Why do I get headaches at night?

Working from home in this new COVID 19 era has brought about changes that many of us are just now starting to feel the effects from. With an abrupt switch to being forced to work from home without proper set up or most of us over the past few months just having increased screen time, headaches, especially headaches that occur at night have become more prevalent.

These headaches that you get later in the day or at night are stress or tension headaches and are muscle related. With the increased tension on our lives, our increased screen time and overall decreased movement our muscles have begun to act and respond differently to adapt to the new environments and lack of activities. Most headaches that happen later in the day are due to posture related issues, that can be corrected, and the headaches resolved. But you must first correct the postures, which will then correct the muscle imbalances therefore eliminating the headaches.

What postures do you need to correct?

When I say the word posture, people immediately sit up as straight as they can with the shoulders pinned back as far as they will go. This will last for a few seconds or minutes, before it will start to burn, and you cannot maintain that posture anymore. This is an example of over correction and can be just as bad as the posture we are trying to correct.

Sitting in a slumped position, shoulders rolled forward and back slumped over, causes you to put your neck in a compromising position. Try this: Slump your shoulders forward and let your head fall naturally and go where it wants to. You will notice that your head wants to look towards the ground which puts tremendous strain on the back of your neck (think looking at your phone).  But in order to be able to look at a computer screen you need to lift your head up, putting stress on the muscles in your neck and also diminishing the blood supply to the head, therefore causing headaches.

While sitting in a slumped posture is a posture that needs to be corrected, it is not the sole nor the major cause of tension headaches. That posture is the posture where your shoulders are up near your ears, a less easy posture to identify and correct.

When we get tired, stressed, anxious we start to elevate our shoulders. This is done without you even knowing it and it is a small movement. You tense up, without realizing it and your shoulders start to elevate.

You can test this out right now. Tell yourself to push your shoulders down and see if they drop down. Most people notice that when they tell themselves to drop their shoulders, their shoulders drop sometimes a little and sometimes a lot. This is the posture that causes your muscles to work overtime and causes you headaches.

Your muscles were not designed to hold your shoulders up for long periods of time but in reality you can wind up holding your shoulders in that position for hours on end, causing knots in your neck and shoulders which will then cause headaches.  Prolonged posture like this can also cause numbness and tingling in the hands.

Why does it come on at night or later in the day?

You will not feel tension headaches until later because your muscles are able to withstand some of the initial use. It is only after they have been used for awhile that they will start to get tight enough to cause pain. Think working out at the gym. You can do a few reps of an exercise without fatigue but the more you do, the more fatigued your body becomes. But in this case your body does not stop holding your head up, the muscles just continue to work harder and harder, causing the headaches.

What can you do?

It is not as easy to say fix your posture because it took you a long time to train your muscles with how to react to environments and stress and therefore it will take you a long time to correct how they react to stress and environments.

For starters you need to make sure that if you work from home that you have your workstation set up correctly. You cannot use a laptop and have it set up correctly. If you use a laptop, you must either use a separate keyboard or separate monitor and most companies will provide you will the proper equipment if you have a doctor’s note. But having the monitor at eye level is a must to keep your neck in proper alignment.

Then you want to roll your shoulders up, back and drop them down. You want to let your shoulders drop down, not pin them back and down, let them fall naturally. Bend your elbows to about 90 degrees and this is where your keyboard should sit.

Ideally you have a sit and stand desk so you can move every 30 minutes. But if not then set a reminder on your phone to drop your shoulders every 30 minutes. It is likely that every time you remind yourself to drop your shoulders that you will find that they drop. You will get to a point if you continue to do this that you will start to notice on your own when your shoulders start to creep up. But until that moment, keep the reminder on your phone so you can limit the stress on those muscles throughout the day.

These postures will not correct themselves nor will it be corrected in a day or a week. It takes consistent retraining of the muscles and proper set up of workstations to fix these postures and get rid of the headaches gradually overtime.

If you or someone you know suffers from headaches and wants a free consultation with a doctor of physical therapy call our office at 215-997-9898.


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