Have you had a great summer? I hope so. I am lucky, I have just returned from my holidays, and I’m ready to go!

This month I want to talk about headaches. Headaches come in many shapes and sizes, and for a wide variety of reasons. The sorts of headaches that Osteopaths mainly are involved in treating, are those that relate to the neck, often due to poor posture and tension.

The two factors are often interrelated. When stressed, there is a good chance you will be holding yourself tensely creating muscle tension, but probably then demonstrating poor posture. So this is a common factor. There are sometimes changes in our breathing that may come alongside longer term stress and anxiety issues. Or possibly as a result of chronic respiratory problems.  This may cause us to over-use the muscles across our chest, and travelling up the sides of our neck, and may then create local tension, possibly contributing to such headaches.

Quite commonly, a slumped position when we’re sitting, or even standing, forces our neck into a protracted position. (See picture below). This places greater pressure on our neck joints, and may create hinge- points of movement over time. It also shortens the muscles at the back of our neck and base of our skull. This may then cause local headaches, very often the pain travels over our heads and behind our eyes because of the nerves that can become compressed. If this happens to you, you should make sure that your eyes are checked with the optician, but this may be the reason.

(Image supplied by Google Images)

If someone presents to me with this type of problem, I will assess their posture, and we will consider exercises and management of any underlying issues. There is a lot then that can be done by working on the muscles and joints of the neck to relieve the problem. Work is usually necessary into the shoulders and upper back to better address the whole issue. Possibly issues elsewhere in the body may contribute, so treatment could potentially look at other areas also.

Osteopaths can help some people with migraine headaches, but the causes of migraines are varied. Osteopathy may help with sinus-type headaches, by working on, and improving the drainage from the area thus relieving the pressure.

* Is your headache associated with other symptoms? For example, dizziness, fainting, visual disturbances, nausea. If so, you should check your symptoms with your GP.
* Does your eyesight need checking?
* Are you dehydrated, do you need to increase your water intake?
* Do you watch your posture, does this need to be addressed?
* Are you suffering unnecessary stress and/or anxiety? Are there ways you can find to alleviate this, do you need to seek the help of a counsellor or your GP?

For general care of your neck and posture, here are some gentle stretches.

These exercises shouldn’t cause pain, if you experience a problem, stop the exercise and consult your Osteopath or other medical practitioner. If you have an existing complaint, it would be wise to consult your practitioner to check these exercises are appropriate for you.

Neck chin-roll

You can do this sitting or standing. Its a great gentle exercise to open and articulate the joints of the neck. As well as providing a gentle stretch to the soft tissues at the back of your neck.

Gently allow your chin to drop towards your chest. Then from this position look to one shoulder, and then the other side. Repeat gently 5 times to each side.

Neck side-bending and rotation

Very simple. A lovely gentle way to provide some gentle stretch and movement to the neck. Sitting or standing. With your eyes looking at the horizon. Gently turn your head 5 times to each side. Then allow your ear to drop to one shoulder, and then the other. repeat 5 times to each side.

Side-bending neck stretch
This is a stronger stretch, because you hold onto the base of a seat it fixes your shoulder and upper ribs. This allows for a greater stretch of the muscles that attach from here up into your neck.
Sitting on a chair, grab hold of the base of the seat with one hand (side of the seat). Whilst maintaining this grip, lean your body and your neck away from this side. You should feel a stretch along the side of your neck. Think about taking 5 to 10 relaxed breaths in this position. Breathe in through your nose, and out through your mouth. This should help to increase the stretch of those muscles that attach to the upper ribs. Repeat on the other side.

1. We are facing a growing vitamin D crisis in this country. Are you getting enough? Are you susceptible to osteoporosis? The National Osteoporosis Society (NOS) estimates that 50% of women, and 20% of men aged over 50 years will suffer a kind of bone fracture relating to poor bone health.
Vitamin D is an essential ingredient in maintaining bone health. We get vitamin D mainly from the sunshine, and also from our food. The skin reaction, converting cholesterol to vitamin D from sunlight,  will only happen when the sun is at a sufficiently high angle in the sky to provide light at a specific UV bandwidth. For example, in the UK, level with Cambridge and below. The sun only reaches this intensity for 5 months a year (May to September). Above Cambridge in the UK, it is 4 months a year. In addition, ethnic minorities with darker skin will need longer in the sun for this conversion of vitamin D to take place.
The European Union has set a recommended daily allowance of vitamin D of 5 micrograms a day, for children aged 6 months to 5 years it is 7 micrograms a day, and for the over 65’s it is 10 micrograms a day.
Examples of vitamin D levels in common foods are: half a pint of full fat milk is 0.1 micrograms, or semi-skimmed is 0.03 micrograms. 150g of whole milk yogurt gives 0.06 micrograms of vitamin D. An egg is 1 microgram, 85g of salmon or mackerel is 10 micrograms.
Find out about the vitamin D in your diet. Think about your own situation, and consider if supplementation is necessary?
2. Pillows!! A common question from patients is what pillow should I use to sleep on? My answer is that the type and design of pillow are personal choice. However, you must make sure that it is just your head and neck that rests on the pillow, so shoulders should be off. Also that your neck remains in line with the rest of your spine. So too many pillows will push your head up too far, and vice versa.
It can take some playing around with different types and thicknesses to get this right. Its worth asking someone to take a look at you laying on your pillow to better assess this. 
For this to work, you need to be laying on either side or on your back. Laying on your front, makes it very difficult to achieve a good sleeping posture.

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