Nerve compression is a major factor in the initiation and perpetuation of tension headaches. If we look at the pathway of different peripheral nerves that transect, or pass under, musculoskeletal structures (muscles, ligaments, tendons, connective tissue) it is easy to see how nerve compression can create a tension headache.
o The Suboccipital nerve supplies input to the muscles of the suboccipital triangle. Compression of this nerve can occur at the superior oblique.
o A trigger point in the superior oblique muscle itself will also refer pain to various regions of the head.
Referred pain from the trochlear region in tension-type headache: a myofascial trigger point from the superior oblique muscle. Headache 2005 Jun;45(6):731-7. Fernandez de las Peñas C, Cuadrado ML, Gerwin RD, Pareja JA.
· The greater occipital nerve is located directly under the semispinalis capitis. Compression of this nerve is one of the causes of cervicogenic headaches. The symptoms from these headaches are called occipital neuralgias.
· Occipital neuralgia is a medical condition characterized by chronic pain in the upper neck, back of the head and behind the eyes. This is sometimes known as C2 neuralgia or Arnold’s neuralgia.
§ The lesser occipital nerve and the greater auricular nerve both pass by the SCM. Compression of these nerves will give symptoms of occipital neuralgia.
· The third occipital nerve travels under the trapezius muscle until it pierces this muscle and ends up in the lower part of the head (occiput). Compression of this nerve also causes occipital neuralgias.
In Part Three of Resolving Tension Headaches we will continue with causes of tension headaches.
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