The Headache Clinic
The Headache Clinic
Mother breastfeeding baby

Just had a baby? Life has changed with a new routine in place, one that is very repetitive yet unpredictable.

The emotions we feel after having a baby vary for everyone but are magnified and new to us. There is no right or wrong way to feel. Add to this the physical symptoms we are experiencing, and there is a lot to take in, let alone try to cope with head pain.

We know that the common underlying condition in headache and migraine is a sensitised brainstem. A sensitised brainstem means that your tolerance to normal events is reduced.

Why is the brainstem sensitised?

The brainstem receives information directly from the head as well as the upper cervical spine (top 3 structures in the neck). If there is a dysfunction present within the upper cervical spine, this will send noxious information into the brainstem, leading to the brainstem becoming sensitised.

Our posture leading up to giving birth is challenged by our center of gravity changing. Hormones, which relax the ligaments and soft tissue structures in the body, are not specific, so the structures at the top of the neck can be compromised.

The postures of new mums

When we are new mums, what postures do we find ourselves in? There is a LOT of sitting. We are recovering from the birth, and while we need to appreciate the healing process, which does involve a slower pace, this often involves sitting on a comfy seat with a slouched posture.

There is also a lot of looking down at our baby – baby snuggles are the best! They want and need us, but the position we are in does involve a lot of load to the top of the neck.

  • Feeding – breastfeeding and bottle-feeding generally involves sitting and looking down at the baby. In the early days, trying to latch the baby onto the breast is not always easy and involves a lot of sustained looking down.
  • Lifting and carrying – whenever we lift or carry something, we add load to our neck, especially when it is away from our body. Combine that with a forward head position, and this means we are adding a considerable load to the top of the neck.

Lifting the baby out of the cot or pram, carrying the baby capsule, and lifting the baby in and out of the car are some of the ways that can load the top of the neck.

So what can we do?

We appreciate that you will be in survival mode for the first few weeks and months. However, there are some things that can be done to decrease the stress and strain at the top of the neck and prevent the onset of head pain.

  • Sitting – try using the option of side-lying to assist in recovery and rest and take the load off our body and top of the neck. When we have to sit, ensure we sit tall and in a chair that supports us.

    Avoid furniture that encourages a slouched position. Use pillows or cushions, where needed, while we build the strength to maintain these positions.
  • Looking down at your baby – again, using the option of side-lying and snuggling, or sitting supported with the baby in a good position on your chest, so we are not in that sustained forward head posture, or sitting tall and nodding to look down at your baby.
  • Feeding – whether you are breastfeeding or bottle-feeding, it is important to ensure a good postural and head position.
  • Using the option of feeding in the side-lying position. Have your midwife or lactation consultant check your latch. Ensure you are supported with a pillow so that your head is in line with your spine, lower arm out in front, baby in line with your breast, and upper arm controlling their head while latching/feeding.

    Remember to relax your shoulders. With bottle-feeding, a similar concept applies. Ensure the correct position for baby while not compromising your own body position.
  • Feeding in sitting – sitting tall in a supportive chair that does not encourage a slouched posture. Use a feeding pillow(s) to ensure baby is at the correct height (if breastfeeding) and nod to look down while latching or feeding by bottle. Relax your shoulders.
  • Lifting and carrying – being mindful of your head position and head angle when leaning forward to place the baby in the cot or take them out. The goal is to maintain a neutral spinal position with the bend coming from your hips. Take a moment to reset your posture and head position before lifting. Hold the baby capsule with both arms close to your body rather than on one side.

It is important to try and avoid sitting in a slouched posture for any length of time, feeding the baby unsupported, leaning forward to bring the breast to the baby, and hanging your head forward when looking down.

Head pain from a musculoskeletal origin is not to be confused with pre-eclampsia headache or post-dural puncture headache – both of which are generally addressed when in the hospital or by your LMC.

If there is a dysfunction within the upper cervical spine, it is important to seek treatment and advice from a specialist in this area. Along with postural positioning, there are also exercises that can be done to help lower or eliminate head pain and build the strength required to help with desensitising the brainstem.

The team at The Headache Clinic are experts in this area and can tailor the correct treatment plan for you so you can get back to enjoying these precious days.

If you're someone who is plagued with headaches, you're not alone.

Almost one in six people around the world have a headache on any given day, according to new research by the Norwegian University of Science and Technology.

Listen to the full interview:

It also revealed that 52 percent of the world's population had a headache in the past year while 7 percent experience migraines daily and 9 percent have a tension-type headache daily.

The Headache Clinic founder Helen Tufui tells Karyn Hay although headaches are prevalent, they're not exactly normal - often it's your body's way of telling you something.

"[Researchers] know people with headache and migraine have a sensitised brain stem and if you can figure out what is sensitising the brain stem then you can get to the underlying cause of what is happening with your headache and migraine."

Tufui herself suffered from daily headaches and was fortunate enough to find the cause. She then went to Australia to conduct some studies and came back to New Zealand and opened her clinics.

While there are more than 300 types of headaches and migraines, an international headache disorder classification recognises certain features which set migraines apart.

But what they both have in common is a sensitised brain stem, Tufui says.

Influences on the brain stem, which is at the base of the brain and connects to the spinal cord, include your posture and use of upper neck and back muscles, she says.

"[Researchers] know that the information from the head itself as well as the information from the structures at the top of the neck enter directly into the brain stem.

"There's increasing evidence for the influence that the upper cervical spine or top of the neck has over that area and that's definitely what we're finding in our clinic as well."

A sensitised brain stem will have a reduced tolerance to events like tiredness, stress, dehydration and hormonal fluctuation, she says.

"You can have a pure trigger of every month, bang on, day one or day before your menstrual cycle, always get a headache or migraine but if you desensitise the brain stem by looking at what's causing that sensitivity then you can reduce that threshold, if you like, in bringing that down."

People with headaches and migraines also have a higher level of inflammation throughout their whole body, she says.

"Some people get huge relief from low inflammatory diets, so they can be things like the keto diet ... ensuring you get sleep can also bring down inflammation levels in the body.

"There's quite a few ways you can tackle it, but really it's trying to dig into what's causing it rather than just reaching for the pills.

"That's okay if you get a headache very infrequently but if you're suffering and you're reaching for the pills day after day, you really want to get to the bottom of what's going on there."

Increased screen time can be a trigger too, she says. Her clinic is seeing more children and adolescents who have developed a bad posture due to screen time, and that ultimately affects the brain stem.

"Kids now are getting a device when they're toddlers.

"They are growing up with a head looking down for such long periods of time at a device and that's having a massive effect on the top of the neck which is then leading to noxious information being sent into the brain stem, creating a sensitivity and resulting in a headache.

"Or for children, it can often be stomach pain or food intolerances as well. There's quite a list that goes in behind all that."

But there is a way to have screen time without the harmful effects on your posture. Tufui recommends looking at your biomechanics and how you're sitting.

"You don't have to sit with your hand on your knee and your face right on top of the phone, bent forward, you can actually sit up tall and just nod your head to look down, like your head actually nods on top of your spine without moving your head and your neck together."

The return of the school year is often when our students will experience an increased risk of headache and migraine. With all the mask-wearing and social changes to our school days at the moment, the last thing we need to add to this is headache or migraine. 

With hot and often humid weather, slouching in your chair or lying on your school desk seems like an attractive option. Combine that with the fact that you can’t sleep in until midday like you were during the holidays, some dehydration, plus the stress and anxiety about your new class, new teachers, and the gorgeous new kid who is sitting next to you in maths…what’s the end result? Headache or, even worse, migraine.

Head pain has a huge impact on how we can concentrate and function, so as we get into another year of study - it’s important to ensure that it’s started off on the right foot!

What causes headaches and migraines?

To understand how to deal with head pain, we need to understand what is causing it in the first place. When no pathology is present, the brainstem plays a significant role in headaches and migraines.

The brainstem is a structure found at the base of the brain that receives information directly from the top of the neck and the head itself. We know that people who suffer from headaches and migraines have a sensitised brainstem, which results in reduced tolerance to normal events in the body, such as tiredness, stress, and dehydration.

A common cause of this brainstem sensitivity is a dysfunction or issue at the top of the neck. This dysfunction can be caused by a trauma to the head or neck area (think whiplash) or from sustained pressure applied to the top of the neck - such as the forward head posture when sitting looking at your phone. 

Our 5 top tips for reducing the risk of headache and migraine

To help reduce the dysfunction at the top of the neck, we’ve come up with 5 top tips!

1. Posture is key! When in class or doing your homework, ensure that you are sitting with good posture. Make sure that your head is aligned on top of your shoulders and not hanging forward. One of the worst places to sit doing homework is on your bed with all your work out in front of you! 

2. Make sure your screen font is large enough to comfortably read from a good posture to prevent your head from craning forward. Craning forward will put a lot of pressure through the structures at the top of the neck and increase the likelihood of headaches and migraines. 

3. When looking down at your study material, try nodding your head on top of your neck rather than moving your head and neck as one unit. 

4. Make the most of your breaks between class. Go for a short walk and be observant, moving your head to look around you.

5. Prioritise sleep. It’s really hard to hold it all together when you’re tired! 

Research also shows that poor alignment at the top of the neck can reduce the blood flow to the brain, which is something you need a lot of when you are studying! 

If this sounds like you and you’d like more information on this, feel free to give us a call at 0800 HEADACHE (0800 432 322) or email [email protected]. We have a discounted student rate!

Summer

You have finally hit the road to head away on a family holiday after some last-minute frantic packing. Five minutes down the road, the kids are screaming in the back seat, the sun is pouring in through the windscreen, and you can’t find your drink bottle… maybe it’s still on the bench?

At this time of year, so many of our triggers are in full force. Late nights, alcohol, chocolate, travel, heat and lets not forget trying to keep the peace with the family. We are vulnerable to headache and migraine over the holiday period, and the last place you want to spend your holiday is in a dark, cool room.

To better understand how we can help take control of our headaches and migraines, we first need to know what is happening. 

What causes headache and migraine?

The common underlying condition in headache and migraine is a sensitised brainstem. Think of this like a decreased threshold. When the brainstem is sensitised, your tolerance to normal events is decreased. That’s why you want to scream when you spill your coffee, or the kids are arguing. Our tolerance to stress, tiredness, and even dehydration is decreased when our brainstem is sensitised.

The great news here is that the structures at the top of the neck have a direct connection to the brainstem and can be the driver of our sensitivity. By decreasing the strain at the top of the neck, you can reduce your sensitivity and improve your tolerance! Hallelujah!

Reducing the impact of headache and migraine

So what can you do to improve your tolerance to stress and decrease your risk of headache and migraine this summer?

  • Sleep routine - Be consistent. Try to get to bed at a reasonable hour and get out of bed at the same time each day. If you find you frequently wake during the night or are a light sleeper, consider taking a high-quality magnesium supplement.
  • Take a walk - Walking is not just good for your mental health and overall wellbeing, it can also significantly improve your headache. Walk tall and be nosey and check out what is happening around you. This is a nice gentle movement for the top of your neck and can take away some of the strain from scrolling through your phone.
  • Device use - Take breaks every 30 minutes and think about how you are positioned when using it. Sitting slumped forward with your head hanging over your phone or lying on your back with pillows stacked behind your head will increase the pressure at the top of the neck and put you at high risk of headache or migraine.
  • Try some meditation - Slow down that busy brain! There are lots of apps with guided meditations or simply find a secluded spot to sit and bask in the quietness. It’s amazing how just five minutes of quiet can give you the ability to get through. 
  • Breathing - Your belly should rise and fall with each breath. Focus on taking slow breaths that fill to the bottom of your lungs and slowly exhale.
  • Sit tall - Having great posture decreases the loading through the top of the neck. This can directly influence the sensitivity into the brainstem. When you have been sitting for 30 minutes, change position or get up and move.
  • Have fun – Laughter activates the parasympathetic nervous system (our ‘rest and digest’ system) and is linked with a healthy tone in the vagus nerve. Ten minutes of laughter a day is all it takes!

We can’t help with the chaos that comes with having family at home, but we can help take the headache out of summer.

  • CVS is classified as severe vomiting lasting from 3 hours and up to 3 days with no apparent cause.
  • It most commonly starts at the same time of day and lasts the same amount of time.
  • It is most common in children 0-3 years old, with sufferers growing out of it by 7-14 years old. Yet, in some cases, it continues into adulthood

The sad fact about CVS is that it is often not diagnosed for up 2.5 years in children and up to 9 years in adults.  This is due to its complexity of presenting symptoms and misdiagnosis of gastrointestinal issues or abdominal migraine. It crazily has led to most patients having avoidable medical procedures before getting a proper diagnosis.  It’s even recorded that up to 27-50% of CVS sufferers will become migraineurs into adult life. 

CVS has a huge impact on quality of life, with increased anxiety and depression, as nausea and vomiting are so debilitating.  It is linked to poor psychosocial function and increases in irritable bowel syndrome.  

Nausea and vomiting is the cause of 38% of all missed workdays, leisure days, and household activity days.  Children are also reported to miss up to 19-24 days of school or childcare. Even scarier than watching your poor children suffer is to learn that 50% of children need IV intervention and hospital admission and 27% of them need this every episode.

So, how can The Headache Clinic help? 

We have known for many years that the upper cervical spine has been involved in causing nausea and vomiting.  Furthermore, recent research has explained a common underlying condition, which is sensitivity in the brainstem.  This is the same for migraine, cervicogenic headache, tension-type headache, and menstrual migraines.  The brainstem receives information from two inputs only - the upper cervical area, including the upper 3 joints, one disc with the surrounding muscles, and the trigeminal area of the brain. The brainstem sits at the bottom of the brain, connecting it to the spinal cord, and is nestled in the canal of the upper cervical spine. 

So, you can just imagine how much of a direct input the upper cervical has into the brainstem itself.  So, back to the sensitivity.  This sensitivity in the brainstem reduces our tolerance to normal events, such as poor sleep, stress, dehydration, bright lights, poor head postures, hormonal fluctuation, and foods such as cheese, wine, chocolate, and other additives.  Other triggers of CVS can be viral infections and emotional events that include panic attacks, anxiety, and even social events such as parties which are supposed to be fun….sigh!

I bet you are asking, how do children have all this sensitivity at such a young age?  They are just starting out.  They usually haven’t been subjected to large amounts of stress, binging on alcohol, or significant hormonal fluctuations. 

However, they do have a heavy head and weak un-developed deep neck stabilising muscles.  These get stronger with age, and this may explain just how they grow out of it.  It may also explain why some continue to have symptoms into adolescence or adult life.  Especially if they have had a head knock, concussion, or neck injury, which is not uncommon in children as they play, learn and grow.

This may be the reason so many of these children become migraineurs, as this sensitivity remains in silence until the threshold is exceeded and migraine results.  That is unless it is addressed and the dysfunction in the upper cervical spine is corrected.  

It may be surprising to know that the treatment of CVS is similar to migraine treatment with the use of amitriptyline, a tricyclic antidepressant that works in the brainstem by blocking receptors and anti-nausea drugs.  These are being given to children at such a young age which is alarming when considering the long-term effects of medication.

Experience relief from cyclic vomiting syndrome (CVS)

The key is to find out why you or your child have sensitivity in the brainstem.   At The Headache Clinic, we frequently treat those with CVS, abdominal migraine, and nausea, vomiting symptoms.

Our practitioners all come from either a physiotherapist or chiropractic background who have undergone special training to diagnose and effectively treat the upper cervical spine and reduce the sensitivity with great success.  If any of this resonates with you or your child and you would like to have a chat with one of our practitioners, please feel free to give us a call and request a free 15-minute consult.  We are here to help.

Was your New Year’s resolution to get fit and improve your health, only to find that going to the gym triggers a Headache or Migraine or gives you neck pain?

You are not alone! There is an explanation for this, and I’ve got some great advice on how to work out without triggering a Headache or Migraine.

Plenty of research says physical activity helps prevent Headache and Migraine, so why does going to a boot camp or the gym trigger Headache and Migraine?

The answer is not hydration! Although hydration is important, there is another factor at play here.

Deep stabilising muscles

Research shows that those with Headache and Migraine, previous trauma to the neck or head, or neck pain and stiffness have a delayed activation of the deep stabilising muscles in the neck. These muscles help to stabilise and support the neck. 

Usually, what we would expect to find in people without these conditions is an activation of the stabilising muscles just before moving the arm away from the body. This prevents unnecessary strain from being applied to the structures in the neck and decreases the risk of injury.

You can imagine how many gym activities involve the arms being away from the side of the body, let alone adding in those weights! So, if there is load coming onto the neck when you lift your arms, and the neck is unsupported by the stabilising muscles, it is no wonder that the end result is a Headache, Migraine, or neck pain.

How do you prevent this from happening?

Activating and strengthening the stabilising muscles of the neck is a must! In our clinic, we treat patients with Headache, Migraine, and neck issues by correcting the dysfunction in the neck and tailoring a specific strengthening programme for the stabilising muscles.

However, there is something you can try next time you are at the gym. When lifting weights, stand or sit with correct posture and tuck your chin in, or as some people would say, “pull your head in”.

Not so you are looking down but so that you are on the verge of giving yourself a double chin. Another great thing to do is to book a session with a personal trainer so they can watch and correct your technique during a workout.

This is a great way to check you aren’t loading your neck unnecessarily while also helping prevent injury to other areas in the body.

If you find you are still having issues with Headache, Migraine, or neck pain after physical activity, come and see us at The Headache Clinic.

Give us a call on 0508 HEADACHE because we’re here to help you take control!

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