As a consultant, you will typically work long hours, and during this time you might find yourself creating slide decks, analyzing massive data sets, and working within fast paced teams to solve your clients’ most challenging problems. To add to the stress, consultants are often travelling long distances for on-site visits with the client or to collaborate at other offices. A common result of the demanding work schedule is headaches. Literal headaches.
Before addressing remedies for this potentially debilitating malady, we will look at the medical definition for the most common type of headache as well as causes and onset symptoms. Afterwards, some risks and misconceptions will be addressed, followed by some solutions including stretches and exercise.
Cervicogenic Headache
The most common headache faced by consultants is the Cervicogenic Headache, which can be diagnosed by the familiar pattern of pain that it produces. Consultants may experience a recurring pattern of pressure headaches, migraines, and jaw pain. The pain intensity might range from dull yet noticeable, all the way up to debilitating pain that radiates from the neck to the skull and facial region. Often the ache is accompanied by neck pain and localized to one side of the head.
Causes of the Cervicogenic Headache
The onset of the headache can occur in a variety of ways. Common causes include traveling for long periods of time, poor posture, dehydration, and emotional stress. These factors can compound, such as emotional stress from trying to work while traveling. Additional causes include large amounts of screen time or intense desk work, especially if you look down at your screen or paper. Craning your neck straight downwards contributes to poor posture and may produce a headache.
Getting further into the medical details, the Cervicogenic Headache is most often attributed to muscle weakness in the neck and back, including upper trapezius, sternocleidomastoid, scalenes, leveator scapulae, and pectoralis. You can weaken these muscles if you frequently have poor posture and neglect to stretch or work them out.
Risks and Misconceptions
An immediate thought to fix headaches is to take medication, but there are some risks you should be aware of. First, medications such as Aspirin and Ibuprofen are NSAIDs (Nonsteroidal Anti-Inflammatory Drugs), which can cause gastrointestinal issues such as ulcers, indigestion, or even gastrointestinal bleeding when used frequently or in high doses. For example, people with pre-existing hypertension could see a noticeable spike in blood pressure levels.
In addition, acetaminophen or Tylenol, although generally well-tolerated, can lead to liver damage if used in excess or combined with alcohol. This risk becomes particularly salient for consultants who might be attending social business events where alcohol is served. The liver toxicity risk increases significantly when taking more than the recommended maximum dose of 4000 mg per day.
Finally, muscle relaxers might offer relief from muscular tension but come with their own set of problems like drowsiness, dry mouth, and potential dependency issues. They could also interact negatively with other medications you might be taking, like antidepressants or sedatives.
All of these medications are available over the counter, but given the potential risks, they should be used sparingly and considered a last resort after discussing with a healthcare professional.
Another knee-jerk reaction is to combat a headache with coffee or alcohol. The caffeine in coffee might act in a similar way to acetaminophen, while alcohol might help you ignore the headache for a bit. However, these solutions will likely end up increasing the problem if they become your default go-to remedy. Coffee, especially late in the day, may prevent you from sleeping which is necessary for a full recovery. Alcohol might remove the headache at first, but the headache will likely return with vengeance in the morning. In addition, headaches coincide with dehydration, and both coffee and alcohol will exacerbate this problem.
Solution for the Cervicogenic Headache
To correctly remove Cervicogenic Headaches, you need to build up the weakened muscles that are causing the problem. Consultants are busy, and so it is a good idea to use a quick and easy exercise routine to address the issues associated with constant travel and consistent desk work.
Below I outline five basic exercises that you can employ as part of a consistent exercise routine. The exercises are so simple that they can be completed in any setting (hotel, elevator, or plane), and you will not even break a sweat. They can also help you to alleviate stress and reduce resultant back and shoulder pain.
1. Levator Scapula Stretch
Instructions: Turn your head towards your armpit and place the hand from the same side on the back of your head. Gently guide your nose closer to your armpit.
Sensation: You should experience a stretch originating from the base of your neck extending down towards the shoulder blade on the opposite side.
Duration: Hold the stretch for 30 seconds. Complete 3 repetitions on each side.
2. Chin Tuck with Overpressure
Instructions: Extend your neck forward to its full range, then retract it backward to create a ‘double chin’. For added pressure, gently place your hand on your chin during the retraction.
Sensation: You should feel your neck muscles engaging.
Duration: Perform 10 repetitions for each set, completing 3 sets in total.
3. Suboccipital Stretch
Instructions: Wrap a towel (or a belt or scarf) around the back of your head, positioning the edge right at the base of your skull. Grasp both ends of the towel with your hands, keeping them in front of your face and above eye level. Tilt your head upwards and gently pull the towel upwards towards the crown of your head while allowing your neck to relax.
Sensation: You should feel a stretch at the base of your skull.
Duration: Pulse lightly for 30 seconds, completing 3 sets.
4. Push-Ups Plus (Serratus Anterior Strengthening)
Instructions: Place your hands against a wall at shoulder height, as if preparing for a wall push-up. Perform the push-up action, and upon reaching full arm extension, roll your shoulders forward to move your body slightly away from the wall. For increased difficulty, use a countertop, then progress to the floor.
Sensation: You should feel your shoulder muscles engaging.
Duration: Complete 10 repetitions for each set, with 3 sets in total.
5. Serratus Anterior Wall Walks
Instructions: Stand facing a wall with your elbows bent at a 90-degree angle, forearms against the wall, palms positioned towards your face. Maintaining the parallel position of your forearms, ‘walk’ your arms up the wall to a comfortable height, and then back down, all while keeping your feet stationary.
Sensation: You should feel your arm and shoulder muscles engaging.
Duration: Perform 10 repetitions, completing 3 sets.
Bottom Line
As a busy and focused consultant, headaches are inevitable. Long travel days, poor posture, and lack of water can all contribute to Cervicogenic Headaches.
Medications will not perfectly solve the problem and instead can also introduce other issues.
Cervicogenic Headaches should be addressed by working out and stretching the muscles that are causing the problem. Performing the five exercises outlined above should be a priority when you feel the onset of a headache occurring.
Note: Although this blog was written with the assistance of a licensed Doctor of Physical Therapy, the author is not a physical therapist nor are they providing you with medical advice. The information provided in this article is intended to get you thinking about your health. Please seek professional medical advice for any specific pain you may be experiencing.
Richard Hollenbach is a Thermal Sciences Associate at Exponent Scientific and Engineering Consulting. He is a licensed professional mechanical engineer that solves problems in the thermal-fluids, heat transfer, aerospace, and turbomachinery fields. He earned his Ph.D. in Mechanical Engineering at Duke University.
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