A patient comes into the office complaining of a headache that starts at the back of her head and travels into her neck. She gets these headaches frequently, most often at the end of the day. Since 99% of my patients sit at computers all day, I know where I need to check right away. How is her head sitting on top of her neck?
Does your head really get crooked?
Yes! The skull, more specifically the occiput (the back of your head part of your skull), can misalign on the first vertebra. I see this a lot. A lot of it has to be from looking down on your phone or how you sit at your computer or laptop. Too much looking down or down to the side and those muscles can get tight.
If the muscle remain tight and eventually shorten, they will slowly but surely pull that bone out of alignment. Symptoms are usually described as a headache, occasionally as jaw pain. You may feel like your head is tilting or tight on one side. I just see a head that’s not screwed on straight.
What does it look like?
Take a look in the mirror and you may see that one ear is higher than the other. Or you may see more space between one side of your head and the shoulder than the other side. When you’re laying on your back waiting to get adjusted, it becomes even more obvious to me. Your head is off and needs some attention.
I’ll start by looking for areas of spasm or muscle tightness. You may say something like, “What is that? Why does it hurt?” I’ll keep working on the muscle until I feel it start to relax. Once I’m comfortable it’s relaxing, I’ll put you in the position I need to get you adjusted.
Sometimes the area will “crack” a lot, sometimes it’s more subtle. I feel for the area to move and then will recheck how your head is positioned. I may continue to work on the muscle to help keep it relaxed. I don’t want a tight muscle to pull things back out of pace again once you leave the office.
What can you do about making sure it doesn’t keep happening?
In nearly every case, this is a posture problem. Like any posture problem, you are either doing a specific action repetitively or you are holding an awkward position for an extended period. If you sit at a computer all day, it’s holding your head in an awkward position for an extended period. Chances are, you do it a lot.
One patient was spending a lot of time using her laptop on her couch. Another patient had his computer monitors a little too low and off to one side (near the corner of his desk). Another patient has less vision in one eye and reads with her head turned. Still another patient recently downloaded an addictive game on his phone and spends stretches of time looking down and pondering game strategy.
To keep this problem from coming back — avoid the bad posture that got you that way in the first place. If you can’t do that, it’s time to take some proactive measures to counter the position you find yourself in all day. Even if you can move your monitors or stop looking down at your phone, you will need to add in some additional help to undo what you’ve already done.
In addition to chiropractic care…
Use Your Neck wedge
Our patients love the neck wedge. There are a few neck curve building devices out there, but this is the one we recommend most often. Nearly every patient finds it comfortable and it’s reasonably priced. While many patients just lay on it passively, I recommend extending your head gently and often while you spend 15 – 30 minutes on this awesome device.
Nearly every patient that has felt the pressure at the back of the neck stretches it the same way — incorrectly. They feel pressure at the back of their head, so they look down and pull more down. This does stimulate blood flow so they feel a little better and think they’re doing the right thing. However, this only makes the long muscles too long. We need to stretch the front of the neck to allow the head to come back.
It’s the looking down that creates all the pressure at the back of the head. Getting the head back will take pressure off. It may seem counterintuitive at first, but stretching the front will make a big difference. Additionally, you can tilt your head to the side and gently pull from side to side, just don’t pull down.
Long term, building up strength in the back of your head and neck will help avoid this problem as well. Your occipital muscles won’t spasm and tighten if they’re strong enough to hold your head in the right position. When the muscles start to fatigue, they tighten up to make up for a lack of strength.
You may have strength in your muscles to hold you up for 6 hours, but you just worked for 10. You need to build up your endurance. Cervical extensions are a great exercise with which to start, adding a band or pushing into a soccer ball for additional resistance.
Last but not least is to mobilize the area. We often teach using a lacrosse ball to break up knots, but this can be too hard for use at the back of your head. For this area, a tennis ball does the trick. You can take two tennis balls and tape them together to work on both sides of your head at the same time, or just use one and apply pressure to the problem area.
Laying on the floor may be the most comfortable, but you can use a wall if you’re at work at can’t lay on the ground. Either way, the goal is to apply pressure, not roll around on the ball. This shouldn’t be overly painful, you just want it to feel like someone is pushing on a knot (which is exactly what is happening). This is a great “go to” option when you can’t get in for an adjustment right away.
Your head can be crooked and that can feel like it’s not screwed on straight. I’ve found patients describe the feeling perfectly when they’re having this issue, they just aren’t aware that it’s possible for your skull (occiput) to go out of alignment.
Work on the areas of posture you can to help avoid this problem, then exercise, stretch, and mobilize the problem areas once they show up. You’ll feel much better and avoid problems like “growing a horn” at the back of your head. Yes, that’s a real thing, check out an article about it here.