|Body Region:||Head and Neck|
|Conditions Associated with TPs:||Headache, stiff neck, eye strain pain, tinnitus|
|General Symptoms:||Most common is headache. The severity can be great and lead a patient to believe it is a migraine. A true migraine has specific symptoms which a specialist should determine. A severe headache is NOT necessarily a migraine.|
|Common Causal Activities:||
Any time there is any injury to the head/neck region is a manner to cause the head to bend forward and/or backward quickly there will be some ligament damage to the cervical structures. This "whiplash" leads to tightening of the muscles and can lead to TPs.
Non-traumatic causes involve anything the person is doing which causes them to hold the head in an unbalanced position in any direction for an extended time, i.e. computer work, typing, working at a table or desk, reading, bending forward to do work, etc. This puts a strain on the muscles of the neck to maintain it's position and can lead to TPs.
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Since the neck is affected by a wide area of muscles they should all be checked and treated. For initial instructions read the rest of the text below.
Posterior Cervical Muscles from the base of the neck to the bottom
of the skull are best done in a seated reclining position with the head
falling backward. Interlace the fingers together as in prayer and place
the palms and fingers behind the head is a laid back relaxing posture.
One palm will cup the head and hold it in place while the thumb of the
other hand presses into the muscles in the area between the midline
in back and midline on the side of the neck.
Since the head and neck involve different planes of the body each must be handled in a different way.The top of the shoulders is best treated with the patient face down or seated by a flat fingers to palm or thumb squeezing while grabbing as much if the muscle as possible. Do this from the base of the neck out to the top of the shoulder. The deeper muscles of the same region are best pressed into with a one or two fingertip point on a hooked hand. If the patient is standing use the other hand to press the treating hand down into the deeper muscles. If the patient is face down form a hook with you hand and pull from the head toward the feet (not from the floor to the ceiling).The lower cervical paraspinals are best treated as described in the Mid-Back instructions.The neck muscles are best treated with the patient face up. Cup your hands under the head with one index fingertip pressing into the muscles of the paraspinals and the suboccipitals. When doing this the head will have a tendency to roll away from the fingertip. Use the palm of the other hand to hold the head in place. Treat only one side at a time. For the suboccipital muscles make sure you are under (inferior) to the ridge of the skull. If you're correct the chin will elevate. If you're too high the forehead will elevate. Make sure you work out sideways to the mastoid process.
The anterior muscles usually only involve the SCM. Have the patient face up. Turn and extend the head just enough to have the SCM stand out. Pinch with fingertip to thumb tip behind the SCM to try to pull it out from the neck. This applies the pressure needed. You don't have to squeeze much - just enough to keep the SCM from slipping through your fingers.
|Special Notes:||Migraine headaches are due to a change in the blood flow within the brain. TPT does not affect true migraines. However, many times the migraine will be associated with tension of the cervical muscles which can be aided by TPT.|
The neck is one of the more complicated regions to treat due to its
differing muscles, locations and settings. The best position in which
to treat a patient is the supine or face up position. This allows you
to use gravity effectively for much of your work and allows you to sit
during the process.
If not, you will not be getting into the deeper muscles you need to treat.The two pictures above illustrate the correct (left)and incorrect (right) head tilt when pressure is applied. The following video will help youunderstand some of this process.
The front of the neck is mainly treating the SCM muscle. Since its
purpose is to compliment the posterior muscles, it will tighten up and
develop TPs if the ones in the back do so.By turning and raising the chin slightly,