06/10/2025
After forty year's experience I am sure that by far the most headaches come from tension and muscle spasm.
Neck- ,shoulder- and muscles around the tempero-mandibular joints go into spasm and irritate the neurovascular bundles of the Greater Occipital and Pre- Auricular nerves, leading to progressive headache and tenderness of muscles.( Over the arrachment of the posterior neck muscles to the occiput and the TM joint in front of the ear).
This is aggravated by posture while driving, working on computers or even with microscopic medical posedures like retinal surgery, etc.
As the headaches often start on the one side, then move initially to behind one eye, people often suspect and might be treated for migraine..
Mostly the headache responds very well to gentle mobilisation of the paravertabral joints and the palpation and injection of triggerpoints in the neck-, scapular-, and/ or masseter and Temporal muscles.
This relief may wane after a while if not followed by 3 regular easy exercises of the neck and shoulder muscles,which take 3 minutes of your time two or three times a day and can be done while lying, sitting or standing.
A MRI, followed by a servical fusion or fusions for purely degenerative changes are in the majority of cases not necessary or effective, though it is regularly done.
Worrying synptoms and neurological signs; that do not clear up with treatment, warrant scans to exclude other causes like rare vascular abnormalities, intra-cranial tumors or infections.
These tension-related/muscle spasm associated headaches are more common in female patients. Perhaps because they must multi-task between household- motherhood and professional duties. It is natural to worry about such a headache, but please get second or third opinions before having neck surgery and if the first one does not help the chances of repeat opererations being succesfull is very low.
