Causes of Headaches

About 80% of headaches in the general population are tension headaches, which are headaches caused by a sustained contraction of the neck-shoulder or face muscles. Even migraines, which account for another 13% of all headaches, frequently occur together with tension headaches and improve significantly when tension headaches are resolved.

How can tight muscles cause headaches?
What is myofascial pain?

If any muscle in your body tightens up and maintains that tension for a long period of time, it will eventually develop knots or nodule-like spots inside it. These knots are easy to find because in addition to having a distinct, nodule-like texture, they are tender when pressure is applied to them. These tender knots within a contracted muscle are called myofascial trigger points. (Myo means muscle, and fascia is the connective tissue that holds muscles together.)

Although trigger points are sensitive to pressure, they initially don’t cause any problems. Yet over time, myofascial trigger points start producing a sensation of pain in distant sites. That type of pain is called referred pain, because it originates from places outside of where you perceive it.

Pain referred from myofascial trigger points is called myofascial pain. If left untreated, myofascial pain may become chronic and develop into a condition known as myofascial pain syndrome or myofascial pain disorder.

Each muscle in the body tends to develop myofascial trigger points in specific locations. And each trigger point has a specific, predictable and reproducible pattern of pain referral.

Trigger points in the neck muscles refer pain to various areas of the head and trigger points in the face muscles refer pain to the head and face.

Below are some examples of referral patterns for specific trigger points in the neck muscles associated with tension headaches. The black x sign indicates a trigger point within a muscle and areas marked in red illustrate where that trigger point sends referred pain:


How can neck structures cause headaches?

If joints, discs, or other innervated structures of the neck are inflamed or irritated, you may feel a headache, neck pain, or both. This happens because of the sharing of nerve tracts between your neck and head areas.      

If something irritates a structure in your neck, your neck’s pain receptors pick up the pain signals and send them along nerve fibers to the spinal cord, and from there to the brain. The brain then interprets the signals and you become aware of pain. The nerves traveling to the brain inside your spinal cord form special “tracts”. (These tracts can be compared to roads along which nerve impulses travel to the brain). Your neck and head nerve fibers use the same spinal tract, which creates a potential for confusion. When a neck pain signal reaches the brain, due to intermingling of the neck and head sensory nerve fibers inside the spinal cord tract, the brain may “think” that the signal actually originated in the head. In this case you will feel a headache, even though what really hurts is your neck.

What causes the “headache muscles” to become tight?

  1. Behavioral and life-style causes
    • Poor posture (forward head, slumped shoulders)
    • Daily work in a seated position (e.g. computer work) or in a position that requires looking down for long periods of time (e.g. jewelry making, knitting, using a microscope)
    • Prolonged activities involving repetitive hand and arm movements (e.g. work on an assembly line)
    • Strenuous manual labor or physical activity (especially if performed repetitively)
  2. Emotional causes
    • Emotional or intellectual stress
  3. Structural and medical causes
    • Unbalanced bite
    • TMJ disorder
    • Grinding or clenching of the teeth
    • Eye strain
    • Abnormal alignment of cervical vertebrae
    • Injury affecting joints or muscles of the neck (e.g., whiplash injury, neck injury due to a fall or blow to the head)
    • Degenerative diseases of the neck (neck arthritis, degenerative disc disease, cervical spondylosis)


Note: If your neck muscles are dysfunctional and tight, eventually the joints, discs, and ligaments of your neck will also become affected and will develop mechanical dysfunctions. Conversely, inflamed joints, ligaments and cervical discs will eventually cause tightening of the neck muscles. Because of this, the predisposing factors and possible causes of tension headaches and cervicogenic headaches are practically the same.

testimonialsI was suffering from severe headaches and neck pain when I met Teresa. Her warm, caring bedside manner and her expertise in pain management / treatment were invaluable. I truly believe that my appointments with her were the reason I recovered as well as I did. I recommend her to anyone seeking relief from headaches and neck pain.

– Male, 48

testimonialsI am a competitive wrestler and a very active person during the off-season. I started having a lot of pain in my jaw and head, to the point that I had to avoid physical workouts for fear of the pain getting worse. Specialized doctors offered treatments that gave little to no relief. I was so lucky that a year or so later I was referred to Teresa. Since I started treatment with Teresa, I have been able to maintain my vigorous workouts and wrestling sessions with very little or no headaches. I attribute my progress to Teresa’s help, and I feel fortunate that I found her. Teresa knows what she is doing: see her! Aside from the fact that she is good at what she does, she is also really personable.

– Male, 19

testimonialsMy entire family is grateful to Teresa for helping me resolve my headaches and return to my healthy and happy self. All my life I had issues with my TMJ, but I was able to function with occasional jaw pain until I started also getting headaches (that happened when I was 27 years old, just after I had my first child). I saw many doctors and tried many medications and finally my neurologist diagnosed me with tension headaches, but he said that he could not do anything for it, other than prescribing muscle relaxants and antidepressants. I was devastated. I did not know how I would live my life like that!

I decided to try acupuncture and chiropractic treatments, but my headaches were still there. Then a person from my church told me about Teresa. When I saw Teresa first time, she easily found tender spots in my neck and explained to me what trigger points were and how these points were causing my headaches. She also evaluated my jaw and found trigger points in the muscles inside my mouth. Some of these muscles were also sending pain to my head. Everything Teresa was describing sounded exactly what I had been experiencing. I couldn’t believe that I found somebody who not only understood me, but also was able to treat me.
Our manual therapy treatments were very effective and within 4 months I was virtually free of pain. In addition to seeing Teresa, at her recommendation, I also started working with a dentist who made a day and night splint for me. About two months into my treatment I also did hypnosis, which I think helped me progress faster with manual therapy because it helped me relax all my muscles and sleep better.

I am feeling the way I used to feel before having my first child. My headaches are just a memory and if at any time I feel a pressure in my head (which in the past was always leading to a headache), I just take a few minutes and listen the recordings of my hypnosis sessions with Teresa. Once I relax (and I always relax when doing self-hypnosis), the pressure sensation goes away. I remember that when I started my treatment with Teresa I was hopeful, but I did not believe that I would ever be free of pain (I was hoping to just feel better). And now – I no longer have headaches, I feel happy and enjoy my life.

– Female, 33

testimonialsBefore starting work with Teresa, I suffered from headaches for many years. She clearly knows what she is doing and I’ve seen tremendous improvement during the time I’ve seen Teresa. And while there is still work to be done (I needed to stop the treatment because I moved out of the country for a year), I expect nothing but a positive outcome. I would most definitely recommend Teresa to anyone I know suffering from headaches. She’s a true professional!

– Male, 25

testimonialsI was referred to Teresa by my doctor for treatment of a head and neck injury that resulted in migraine-like headaches. I could not work out because any exercise was causing severe migraines. I found Teresa’s treatments to be WAY more beneficial to me than any other treatments that I tried before. With Teresa’s treatments, my headaches resolved – I have not needed to come back and I am able to work out vigorously every day. Teresa is very knowledgeable in her field, and I would most definitely recommend her to others.

– Female, 31

testimonialsTwo years ago I drove nearly two hours each way to see Teresa for treatment of severe headaches and migraines. It was difficult to fit the treatments into my schedule because I run a busy business, but I did not have a choice – I got to the point I was afraid I would not be able to work. I knew that stress played a big part in my headache and migraine symptoms, so once I learned that Teresa was also a hypnotherapist I decided to also engage in hypnotherapy with her. I was amazed that within two months of us working together I was feeling 75% better – my baseline headaches were practically resolved (I just felt a sensation of tightness in my head, but there was no pain) and migraine attacks decreased from 2-3 times a week to just 3 in a month. With continued treatment, my headaches completely resolved and my migraines became sporadic (I had just 2 migraine episodes in the last year).

I am very grateful to Teresa for her help because not only my headaches are gone, but thanks to hypnosis, I am now able to handle hectic job and stressful life in a way that does not harm my body.

– Female, 45

testimonialsTeresa Sienkiewicz is a tremendously knowledgeable manual therapist, who is totally committed to her patients. To say that she changed my life is an understatement. Prior to working with Teresa I had suffered from severe headaches for over 30 years, during which time I had seen a whole range of doctors and health care professionals, but none of the treatments I tried were successful, until I met Teresa. Teresa was the first and the only person who offered a treatment that worked. I have now lived headache-free for almost two years! I would highly recommend treatment with Teresa to anyone suffering from headaches.

Female, 57

testimonialsI saw my primary care doctor to complain about migraine-like headaches, jaw pain and cracking, and limited ability to open my mouth. My balance was off, and I was experiencing some dizziness. I was pretty miserable. This was especially debilitating for me since I work as an engineer, and I need to be clear-headed to concentrate and do well. My doctor referred me to Teresa for manual treatment. I was completely amazed that there was any kind of manual therapy for this at all, and even more amazed that it worked that well. Thanks to the work with Teresa my pain is now resolved. Teresa is very knowledgeable and well connected to the medical community. I could not recommend her more highly.

– Male, 55

testimonialsI thank God for Teresa! By the time I met Teresa, I had extreme head pain. I had been to several physical therapists before seeing her. From our first appointment I knew I was in the right place. Teresa exuded knowledge and competence, while making me completely at ease. Her treatment could not have been more effective. I traveled far (1.5 hours each way) for my appointments, but it was truly worth it. Teresa is the best!

– Female, 56

testimonialsTeresa has really changed my life. I saw her because I was suffering from debilitating headaches. Teresa truly understood my pain, where it came from, and how it affected me and during her treatments she was finding areas on my face, neck, and shoulders that were triggering my headaches. I no longer suffer from headaches. I have my life back! Teresa truly excels in her field.

– Female, 42

testimonialsI came to Teresa for treatment of severe headaches. I had headaches in high school, but by the time I finished my first year in college my headaches became unbearable. Prior to seeing Teresa I tired different forms of headache treatments, but none of them helped me (even medications had a limited effect). I couldn’t believe that after only a few manual therapy treatments I was starting feeling better. My entire treatment took about 5 months (I was initially coming twice a week, then once week, then every other week), but after that time I was feeling great! I have not seen Teresa for over a year now and I am still feeling good.

– Female, 21

testimonialsTeresa at New Body – New Mind helped me resolve chronic headaches and TMJ pain. Teresa is professional and results-driven, but at the same time she is compassionate and caring. She is passionate about her work and her intellectual curiosity, problem-solving skills, and ability to think outside the box are unparalleled. In addition to providing a relief from headaches and TMJ pain, Teresa helped me understand my condition and taught me what to do in my daily life to remain pain-free. I highly recommend her to anyone in need of treatment of any physical pain.

Male, 45

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– Male, 13

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– Female, 41