The Relationship Between Headaches and Stress
Stress can cause all sorts of problems with our health. Prolonged stress can lead to diseases such as diabetes, high blood pressure, anxiety and depression. It has also been linked with cancer and heart disease. So, it should come as no surprise that headaches and stress go hand in hand.
What is a Headache?
A headache, known by the medical term cephalalgia, is pain located in the head or neck area, but not all headaches are created equal. There are several different types of headaches and they are typically classified into two different categories:
The primary category of headaches includes tension headaches, migraines, and cluster headaches as well as a number of uncommon headache types. Cranial neuralgias and facial pain are also a part of the primary headache category and can be extremely painful. Facial pain can be caused by a number of different problems, including trigeminal neuralgia. Cranial neuralgias include:
- Trigeminal neuralgia (a main cause of facial pain)
- Occipital neuralgia
Secondary headaches are caused by an underlying disease or other problem such as injury to the head or neck. These can include (but are not limited to):
- Cough headaches
- Exercise headaches
- Sex headaches
- Hypnic headaches
As you may have guessed, stress is a factor in only a few of these headaches. Cough, exercise and sex headaches have specific causes as their name suggests. Primary headaches such as migraines, tension and cluster headaches can be caused by stress, but they can also be triggered by other factors. For example, migraines can be caused by fluctuating hormonesor triggered by environmental influences.
Stress will typically exacerbate any headache, or condition that causes a headache. This is the case with the neuralgias. Occipital neuralgia especially is exacerbated by the effects stress has on our neck muscles.
Location of the Trapezius Muscle
The Trapezius Muscle
Stress and Tension – Type Headaches
Stress can cause headaches a number of different ways. The most common, tension headaches, account for approximately 90 percent of all primary headaches.
The most common culprit is spasms in the neck muscles, specifically the trapezius. This muscle connects the shoulder to the base of the skull and is responsible for the majority of tension headaches and occipital neuralgias. However, most people don’t know that it can also trigger a migraine.
When the trapezius muscle is in spasm, the muscle pulls down on the skull causing compression of the cervical vertebrae, specifically C1, C2 and C3. When these vertebrae are compressed, pressure is put on the surrounding nerves, and the flow of cerebrospinal fluid (CSF) is drastically reduced.
The lack of CSF to the brain can cause an excruciating headache, or migraine due to the reduction in serotonin levels the lack of CSF causes. This is a similar phenomenon to that of post-lumbar puncture headaches, or severe head pain that occurs after a spinal tap (tapping the spinal cord and taking a sample of the cerebrospinal fluid).
Tension-type headaches can be chronic in nature and occur in approximately 3 percent of the population. They are caused by chronic spasm of the trapezius and other muscles of the head and neck that become myofascial trigger points, or knots, after long periods.
Tension - Type Headache Pain and Symptoms
Tension-type headaches are bilateral (on both sides of the head), unlike migraines which are typically unilateral (only on one side of the head).
The pain often feels like a constant pressure sensation encompassing the entire head. Many people say it feels as if their head were in a vice. The pain can vary from mild to severe.
The frequency of tension-type headaches can be episodic (less than 15 days a month) or chronic (more than 15 days a month for six months or more). Their duration can last anywhere from minutes to weeks. The typical length of a tension headache is about four to six hours. Lying down can alleviate some of the pain, and sometimes the headache entirely.
Tension headaches are not usually associated with sensitivity to light or sound, or nausea and vomiting, which are symptoms usually associated with migraines. But these symptoms can occur with tension headaches.
Occipital neuralgia can also be called C2 neuralgia in reference to the vertebra that causes the disorder. It is characterized by chronic pain located behind the eyes, the upper neck and the back of the head. The pain is caused by damage to the occipital nerves, which usually occurs due to trauma.
The Vertebral Column
I actually have personal experience with this type of headache. Due to a neck injury I sustained 13 years ago, I have had chronic, almost daily, migraines.
My trapezius muscles are in full of knots, and this has led to permanent damage to the structure of my neck including levoscoliosis (irregular curvature of the cervical vertebrae to the left), degenerative disc disease, and osteophytes (bone spurs).
The resulting compression puts pressure on the occipital nerve, causing a headache, and sometimes a migraine.
Stress often exacerbates occipital neuralgia, because the occipital nerve passes through the trapezius muscle and ascends through the C2 vertebra.
The more tense a person becomes, the tighter the trapezius muscle gets and more pressure gets put on the occipital nerve. Lying down tends to alleviate the neck pain, but sleeping for four or more hours, or taking anti-inflammatory medications will alleviate the headache.
Stress, Headaches and Other Health Problems
Stress can cause a number of other health problems which can lead to secondary headaches. Stress has been known to cause:
- High blood pressure
- Cardiovascular disease
One of the symptoms of high blood pressure, which can be caused by chronic stress, is a headache located at the back of the head that usually occurs upon waking. But headaches themselves can actually cause hypertension. (It’s not unusual for pain of any type to cause an increase in an individual’s blood pressure.)
This can lead to a vicious cycle in which stress causes a headache, which causes an increase in blood pressure, which causes a secondary headache the next morning and then the cycle repeats itself.
Many people console themselves by eating when they are under a great deal of stress. This can lead to obesity rather quickly. Obesity can also cause headaches, mainly because of the other health problems it can cause such as diabetes and hypertension.
One of the symptoms of diabetes is headaches. They are related to the high sugar levels in the blood stream. Interestingly, there is a theory that stress can also cause diabetes, although there is not much evidence to support this. However, we do know that cortisol levels can cause diabetes.
For example, in patients with Cushing’s syndrome, the body produces too much cortisol because of either a pituitary or adrenal adenoma. Cortisol causes the retention of visceral fat, or fat surrounding the organs, which increases the risk of diabetes. It’s not a far stretch to conclude, that high cortisol levels in any individual will have the same effects, and increased cortisol levels are a natural response to stress.
Suffering with chronic stress has significant repercussions to our health, and headaches can be an early warning sign. If you notice a sudden increase in your headaches or a change in the severity or duration of your headaches, contact your doctor right away and let them know. It’s easier to stop the progression of occipital neuralgia or tension related headaches than it is to fix it once it’s a full blown problem.
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