The Role of Positioning in Migraine

By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD

Positioning can play a significant role in migraine symptoms; for example, proper positioning can help minimize pressure on sensitive areas of the head and neck. Implementing ergonomic principles at home and in the workplace may be a potential non-pharmacological option for managing migraine. Ergonomics is the science of designing and arranging objects and environments to fit the people who use them, aiming to optimize comfort, safety, and efficiency while minimizing the risk of discomfort, injury, and fatigue [1]. In today’s blog post, we will dive deeper into the role of trigger points in migraine and how positioning has an impact on migraine specifically. 

Myofascial trigger points are defined as hyperirritable spots in skeletal muscle that have been suggested to have a role in primary headache disorders [2]. In tension-type headache, tenderness in pericranial myofascial tissue is correlated with the intensity and frequency of headache [3, 4, 5]. These points are areas of increased sensitivity within muscles, often associated with tension and stress. When these points are triggered, they can lead to the beginning of a migraine episode, or even intensify an already existing episode. Common myofascial trigger points for migraine include the upper trapezius muscle (base of the skull and upper part of the shoulder blade), sternocleidomastoid muscle (sides of the neck), and temporalis muscle (in the temples along the sides of the head) [2]. Identifying and managing trigger points through relaxation techniques, physical therapy, and stress reduction strategies can be integral in the holistic management of migraine.

Ergonomics considers proper positioning of the head, neck, and spine, and can be helpful at home and in the workplace [6]. The position of your computer screen can impact your occurrence of migraine attacks due to its impact on eye strain and overall ergonomic comfort [6]. If your computer screen is positioned too high or too low, it can cause you to tilt your head upward or downward. This can lead to neck strain and exacerbating migraine symptoms. In addition, if the screen is too bright or too close to your eyes, it can cause eye strain, and fatigue, and serve as a migraine trigger. Positioning your computer screen in a way that minimizes glare and reflections is vital for migraine prevention [6]. Further, adjusting the distance and height so that it is at a comfortable viewing distance will help promote good posture and reduce strain on your neck and shoulders.

Comfortable seating can also play a major part in migraine episodes experienced while at work. Oftentimes our work requires us to sit for long periods in an uncomfortable chair, leading to muscle tension and stiffness [6]. This tension can exacerbate migraine symptoms. It is recommended to use chairs that have armrests, adjustable seat height, and support for your spine to encourage good posture and support your spine. While having good seating at work can influence migraine, stretching and taking regular breaks can be just as helpful to alleviate tension and improve circulation. Taking breaks from work can provide relief from eye strain, reduce muscle tension, refresh your mental focus, and serve as a source of stress relief [6]. Incorporating regular breaks into the workday and participating in stretching breaks can not only encourage a healthy work-rest balance but also support a more migraine-friendly workplace.

There are a few adjustments to create a migraine-friendly workspace [6]. Using ergonomic chairs and arranging workstations for proper alignment can help promote better posture. By maintaining good posture, individuals can reduce tension in the muscles of the neck and upper back, alleviate strain on the nerves and blood vessels, and decrease the risk of migraine occurrence or intensity. Organizing your workstation so that your items are within easy reach and will not cause you to strain yourself can be helpful. In addition, as previously mentioned, it is recommended to take regular breaks throughout the day to minimize tension and strain [6].

The perception of migraine headache is exacerbated by exposure to light as compared to the pain level felt in the dark [7, 8]. In recent years, some glasses have been designed specifically to alleviate migraine symptoms, gaining attention as a potential non-pharmacological intervention. These glasses typically feature precision-tinted lenses that filter certain wavelengths of light [9, 10]. These wavelengths typically include blue light, which is emitted by electronic screens (i.e., smartphones, computers, televisions). In a study determining the wavelength of light that patients with migraine and tension-type headache find uncomfortable between attacks, there were significant differences between the groups in terms of the specific wavelengths they experienced discomfort at [9]. Further, certain glasses may filter out fluorescent or harsh artificial lighting, which can emit wavelengths in the blue-green range [9]. The goal of these glasses is to block or reduce exposure to these specific wavelengths and alleviate migraine symptoms triggered by light sensitivity [10].

By implementing some of the tips listed above, individuals can potentially reduce the occurrence of migraine attacks and improve their overall quality of life at work by utilizing proper positioning techniques. It is important to remember that small adjustments to your workspace can make a big difference in preventing migraine attacks and enhancing your comfort and productivity at work.

 

References:

  1. Edwards C, Fortingo N, Franklin E (2024) Ergonomics. In: StatPearls. StatPearls Publishing, Treasure Island (FL)
  2. Do TP, Heldarskard GF, Kolding LT, et al (2018) Myofascial trigger points in migraine and tension-type headache. J Headache Pain 19:84. https://doi.org/10.1186/s10194-018-0913-8
  3. Lipchik GL, Holroyd KA, O’Donnell FJ, et al (2000) Exteroceptive suppression periods and pericranial muscle tenderness in chronic tension-type headache: effects of psychopathology, chronicity and disability. Cephalalgia 20:638–646. https://doi.org/10.1111/j.1468-2982.2000.00105.x
  4. Buchgreitz L, Lyngberg AC, Bendtsen L, Jensen R (2006) Frequency of headache is related to sensitization: a population study. Pain 123:19–27. https://doi.org/10.1016/j.pain.2006.01.040
  5. Fernández-de-Las-Peñas C, Cuadrado ML, Arendt-Nielsen L, et al (2007) Increased pericranial tenderness, decreased pressure pain threshold, and headache clinical parameters in chronic tension-type headache patients. Clin J Pain 23:346–352. https://doi.org/10.1097/AJP.0b013e31803b3770
  6. Mansoor SN, Al Arabia DH, Rathore FA (2022) Ergonomics and musculoskeletal disorders among health care professionals: Prevention is better than cure. J Pak Med Assoc 72:1243–1245. https://doi.org/10.47391/jpma.22-76
  7. Noseda R, Kainz V, Jakubowski M, et al (2010) A neural mechanism for exacerbation of headache by light. Nat Neurosci 13:239–245. https://doi.org/10.1038/nn.2475
  8. Kawasaki A, Purvin VA (2002) Photophobia as the presenting visual symptom of chiasmal compression. J Neuroophthalmol 22:3–8. https://doi.org/10.1097/00041327-200203000-00002
  9. Main A, Vlachonikolis I, Dowson A (2000) The Wavelength of Light Causing Photophobia in Migraine and Tension‐type Headache Between Attacks. Headache 40:194–199. https://doi.org/10.1046/j.1526-4610.2000.00028.x
  10. Artemenko AR, Filatova E, Vorobyeva YD, et al (2022) Migraine and light: A narrative review. Headache 62:4–10. https://doi.org/10.1111/head.14250
Published On: February 17th, 2024