Caregiver Stress: Here's a Simple Exercise to Treat Caregiver Headaches by Susan Swetnam

Almost everybody gets headaches now and then, but my experience as a massage therapist with family caregivers suggests that people who tend to aging and ill loved ones are more likely than most to suffer from the throbbing, persistent, near-debilitating kind. "I know stress causes this," a woman who cares for her elderly father with diabetes told me. "But I can't do anything about it, really. You can't take care of somebody with a lot of health problems like Dad's, somebody who needs so much help and is in so much pain, without being stressed. So I'm just trying to get used to the headaches, much as I hate them."

Yes, stress did contribute to her headaches. But that didn't mean that there was nothing she could do about them. In fact, she could potentially lessen or even abate the pain by a simple mechanical trick that requires no specialized skills.

First, though, she had to understand a frequent unsuspected cause of headaches: tight muscles in the neck and shoulders. Key muscles in that area (including the upper trapezius, the levator scapula and the spinal muscles of the neck) actually run up toward the head and are attached at or near the base of the skull in the occipital area (the bony arching horizontal ridge you can feel at the back bottom of your skull). The muscles of the scalp itself – including those in her throbbing temples and forehead – as a group run backwards and hook into that same occipital area. So the problem in this case is a mechanical tug-of-war. If the neck and shoulders are tight and cramped – especially if they're hunched up and the shoulders are forward, as many caregivers' are – they tug on the scalp muscles, over-stretching them and causing chronic pain.

Ideally a person would take systematic long-term steps to relax the neck and shoulder, including being conscious of shoulders-forward position and consciously correcting it often during the day, stretching chest muscles (pectoralis) and bringing shoulder blades together in back, using heat, doing yoga to relax those areas. But most caregivers already have too much on their plates to embark on such a systematic daily regime, so I offered her a simple fix: relax the occipital area with a five-minute exercise, lengthening and stretching muscles in the tug-of-war zone itself.

Here's how to do the exercise:

• Get two small hard bouncy rubber balls (the size of balls used in an old-fashioned game of jacks is ideal).

• Laying face-up on a firm surface like the floor, put them underneath your neck, one on either side of the spine right below that hard horizontal occiput ridge at the base of the skull, pushing up into it. 

When you let go and sink down onto them you'll feel tenderness (OK, maybe pain) just like you feel if you've ever had trigger point massage. That's exactly what this is, a self-trigger pointing or putting deliberate very firm pressure on a tight spot in a muscle to mechanically lengthen (relax) it.

The pain shouldn't be more than a seven on a 10-point scale. If it is, lighten the head pressure. Close your eyes and take deep slow breaths, imagining that you're breathing coolness into the painful area (I find that thinking of myself as sending cool pale green minty light there is very effective) and imagining that you're breathing out the tension when you slowly let your breath go (you can imagine this as muddy brown air leaving your body). Do this for about five minutes as the muscles lengthen and stretch over the little balls at the base of your skull, then gently get up. Many people spontaneously stretch their head, shoulders and neck as the exercise finishes, enjoying the greater range of motion and lessened pain.

The woman I counseled was among them. She found the exercise so helpful in addressing her headache pain that she now does it (if her duties allow her) as soon as she feels a headache coming on. She reports that not only is she feeling less headache pain every day, but that she feels more upbeat and relaxed overall – happy in the sense that though she can't alleviate her stress, but she does have some control over its effects.

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