A popular question that I am asked from my clients and my network of clinicians!
Posture influences pain directly. To maintain good effects from treatment, and to reduce various musculoskeletal pains, excellent (not just good) posture is essential!
Sitting posture, standing posture, driving posture, couch posture, restaurant posture, sleeping posture, and so on, are examples of what I term ‘still life’, or static postures that we hold. ‘Moving’ or dynamic postures include walking posture, working out posture, cycling posture, running posture, yoga posture… you get the idea!
These postures are correctable, which then facilitate a better physical state.
Headache (the reason you found this article), often originates in the neck, consequently, this type of pain is susceptible to changes in spinal posture.
These pictures demonstrate common presentations that I observe in my practice. Of course, I see combinations of these postures as well. Take a moment and observe your own posture. Why are you holding yourself this way? It can be from habit, from something that someone said years ago, from abdominal pain, from visual strain, foot pain, and so on. It can certainly also be influenced by your state of mind (anxiety, fear, stress, confidence) and also the ambient temperature can affect how we hold our bodies.
Perhaps I can help you improve your situation?! 😊
THE HOW
First, let me explain specifically, HOW postural improvement can improve (or at least facilitate maintenance of the benefits from therapy and exercise) your headache situation (and I must state at the outset that, not all headache is from the neck. This needs to be assessed by a clinician well trained in cervical spine examination with respect to headache).
Central sources of central sensitization
Posture improvement means moving the bones into a more neutral position. We do this actively by engaging muscles which pull and rotate our bones. When this more neutral posture of our neck joints is achieved, the joints and discs and muscles that are sources of nerve input to the brain stem (getting a bit anatomical here), send LESS (of what is termed in the research studies) noxious afferent input.
It is like turning the volume down on a device that is playing horribly loud, irritating music. In chronic, persistent migraine headache patients, it is found that the ‘noise’ is not particularly loud, but that the brain stem is especially sensitive, or ‘over sensitized’. We call this central sensitization of the brainstem, in the chronic, persistent migraineur (Watson et al., 2012).
Peripheral sources of central sensitization
I should explain that posture improvement begins at the feet, then moves up to the lower back and finally neck and head. So above I talk about neck joints and discs and subsequently muscles, that are revved up and send too much noxious input to the brain. There is ANOTHER way that posture correction helps. Larger lower, mid-back and neck muscles (erector spinae and upper fibers of trapezii for example) are less ‘taut’ (less lengthened and tight like the guy wires on a bridge, which is how I describe it to patients), leading to less peripheral sources of central sensitization that irritate the neck structures that are related to headache… This is often described as the muscle length-tension relationship, a physics concept. If a muscle is long and tight, there is tension, versus a muscle that is shorter and ‘slack’, or relaxed.
In summary, strive for EXCELLENT posture and postural ‘habits’, to keep the sources of brainstem sensitization low. Turn down the volume.
ADD precise manual therapy of the cervical spine and any other relevant areas in your case, as that if often needed in conjunction with these postural changes. Sometimes joints get ‘stuck’ and need to be released.
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