Let’s dive into why headaches can occur during pregnancy and how you can support your body in order to function more optimally while growing bones and organs for someone else.
Why Headaches Can Occur During Pregnancy
Hormones + Vascular Changes
When you are pregnant, your hormones start shifting on day 1 and do not stop changing throughout the whole pregnancy. Estrogen and progesterone both progressively build during pregnancy, both of which cause vasodilation (relaxation or widening) of your blood vessels. Wider blood vessels paired with increased blood volume (which increases about 50% during pregnancy) can be one of the direct causes of headaches during pregnancy.
Musculoskeletal Changes
While most practitioners like to blame hormones as the primary cause of headaches in pregnancy, the more likely driver is coming from your neck. During pregnancy, the hormone relaxin is released in order to loosen your ligaments for optimal delivery. While your sacral ligaments relax- so do all of the other ligaments in your body. Your body tries to seek stability through hyper-activation of your muscles causing tension and overuse. Posture changes are also evident during pregnancy. Your rib cage expands and you start to carry a lot of new load in the front of your body (your growing baby). This causes postural changes throughout the spine which can lead to excess load and tension in the neck as your body tries to adjust to these changes.
Headaches driven by your neck are called cervicogenic headaches. They are a result of tight and overused muscles, upper cervical joint stiffness, and poor postural awareness or control. All of these drivers can be a direct result of your changing body during pregnancy and are the more likely cause of persistent headaches during pregnancy.
Common Mistakes and How to Avoid Them
Allowing the Headache to Become Debilitating
Many won’t mention a symptom during pregnancy unless it is severe because so many new symptoms pop up on a day to day. Knowing that the headache has a likely musculoskeletal component should promote earlier treatment to avoid chronic long term patterns.
Ignoring Proper Hydration
With increasing blood volume, hydration needs to be at the front and center of self care for pregnant women. Hydration is water intake and electrolyte balance. Without enough fluid, the neural structures in the brain become stressed which can directly cause a headache or can increase a person’s experience of pain if the headache is being caused by something else. Hydration should be a key component of headache management in pregnant women.
Covering Pain with Medication
There are very few drugs that are safe to use during pregnancy, with Tylenol (acetaminaphin) being the primary pharmaceutical used for pain. Using Tylenol occasionally for headache pain can be beneficial but can hide the source of pain when used frequently for pain reduction.
How to Treat Headaches During Pregnancy
Determining and Treating the Right Tissue
Cervicogenic headaches can develop in pregnant women for a slew of reasons. Determining the primary source of where a headache is coming from takes a thorough history collection and examination by a physical therapist whose main goal is finding the root cause of the headache.
Once the primary headache driver is uncovered, it takes very targeted hands-on work to help provide relief. This could look like spinal mobilization, soft tissue work, and posture re-education paired with breathing in order to change the mechanical stress driving pain.
Our clinic is well versed in diving deep into what drives a headache- allowing us to quickly change symptoms as a result.
Strength Training That Supports Posture
Pregnancy causes a shift in your posture, no matter what you do to avoid this change. Strengthening your intrascapular musculature and deep cervical neck flexors can help provide more support to the structures that are stressed with cervicogenic headaches. Some examples include:
- Row variations
- Chin tucks with light load
- Wall slides
Strength=endurance. The more endurance you have in your postural musculature- the less you hang on other structures that drive pain.
Monitoring for Red Flags
Most headaches during pregnancy are benign and manageable, but not all.
Seek immediate medical evaluation for:
- A sudden severe headache
- Visual changes
- Increasing blood pressure
- Swelling in hands/face
Headaches during pregnancy are common, but are not something you need to deal with on a daily basis. Understanding what may be causing the headache allows you to advocate for yourself when discussing your symptoms with a medical provider.
Your body is running a daily marathon in order to create new life. You deserve to not be brushed off when your body is doing something painful and unfamiliar to you.
If headaches are holding you back, we can help you get your symptoms under control.
Schedule a visit with our team, or reach out with your questions.
Let’s get you out of pain and in the best shape possible before delivering your beautiful babe.
About the Author: Dr. Annalise Calo, PT, DPT, OCS