can affect the health and function of the muscles and joints of the neck. Poor or prolonged postural strain from computer use and many desk jobs, repetitive use with some sports, muscle imbalances, lack of stretching or strengthening, or an injury can all lead to muscle tightness, weakness, and a lack of coordination of the cervical spine muscles, which are critical to maintaining the health and function of the head and neck region.

Over time this strain can develop into what is known as micro-trauma. Micro-trauma is very small-scale damage that occurs in the muscles, tendons, joint capsules, and ligaments in response to small levels of strain. In many cases this micro-trauma is not painful, but the damage needs to be repaired. The body responds to micro-trauma by laying down small amounts of scar tissue to repair the area. Over time this scar tissue builds up and accumulates into we call adhesions. As these adhesions form, they affect the normal health and function of the muscles and related joints. In fact, they often lead to pain, tightness, stiffness, restricted joint motion, and diminished blood flow. This places even further strain on the neck muscles, which in turn leads to more micro-trauma. A repetitive- strain-injury-cycle is set up, causing continued adhesion formation and progressive cervical spine dysfunction.

Although straining of the muscles, tendons, and ligaments can be responsible for tension-type headaches through the referred pain phenomenon, it may also cause headaches if it compresses or traps the nerves that supply the head. As the nerves exit the spinal cord, they travel through small openings in the spinal column, then pass through and between the muscles that surround the cervical spine, and on to supply distant structures such as muscles, joints, skin, and blood vessels.

Many of these nerves travel down the arm, which is why neck problems often cause arm pain, but some of these nerves travel up to supply the back, side, and top of the head. Under normal circumstances, these nerves should be able to move and slide between the surrounding muscles. However, when the neck muscles become tight and there is accumulation of scar tissue adhesions in and around the muscles, it is common for the adhesions to affect the nerves. In many cases the adhesions can cause the nerves to become stuck to the surrounding muscles and other structures, and instead of easily gliding between the muscles they become stretched and irritated. When nerves become irritated symptoms are usually generated in the area that the nerve travels to– in this case, the head.

The most common approach to treating headaches is medication to reduce inflammation, block pain, or relax the muscles that may be causing headache symptoms. In the case of chronic or recurrent headaches, sometimes doctors prescribe stronger prescription medications to help alleviate the symptoms. In some cases, even more invasive measures such as joint blocks are used, to block referred pain and other symptoms.

The main reason that medications fail to provide long-term resolution for headaches is that they fail to address the underlying problems of the muscles, nerves, or joints of the neck that are causing the recurrent headaches. Instead, they address the symptoms of the headache and simply cover up the underlying issues in the neck, which, if not addressed, will continue to cause headaches. As a result, many people become reliant on medication to relieve their headaches. This is a temporary fix that only covers up the problem, and increases the risk of side-effects and dependency on the medication.

Muscle tightness, scar-tissue adhesions, nerve entrapment, and abnormal joint movement can not be seen on x-rays or advanced imaging. This is because the water density of scar tissue tends to be quite similar to that of the surrounding tissues. These problems in the muscles, joints, nerves, and ligaments can, however, be felt or tested by the hands of a skilled practitioner, because scar tissue has a very unique texture. A thorough history and clinical examination is usually sufficient to give the clinician enough information to diagnose the problem.

ART® stands for Active Release Technique®. It is a new and highly successful hands-on treatment method to address problems in the soft tissue of the body, including the muscles, ligaments, fascia, and nerves. ART® treatment is highly successful in dealing with many types of headaches because it is specifically designed to locate and treat scar-tissue adhesions that accumulate in the muscles and surrounding soft tissues. Locating and treating the soft-tissue adhesions with ART® allows the practitioner to break up restrictive adhesions, reinstate normal tissue flexibility and movement, and more completely restore flexibility, balance, and stability to the injured area and the entire kinetic chain.

You can think of an ART® treatment as a type of active massage. The practitioner shortens the muscle, tendon, or ligament, and then applies a very specific pressure using their hands as they actively stretch and lengthen the tissues. As the tissue lengthens, the practitioner is able to assess the texture and tension of the muscle to determine if the tissue is healthy or contains scar-tissue that needs further treatment. When scar-tissue adhesions are felt, the amount and direction of tension can be modified to treat the problem area. In this sense, each treatment is also an assessment of the health of the area, as we are able to feel specifically where the problem is occurring.

An additional benefit of ART® is that it allows us to further assess and correct problems not only at the site, but also in other areas of the kinetic chain, that are associated with movement compensation, and are often contributing factors to the problem. This ensures that all the soft tissue that has become dysfunctional and is contributing to the specific injury is addressed, even if it has become painful.

One of the best things about ART® is how quickly it provides results. In our experience, many patients respond very well to ART® treatment, especially when it is combined with the appropriate self-directed neck-stretching exercises. Although each case is unique, and several factors determine the length of time required to fully resolve each condition, we usually find that significant improvement can be gained in four to six treatments. These results are the main reason that many elite athletes and professional sports teams have ART® practitioners on staff, and why ART® is an integral part of the Ironman triathlon series.

To book an appointment to see if ART® can help with your headaches, call our office at (248) 477- 2100.