Your Posture
and Your Headache

by Kelly James-Enger

WRITER DIANE HARRINGTON of Madison, Wisconsin admits she has bad posture. She also suffers from migraines as well, and believes the two are related. They often begin with tightness in her neck or shoulders.

“I always find that the ‘origination point’ is a particular spot in my shoulder or at the base of my skull — always on the same side the migraine is on,” says Harrington, 40. “By the time the migraine’s here, though, no amount of stretching exercises for my shoulders and neck will make it go away.”

When a Pain in the Neck Becomes a Pain in the Head

It turns out your mom was right when she told you not to slouch. As Harrington has discovered, there’s a connection between poor posture and headache frequency. “If someone has chronic headache pain, [we find] he or she often sits in a slouched, head-forward position,” explains Merle Diamond, M.D., associate director of the Diamond Headache Clinic in Chicago. “That aggravates the muscles of the head and neck and can lead to more muscle spasms and more pain.” Doctors call these cervicogenic headaches, and they can cause something called ‘referred pain’. While the problem may originate in your neck, it’s the back of your head that aches.

There are definite associations between neck or cervical spine triggers and both migraine and tension-type headaches, says Robert Kanieki, MD, an assistant professor of neurology at the University of Pittsburgh and director of the Headache Center there. Tension-type headaches are often due to muscle irritation in the neck; the resulting headache is often felt around the area where the muscles insert at the base of the skull, says Kanieki. “The head is essentially a ten-pound structure,” he says. “It it’s not balanced on the top of your neck and shoulders, it can certainly aggravate the cervical spine and trigger muscle tension, and muscle tightness. This can lead to spasms or the development of headaches.”

However, doctors now believe that there’s also a connection between neck pain and migraines. “Recently we learned that migraine, as opposed to being a blood vessel headache, is a vascular headache and truly has vascular origins,” says Kanieki. “And the structure that processes pain in the head that’s inside the brain — the relay center for pain — also relays pain signals from the upper neck.” That’s why doctors believe that irritation in the neck and upper shoulder area — the cervical region — can trigger migraines too.

Sit up Straight, Feel Better

If you already have neck problems, you may be one of the unlucky people predisposed to these headaches. One study found that people with joint or muscular abnormalities in their heads and necks were more likely to suffer from both tension and migraine headaches. However, if you tend to get headaches at the end of the day, poor posture may be the culprit.

Improving your posture and strengthening your neck and shoulder muscles can make a big difference — in clinical trials, people who did posture and strengthening exercises reduce their headache frequency. “One of the things we tell our patients with chronic daily headaches is to work on their posture,” says Diamond. “They should do a check-in and make sure that they’re sitting upright because it’s clear that a lot of these people slouch a lot.”

At the Headache Center at the University of Pittsburgh, patients learn natural means of improving headache, including regulating their sleep and meal patterns, and performing a daily 30-minute walk. Kanieki suggests that headache sufferers keep the phrase, “walk tall, sit straight, stretch out” in mind. During your daily walk, focus on maintaining good posture — imagine that there’s a string at the top of your head and keep your head balanced over your shoulders, back straight.

At work, make sure that you’re sitting straight, not hunched over, and take regular breaks away from your computer. Finally, implement a regular stretching routine into your day. Even a simple series of neck stretches (tilting your head to the left, then right, forward and back, for example) helps. You’ll reduce your chances of leaving work with stiff shoulders and an achy, pounding head — and your mom will compliment you on your new and improved posture as well. •

from the March-April 2010 issue

If someone has chronic
headache pain,
she often sits in
a slounched,
head-forward position

If you tend to get
headaches at the
end of the day,
poor posture
may be the culprit.