According to the World Health Organization, roughly 50 percent of adults worldwide have suffered a headache in the last year.1 And some 2 to 4 percent of the world's adult population are affected by this debilitating condition, and particularly migraines, for 15 or more days every month.
Neurological issues, stress, trauma, fluctuating hormones and postural misalignment all play a part in creating headaches, and these factors can feed into each other, often leaving people confused as to the root cause.
Headaches can be broadly categorized into four types:
Tension: pressure or tightness, often like a band around the head, at times spreading to or from the neck
Cluster: around the eyes, brief and regular, but extremely severe
Migraine: inflammatory and severe, often with nausea
Medication-related: the 'rebound effect' of pain medications taken for headaches, causing the very symptom they were taken to relieve.
Many headache sufferers are aware of factors like dehydration and stress, but less so of other possibilities, such as magnesium deficiency, food intolerance, incorrect eyeglass prescription, sleeping positions, repetitively holding a heavy bag or cradling a phone over one shoulder—even a ponytail worn too tightly.
As the WHO states, "Headache has been underestimated, under-recognized and under-treated throughout the world." But rather than simply reaching for the pain meds, examining some of the root causes for this condition can help sufferers feel empowered to prevent and relieve it.
Pain is an emotional message
There are many physical ways to relieve the body tensions that may create or contribute to headaches, but it is important to view our whole being (body-mind) not just as a set of mechanical parts, but a system that is constantly responding to our mental and emotional experiences.
Recent pain research not only acknowledges the whole person, but also describes pain as a reflex, emotion or memory.2 Any pain response is unique to the person experiencing it.
It involves nerves, immune cells and chemicals, but there is no actual "pain center" in the brain, as once believed. Instead, emotion, memory, attention and action—and how they combine—are all essential to the experience.
As Stephen Haines describes it in his book, Pain is Really Strange (Singing Dragon, 2015), "Pain is so much more than signals of danger from tissues. It is also much more than blocked emotions and belief systems. In fact, the experience of pain can depend on anything that can affect you."
Dr Gabor Maté, author of When the Body Says No (Wiley, 2011), believes migraines to be the result of repressed anger, often as a coping mechanism from childhood, when the sufferer may have learned to suppress such responses to 'keep the peace' as a survival strategy.
We hold our emotional experience within our physical body for self-protection, and this can be expressed as pain, particularly in the presence of unconscious cues. It isn't just damage from physical hurt that can knock us off balance, but the accumulation of trauma that we relive in our bodies as real in the present.
In the words of clinical psychologist and trauma specialist Maryanna Eckberg, "Trauma that is strictly mental or emotional—rather than physical injury—can manifest in . . . a tight diaphragm and shallow breathing . . . and strong tension at the base of the skull and at the bottom of the spine."3
All these effects can lay the groundwork for headaches, alongside digestive issues, anxiety and much more. They can be examined through routes such as psychotherapy, hypnotherapy, somatic experiencing and constellation work. Physical movement is also a critical piece of the puzzle. When performed consciously and with attention to the breath, it can help unravel held trauma patterns and create new patterns with safe associations.
When exercise leads to headaches
If you have been turned off by exercise because it triggered headaches, it is helpful to understand which types of movement and intensity are behind the problem. These are referred to as 'exertion headaches' and are a signal to let you know you have done too much, too fast.
Exertion headaches highlight the need for time spent warming up, slowly elevating heat and circulation around the body. Since exertion headaches can relate to increased blood pressure in the brain, they usually occur with more strenuous activities such as cycling, running or weightlifting, according to the American Migraine Foundation. Warm up by walking, jogging lightly in place, going up and down stairs, or performing standing motions that raise the arms above the head, and you can build up pressure slowly and safely.
Exertion headaches are also a good reminder that exercise is not done in isolation but reflects a larger picture of self-care. Dehydration, lack of sleep, blood sugar dips, and dietary triggers such as chocolate, alcohol and caffeine can all add up as contributing factors to headaches during and away from exercise. The exertion may be the tipping point, so looking after all these factors is vital.
The importance of posture
Improving posture helps to regulate blood flow to the head and brain. Tension headaches that start at the base of the skull may be traced back to modern habits such as hours of chair-sitting and looking down to view a screen.
As shown in the illustration below, natural uplift of the chest supports the head without neck strain. In a hunched position common with laptop and phone use, the head's weight is thrown forward from the body (top panel). These patterns get set into body tissues, so when we rise to standing, our ability to lift the chest and support the head is compromised.
The head and pelvis weigh roughly the same, so when one moves out from the center of gravity, the other shifts to counter it. The bottom panel shows an aligned standing posture with the ears stacked up above the shoulders to hold the head with ease, followed various ways posture can be thrown out as the head moves forward from the line of gravity, and tension is needed to hold it up.
In each of these examples of misalignment, there is compression at the base of the skull, a common source of headaches. The chin lifting that occurs when the back of the neck is compressed in this way is also common in people with stressed breathing patterns. The diaphragm cannot fully move when the chest is collapsed, and this poor oxygenation may also contribute to headaches.
Exercises to prevent and alleviate headaches
One of the simplest ways to keep headaches at bay when sitting at a desk for hours is to do five to 10 chin tucks every hour. Sit up like the example on page 39 (top panel, right), and from there, draw the chin in toward the neck to create space all the way up from the upper back to the top of the neck, then release it forward. Here are some more exercises that can help.
Jaw and temple release
Clenching the jaw is part of the self-protection response to increase blood flow to the brain, the most important organ for human survival. This well-known cause of headache can become stuck as a default, telling the whole body to stay in alert mode.
This hypervigilance can create tension around the temples and forehead, as jaw tightening is designed to keep blood flow high there so the blood vessels constrict for heightened brain function in times of stress.
Movements and awareness that allow the bottom jaw to slacken away from the skull and any frowning to melt away can involve the jaw, neck, shoulders and facial muscles:
• Making funny faces gives tense muscles a well-needed inner massage, releases the need to present 'a mask' to the world and helps remind us not to take our practice too seriously
• Gently moving the jaw side to side
• Rocking head subtly back and forth
• Moving just the eyes side to side
• Sticking out tongue
Freeing neck movements
From sitting or standing, inhale bringing your chin to one shoulder, exhale the chin down past the breastbone in a semicircle to the other shoulder and continue, side to side.
Next, on an inhalation, move the shoulders forward and up, and on the exhalation, bring them back down and round, creating full circles. Then move the shoulders in the opposite direction, and from there explore moving them in any way that feels you are creating space and letting the breath fully flow.
Sitting or standing, lift the right arm up over your head to cover your left ear with your hand. Allow the head to rest into the crook of the right elbow, keeping both sides of the neck long.
Breathe to feel as though a weight was gently but consistently pushing down on your left shoulder to lengthen that side of the neck. Stay in the position long enough to notice deep release, and then move to the other side.
Moving bridge pose for upper back and neck release
Lying with feet at least hip-width apart, feel good contact with the base of the big toe, so that as you inhale and bring the arms up and over the shoulders, you direct the lift into the chest rather than the lower back.
On the exhale, lower the spine back down, vertebra by vertebra, hands coming to meet the ground in sync with the tailbone.
Lift up and down as long as your breath can stay long, face and jaw soft, eventually holding the pose up for as long as you feel neither stress nor strain in the body or breath.
Soothing fetal position for opening the base of the skull
After bridge pose—or simply to relieve headaches—draw each knee in toward the chest, holding the backs of the knees. Using a folded towel or blanket, ensure enough lift height under your head to avoid feeling that your chin is lifting or your head is tipping back.
This is where you can release the lower jaw, soften the eyes and breathe space into the base of the skull. You can move around here as feels helpful in the jaw, head or lower back, and also cover your eyes with a scarf or eye pillow.
Interlinking the fingers, clasp your hands behind your head to lift the head and feet to curl into your belly. Explore moving the chin into the chest and side to side as well as moving the jaw as you go. Breathe fully to trust the action of the abdominals to hold you up without creating shoulder tension.
Twisting tension away
A simple twist can be done in a chair or seated in any position where you can lift the chest. This frees tension held in the torso that can ripple upward, and it opens out the collarbones to encourage chest lifting.
The head can also be turned in twists for a counter-rotation—chest going one direction and head the other—that relieves tension up the neck. You can inhale the head in the direction of the twist and then exhale the chin over the front shoulder, forward and back several times, before settling in this final position with soft shoulders.
Soothing the forehead
Supporting the head on a chair during a forward bend, we can let go of its weight and soften the eyes, jaw and mind; we may even salivate as the soothing parasympathetic tone of the nervous system engages. With arms folded onto the seat—legs crossed or sitting on a block or bolster as needed—rolling the head to massage the forehead can encourage this effect via the trigeminal nerve located there.
Relieving pressure in the head and heart
Raising the legs above the head calms the rate and pressure of blood flow to the head, as the heart doesn't have to pump so hard to move the blood from the lower body back up to the head when it isn't working against gravity. This simple version of the position, with lower legs raised onto a chair, takes any hamstring issues out of the equation. Support the head so it doesn't feel tipped back