Headaches, migraines, ringing in the ears (tinnitus), lights in front of the eyes (scotoma)

CLBolestCelistnihoKloubuNowadays there aren’t much people who never experienced headache. Unfortunately headaches and migraines are often treated with pills for the fastest possible relief from pain. However, the essence of the headache which is often derived from the disorder of the cervical spine is not treated anymore.

This article is focusing on the problematics of the head pain as an option of the dysfunction of the cervical spine and the goal is to show that even these problems can be treated thanks to physiotherapy, which we can offer you, without using any medications, that only lead to numbness of the symptoms, but they never solve the cause of the problem.

Cervical spine is one of the most demanded parts of our body. Not only does the cervical spine enable us to move in various directions and have bigger range of movement compared to the rest of the spine, but at the same time, the head sits on the spine, which is a big burden especially for the first and the second cervical vertebrae.

Given to its big flexibility, which is exposed to fairly big weight of the skull and brain, there is a joint connection between the first vertebra and the skull (atlanto-occipital joint - also known as AO joint) which is very vulnerable and located in a problematic area. Therefore the blockages occur exactly here. The blockage of the AO joint is one of the most common problems, which can cause unpleasant pain of the head or migraines, ringing in the ears (tinnitus) or moving lights in the view of the person (scotoma).


One of the causes of the blockage of the AO joint is holding the head and cervical spine in an uncommon position. Few hours in front of a computer, long term sitting behind wheel in a car, as well as many manually focused working positions force us to keep head in wrong positions for a long period of time.

Our head, is apart from other muscles holded by suboccipital muscles. These muscles are on the surface and therefore they can be easily spotted on the lower edge of our skull, they are often sensitive on touch, which is a sign that they are being overloaded. E.g. during long term sitting in front of a computer it becomes necessary to keep your head straight, and therefore these muscles are in constant tension.

Each muscle is connected with a blood vessel, which supplies the muscle with oxygen. The muscle functions on the principle of a pump. For optimal security of the nutrition it is necessary to switch the contractions constantly (clenching muscles) and decontraction (relieving the muscles). During a long lasting contraction of the muscle, the blood vessel becomes suppressed and it restricts the blood flow, the muscle then becomes insufficiently oxygenated and the cerebral cortex will send a painful impulse to the area, which should relieve the muscle and restore the blood flow (also nutrition and oxygen).

Therefore the muscle starts to hurt during long contraction or it gets to a spasm. It is same with short muscles, which hold the head. If these muscles are exposed every day to such long lasting burden, it can lead to significant overloading, which can cause headaches and migraines.

If these extensors of the cervical spine are in a higher tension, muscle dysbalance occurs among surface and deep muscles of the cervical spine. It becomes necessary to regain the balance with functional exercising and activate the deep muscles of the cervical spine and mouth bottom for recovering the muscle harmony.

If the problem is not treated for longer period of time, the high tension in the muscles will be transferred also to the scalp of the head. Tension in the scalp leads to strong pain of the whole head. In order to relieve it, soft techniques of the soft tissues need to be applied. Massaging the scalp or the short muscles beneath the head already brings the first relieve from pain.


Another common cause of the headaches and migraines is overloading of the chewing muscles and blockage of the temporomandibular joint (articulatio temporomandibularis). Increased tension in the chewing muscles or blockage of the TMJ can occur under several circumstances:

  • Grinding and jaw clenching of the teeth (bruxism) - wearing out the TMJ as well
  • Stress - clenching the teeth during stressful situations
  • Problems with wisdom teeth or their recent removal - pain in the teeth cause higher tension in the chewing muscles
  • Frequent otitis media - it can relate to blockages of the TMJ
  • Incorrect occlusion - when one side is burdened more during chewing than the other.

Increased tension of the chewing muscles and blockage of the TMJ is closely related and often time they accompany each other. Both functional disorders often lead to excruciating headaches and migraines, ringing in the ears or smaller lights appearing in the vision, which cannot be focused - as if they would constantly flinch, when you want to look at them directly.


Soft techniques of the soft tissues will change the tension in the face, they will relieve the chewing muscles and mobilize the TMJ. subsequently it is necessary to remove the cause of the problem. That means focusing on the optimization of the chewing stereotype and solve the problem complexly so that it wouldn’t return. In our facility we use very effective radial shockwave therapy, which can lower the muscles tension and enable the joint to move in bigger movement range, and it will indirectly relieve the blockage of the cervical spine and TMJ.

Because our body reacts very complexly through muscle loops, we often find along with the blockage of the TMJ also blockage in the AO joint. The AO blockage alone is almost always commented to overloading of the surface extensors of the head. Next to the tensions in the chewing muscles we also find tension in the surface muscles of the cervical spine. That only proves how much is our musculoskeletal system interlinked, and that for successful therapy it is always necessary to treat also the seemingly distant disorders, because even they can be the starters of the pain.


Relaxing jawRelaxing the NeckmusclesRelieving neck musclesRelieving the jaw musclesYTJemná trakce krční páteře (1)YTpnf pro hlavuMobilization of the cervical vertebraeYTJemná trakce krční páteře (1)Stretching the muscles beneath the skullRelaxing facial musclesStretching neckStretching the nape muscles


Author: Mgr. Iva Bílková FYZIOklinika physiotherapy Ltd., Prague, Czech Republic

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