Friday, 8 July 2011

Head and Neck Pain (Part One)

I hope that this finds you well and that you are ready to get nerdy with me. Last week I promised that I would write a few blogs on head, face and neck pain, so lets start today!

(If you have just joined me with the blog, please do read the posting entitled: Pain Patterns Explained as it will make the following easier to understand).

Firstly I would like to introduce my study partner; Gilbert. He stands behind me every day as I sit at my desk and provides me with a very willing volunteer when I am revising my anatomy. I have decided to use Gilbert as a visual aid for a few key muscles that effect people with head and neck pain. I would like to caveat that the photos below are simply an aid and not anatomically accurate (any Anatomist would have a lot to say about the bulky attachments and the width of the ribbons). However, I hope that over these blogs Gilbert and I can try and show you just how important knowing your anatomy is if we want to look at pain in any depth.

The first thing that we need to do is take a look around the head, face and upper portion of the chest. The head is made up of 8 cranial bones, but the ones that we will be looking at are the Temporal, which is on the side of the head and the Zygomatic, which is your cheek bone. We also need to be aware of some facial bones; your Mandible, which is your jaw bone, the sternum; your breast bone, and your clavicle, which is your collar bone. These bones form the attachments to the muscles that we will cover today.

There are 11 main muscles that when I am carrying out a treatment for a client I will make sure I treat if they suffer from any form of head and eye ache that may go into migraine attacks, neck pain, toothache, earache, as well as general discomfort and tension. Today I would like to share with you some knowledge about 3 of them that I think are easy for you to treat at home when you have had a Clinical Massage Therapist show you how, so you can start to help yourself in between treatments. They are:

The Sternoclydiomastoid (SCM)
The Masseter
The Temporalis

The Sternoclydomastiod (SCM) is a wonderful muscle; SCM is thick and strong, it allows us to move our neck and head laterally to the same side that it is on, it helps us rotate the head to the opposite side from where it is and it helps us to breath in. We have one SCM on each side of our necks and it attaches just behind the ear on the temporal bone (at the Mastoid Process) and then it splits in to two, allowing for two attachments, one on the sternum and the other on the third of the clavical that is nearest the sternum.

However, when it gets grumpy and filled with trigger points we need to watch out as the referral pain is wide ranging. The end that attaches into the sternum refers from the sternum, up to the back of the head, into the top of the head and then down around the top of the eye. It can also be felt in the chin. The other end that attaches onto the clavical refers into and around the back of the ear as well as into the forehead and can jump; so if your left SCM is referring pain you may feel it on the right side of your forehead.

The Masseter is a powerful muscle and I call it the 'Jack Bauer Muscle'. If any of you have seen the series '24' you may have seen the bit where the lead character, Jack Bauer, killed a man by biting his neck. Horrid. However, to do that the character would have had to use his Masseter muscle to full effect as its job is to close your teeth together and one muscle can exert 140 pounds worth of force. It's a very cool muscle and you can find it going from the zygomatic arch (your cheek bone) and going down to the Angle Ramus of the Mandible, which is a fancy way of saying the angle of your jaw. You have two layers to is, the Superficial is near the skin side of the cheek and the Deep layer is nearer the inside of the mouth.

The Masseter is a personal challenge for me as I have trigger points in it on my right side. The pain that the superficial belly produces is into the back molers, so it can feel like tooth ache in your back teeth, (which is how it manifests in me). You may also feel it in the mandible, just below the teeth, or just above it in your cheek bone, radiating above the eye. The Deep belly causes ear pain and some eminent therapists have suggested that it can make tinnitus worse.

Temporalis is the last muscle of the day and that is a fan shaped muscle on the side of your head. It has a fascial connection with the head and also attaches to the temporal fossa, then it reaches down to the cocnoid process of the mandible. If you put your finger half way along your cheek bone and then open and close your mouth you may feel this part of the mandible come down as you open and then go back up when you close.

The reason why it is vital to cover is that the pain can be felt over the entire muscle, going up the side of the head. Or it may come down the side of the face in to the top back teeth. It's a far reaching pain pattern and one that can be over looked.

So there you have it; 3 muscles that are easily reached and easy to massage yourself. Just using gentle stroking moves with little or no oil around these areas can really help lower your pain patterns if you suffer a lot from them.

In the next blog we will be looking at one final, but very large muscle, the Trapezius! We will then go on to see how Clinical Massage Therapy can help with Pain Patterns and Trigger Points.

I hope you have enjoyed the read and that you are able to join me next time!

Disclaimer: This blog is not a diagnostic tool and I would advise anyone suffering from pain to seek medical help. I am a Soft Tissue Massage Therapist and not a clinician and am simply writing about pain from a soft tissue point of view.

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