Friday, March 31, 2006

Needles Etc.

Physio Day #2.

My neurologist (one of Canada's leading headache experts) recommended some physio to see if they can do something (anything) to alleviate my chronic neck/shoulder pain. I don't think I have any particular neck problems, but using a computer 8h every day (and a natural forward-head posture) means that certain neck/back muscles are indeed tighter than others. Everyone has this, but it might be affecting my headaches.

You see, tension-type headache has a huge muscular component for many. According to my esteemed neuro, the role of the neck/shoulder muscles in this type of headache is highly controversial. Neurologists write books espousing one theory or another, but, like migraine, no one seems to agree conclusively on mechanisms. They all have their own theories, and studies are contradictory. What they can't fathom is whether a muscular issue in the neck/shoulders induces the headache (external cause), or if the headache phenomenon (internal) actually triggers the sensation of pain in the neck/shoulders. All I know is I ache from the top of my head to the middle of my back, and some days I am so sore I feel like I fell down a (long) flight of stairs.

Since they can't decide what the role of the muscles is, there is also heated debate over the role and efficacy of massage, physio, acupuncture, and numerous other muscle-related therapies in treating these headaches. Over the years, I have tried it all. But I'm making a renewed effort now that things have become chronic.

More on the neuro's:

Some neuro's (and some studies) suggest that muscle contraction, or maybe muscle tendon issues, triggers the headache. And also that there is increased sensitization in these muscles (greater tendency to feel pain for the least little reason). Yet other studies show that the neck and shoulder muscles of tension-type headache sufferers are no more contracted than anyone else's. Others believe that tension-type H/A is part of the spectrum of migraine (internal, vascular and other causes) and that neck/shoulder pain is somehow secondary. I don't know what to believe, but I do know that my muscles are super-sensitive, super-tender, and that doing muscular activites is a potent trigger for me. Sitting in a bad chair at a meeting can result in my back starting to seize up, muscle by muscle, and my headache rocketing from a 2 to an 8 in a matter of minutes. My headache ranges from average (like normal people get) to quite severe. But the muscle pain is always there, always leaving me physically fatigued. Spent.

Anyway, on to physio. After rushing over there (not helpful)...Deb, the physiotherapist, did acupuncture and dry needling on me. I have little faith in acupuncture. I had it once before and felt nothing, but maybe my chi wasn't ready. And studies on acupuncture and TTH show its' effects are virtually nil. But it's nice to be resting, mid-day, on a warm heating pad in a quite room, perfectly still, with needles quietly planted in symmetrical patterns about my body. I didn't like the "third eye" one on my forehead, nor the ones in my hands that prevent me from scratching. But after the last acupuncture session, I felt *rested* and relaxed, so I'm trying to get my chi to stay open about it. Dry needling is another story. A more invasive intra-muscular discipline. It hurts. But I once had some vague relief from it, so try try again.

So...I had 12 acupuncture points and dry needling both sub-occipitally (base of skull, top of neck) and in my tight pecs. Last week I felt good after the procedure, but ended up having a headache (and neck/shoulder pain) from hell all week after. Physio suggested it's because we've *stirred things up* with my chi and muscles and something I didn't understand. I can support that, that getting things *unstuck* in my muscles will take time and may cause interim pain. But this afternoon, I feel the onset of a droning, sickening headache.

I'm spending the weekend out of town with my boyfriend. I'm hoping fresh air, a visit with his Mom, good food, love, reading, and some meditative sudoku time will help the needling take effect. Let's hope.

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