Let's Talk About Headaches

Have you experienced a headache?


If you have had headaches before, you know how debilitating they can be. 

You, likely, also know their cause can be complicated to figure out. 


One thing I will bring up in the discussion of resolving headaches is the aspect of referred pain from trigger points, or sensitive areas that can cause the start of headaches, usually from upper body musculature. 

Even if you have migraine type headaches these trigger points can still contribute to the syndrome of pain. 

If you have TMJ , or jaw pain, this definitely can contribute to headaches. 

If you have visual strain or tension headaches these can also be part of what’s going on. 


So let’s cut to the chase. 

I like visuals, so I’ll use them to help demonstrate the following: 


  1. The black X is for the locations of likely trigger points in specific muscles
  2. Red patterns represent ‘’referred pain” where the pain actually travels to and from the trigger point.


For further clarity, these are mapped out over decades of thousands of head ache and referred pain sufferers. They are not imaged. They are palpated, manually examined. They can be manually treated, or sometimes require a form of injection whether with a medication or without, called dry needling. They can also be addressed with acupuncture/ acupressure techniques. Here at Evergreen we use both manual and postural / movement exercise foundations to resolve them. 


Here are some of the most common problem areas that can cause headaches: 

  1. Sterno-cleido-mastoid : These are two bands of muscle on either side of your neck. Each with a different pattern of referred pain. 

Note the areas of red. Do they, in any way, match your head ache pain? Intensity and consistency of pain seems to be located in solid red while the stippled areas can be associated with varying levels of pain. 


Causes are numerous but can be from a forward head posture, whiplash, concussion, extended computer time sitting, visual strain which causes one to crane their neck forward. Screen time or middle back roundedness can contribute as well. 

  1. Upper Trapezius Pain 

Or, this, with headaches more on the sides / around the temples, or back of head. Again, postural reasons abound. Sometimes folks will notice they carry tension in their upper trapezius, which is just an underlying tendency to hold shoulders up toward ears, often unconsciously. More often though, there are some who are weak in the upper trapezius, or heavy armed / breasted causing the shoulders to hang low. 


  1. Temporalis Pain 

Temporalis muscle pain is another jaw-related pain, but manifests in a different location, on the side of the head. This type of headache might plague folks with that have a tendency for jaw clenching, grinding of teeth, and holding their teeth close together even if they are not clenched. Often you’ll see individuals rub their temples to reduce pain. Perhaps they intuitively know these muscles need some movement or massage. 


There are many more common headache patterns that we can get into, but I think you’re starting to get the gist of it. Often headaches are complex and require more permanent, long-lasting interventions. Physical Therapists can provide those interventions. We evaluate trigger points, posture, muscle over and under use, which can all be reasons for your persistent, nagging headaches. 


Let us know if you’d like us to assist with headaches. 

We do what we do so people live their lives, and sleep their nights with peace of mind. Headaches often get in the way. 


Cheers to peace of mind and lifetime of smarter health 



Dave is the owner and founder of Evergreen Physical Therapy Specialists. He and his wife Tammy, an RN at CHLA, opened Evergreen over 15 years ago to provide the community of Pasadena with specialized and compassionate care. David has over 25 years of experience in orthopedics, neuro-rehabilitation, and pediatric physical therapy. 



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