Headaches During Pregnancy? Treat it without Medication

Treating headaches during pregnancy can be a real pain (pun intended 🙃). Some women experience new or worsening headaches during pregnancy, which may be related to changes in bodies. Read on for some non-medicated remedies for headaches during pregnancy. 

IMPORTANT❗️❗️❗️If you have any of the following symptoms with your headache, you should talk to your doctor as they may be signs of something more serious:

• visual changes
• nausea/vomiting
• seizures
• hearing changes (such as hearing whooshing or ringing in your ears)
• facial drooping
• changes in sensation

And as always, this is for educational purposes only. While I am a physical therapist, I’m not your physical therapist and any information provided shouldn’t substitute for evaluation and treatment by your medical or health provider.

Why are headaches during pregnancy so hard to treat?

Headaches during pregnancy are particularly frustrating because we’re not sure what medications we should or shouldn’t take. And then, even if we find the answer, do we still feel comfortable taking said meds? 

The solutions we’ll offer here are medication free. They just require a little time and attention to your body. Which, honestly, most of us could use a little more of.

However, they probably won’t help all kinds of headaches. I know, bummer. But they are pretty effective for tension-type headaches. 

These tricks will allow you to lessen the “head-in-a-vise” feeling without worrying about how medication might impact your baby. 

What causes headaches during pregnancy?

Another reason headaches during pregnancy can be so hard to treat is we don’t often know the cause.

They can arise from many different reasons (some of which are the same reasons women get headaches while not pregnant). These include:

• Hormonal changes (although elevated estrogen and endorphins actually improve headaches in some women!) 
• Postural changes
• Lack of sleep
• Lack of movement
• Inadequate nutrition or food allergy
• Dehydration
• Stress
• High blood pressure ← This one is super important to monitor
• Unknown causes

Obviously some of these factors we can control and some – like unknown causes – we can’t. So we’re going to try and do as the Serenity Prayer states, “God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.”

Headache be gone! Treatment for headaches during pregnancy 

Headaches are something I deal with personally, so I know what a pain they can be. My husband is sometimes exasperated by my unwillingness to take medication to help (what can I say, I’m stubborn and would rather try something else). 

As such, I can say I have tried many of these techniques myself, as well as on my patients. 

My favorite story comes from a woman I was treating whose doctor told her the only way she could get relief was by having a nerve block (i.e. a needle injected into the back of her head).

After one visit her pain was decreased from an 8/10 to a 3/10. And after 3 visits and a home exercise program, her pain was gone. Needless to say, we were both pretty excited for her!  

So let’s talk about some of the things we can do without medication to treat headaches during pregnancy.

Lifestyle changes

Avoid triggers – perfumes, dyes, specific foods, psychological stress

For some women, certain smells can trigger a headache.

For instance, one of my co-workers gets a headache whenever she is around the smell of cigarettes. Personally, I develop a headache if I’m around artificial fragrances like in air fresheners or candles.

This is especially true with the heightened sense of smell some women experience in pregnancy. 

Other ladies experience headaches with certain foods, dyes, or preservatives in the foods.

I treated one woman who experienced headaches after eating processed cheeses.

Here is a list of possible triggers from the Cleveland Clinic but it’s more important to be mindful of how you feel after eating. No woman I’ve worked with has been sensitive to all of the foods, so you have to find what’s problematic for you. 

Lastly, stress is a huge trigger for many of us – myself included. And it’s impossible to avoid stress completely. But learn what stress reduction practices work for you. 

Some ideas:

• Taking a few cycles of breath – breathe in for a count of  5 and breathe out for 5 
• Taking a bath. 
• Going on a walk 
• Praying or meditating 
• Calling a friend 
• Listening to music 
• Drawing or painting 

You may find one, all, or none of these work for you. That’s cool. Just start experimenting so you can find something that works for you. 

Sleep

I know sleeping during pregnancy can be a real challenge. I could go on and on about the importance of sleep to your mental and physical health, but I’ll save that for another day. 

Instead, let’s talk about one thing to help you fall asleep more easily and might make sleeping more rejuvenating – a nighttime routine. 

A lot of people talk about the importance of a morning routine to get the day started on the right foot. And I’m definitely better at that some days than others. 😬

But I love sleep so I pretty much stick to my routine before bed. Mine includes a shower or bath 🚿, reading for pleasure 📚 (but I have to watch out to make sure it’s not too engrossing!), Bible study and prayer 🙏, and, sometimes, herbal tea ☕️. 

This routine habit gives my brain the hint it’s time to start relaxing and get ready for bed. 

A couple of things to keep in mind: 

• Blue light from screens can disrupt your circadian rhythm so blue light glasses are a good idea when the sun goes down if you still want to watch TV. You can head over to my Favorite Things page to see the ones we have. 
• Getting too hot during the night can disrupt sleep patterns so you might want a fan or to try different pajamas
• If you decide to watch anything or read before bed, try to make it less than exciting as this can amp up your adrenaline
• Light in your room can also disrupt sleep. Use blackout curtains (find the ones we use over on my favorite things page) if you have a street light outside your window like I do and cover any other light sources (unless you need them to help you get safely to the bathroom, of course!). A good compromise if you need some sort of light is a salt lamp as it puts off a warm light – more like a candle – than typical electronics. 

Relax Your Jaw

At times, headaches can be related to your TMJ. There are physical therapists who specialize in treating this, but one of the first steps is to relax your jaw.

When I was in my doctoral program, I started clenching my teeth and developed jaw pain and headaches from it. I had to remind myself throughout the day to stop clenching and grinding my teeth. And I started massaging my masseter muscles, which I’ll talk about below. 

If clenching or grinding your teeth happens while you’re sleeping, try doing some relaxation before bedtime (see stress reduction above). Some of my favorite ways to wind down before bedtime includes drinking herbal tea, journaling 3 things I’m grateful for from the day, and silent prayer. And you may want to talk to your dentist about a mouthguard, as well. Gotta keep your chompers healthy too! 

Eat Enough

Too often women get headaches because of hunger. I can’t tell you how many women I see who tell me they have been too busy to eat. Y’all. If you don’t eat, you can’t take care of your body, let alone a baby growing inside you! Food powers us to get through our day. So don’t rob yourself of energy. (You can read more about the 3 general things I think about when preparing a meal here) I find that meal prep is key for me so I have food around to keep me from getting “hangry.” 

Hydrate

To go along with eating, you also want to stay hydrated – especially important during pregnancy as you’re total blood volume increases 30-50%!

Hydration is a challenge for me and often the culprit of my headaches. The biggest key for me is keeping a water bottle with me AT. ALL. TIMES. Like people almost laugh at me because I have my water bottle with me everywhere. I have a Hydroflask (you can see the one I have over at http://elizacait.com/favorite-things/) so I don’t have to worry about the chemicals from plastic leaching into my water. (I used to have a glass bottle, but I dropped it so many times I was nervous I would break it 😬) 

Exercise and Muscle Release

Cervical retraction

This is the first exercise I recommend to anyone with a headache. In fact, this is the main exercise that helped heal the patient I talk about earlier. I like to have people perform it both lying on their back (side note – if you start to get dizzy or lightheaded while on your back during pregnancy, roll to your side) and in an upright position. 

To perform lying down:

• Lie on your back with your head on a small cushion. Ensure the plane of your face is parallel to the ceiling.
• Gently press the back of the head into the surface you’re lying on. Hold for 5-10 s and gently release. Repeat 5x.
• You should feel a stretch in the back of the neck. Don’t press so hard that the muscles on the front of your neck pop up. 

To perform in sitting/standing:

• Sit/stand tall with good alignment (ribs down and sternum parallel to the wall/perpendicular to the floor, and your face is in the same plane as your sternum.
• Move your head back while keeping your chin in the same plane (like you’re giving yourself more of a double-chin). Hold 3 s. Release back to the start position, not pushing your head forward. Repeat 10x. 

With both exercises, you should feel lengthening in the back of the neck, particularly close to the base of the hairline. These muscles are called the subocciptals and are the culprit for many headaches.

In the next section, we’ll talk about how to massage and release them, as well as two other muscles that are often problematic. 

Self-massage – subocciptals, masseters, temporalis

I could talk about many different structures that could lead to headaches, but I’m going to address 3 of the main muscles I see as the culprit in my practice. 

Masseters

As I discussed above, the tension in your jaw can cause headaches. One of the ways to release this is through massage of the masseter muscles.

These are on either side of the jaw and are the strongest muscle in the body by size! They help you chew so I’m glad they’re workhorses. Because eating is kind of important. And I enjoy a good meal 🤤

To find them, put your fingers in front of your ear lobes and clench your jaw. You should feel a muscle bulge out on either side of the jaw a little lower than your ears. Congrats, you found your masseters! 

To massage them, place the pads of your fingers over these muscles and move in small circles while taking in nice, deep breaths and thinking about relaxing the jaw, including the tongue. Do for 30 s or more if it’s feeling good. 

Temporalis

These muscles are on either side of the head, near the temples. Similar to the masseter, they also help with eating. Hence, they are also overworked when we clench our jaws – common with stress. 

To find these muscles, place your fingers over your temples and slide up and back. If you clench your jaw, you will feel them pop up under your fingers. As with the masseter, take in deep breaths all the way around the rib cage (not just the chest) and slowly massage in circles for 30 s or more. 

Suboccipitals

These muscles at the base of the skull may be small, but they have a big job. They work to help keep your head up and are often short and tight in most of the people I treat.

Importantly, they also have a nerve that runs through them (the greater occipital nerve), which can be compressed and cause headaches in some people. Stretching and releasing these muscles can help open the space for that nerve and decrease the resultant pain.  

To find these muscles, place your fingers on the 2 rounded bony parts at the bottom/ back of the skull where your head meets your neck (about at the hairline). The suboccipital muscles run along this line. You can do small circles or slowly rub your fingers up and down across these muscles. And don’t forget to breathe!

While I like to massage of all these muscles, releasing the sub-occipital muscles is my favorite quick, trick for treating headaches in pregnancy without medication. 

Self-towel release

This is a trick I picked up in PT school when I was having a lot of headaches from all the stress and tension. And it’s one my patients tend to love when they’re hurting too. There are a couple of ways to perform this. 

#1 Active release

The first requires a pillowcase, sheet, or towel. 

You’ll place the edge of this right under the rounded bony parts at the bottom/ back of the skull where your head meets your neck that we talked about earlier. 

Then allow the weight of your head to move back into the edge of the sheet/towel/pillowcase as you lift the ends of the pillowcase up toward your eyes. 

Breathe and feel the release. 

#2 Passive release

The second way requires you to find something firm to lay the back of your head against, like the edge of a piece of furniture.

Instead of using the edge of the fabric as above, you’ll place the firm edge of the furniture in the same place and relax into it. 

One of my patients actually came up with this idea. She would take the cushions off the back of her couch and then lay her head on the edge. She loved that she was able to relax into the release for longer amounts of time. 

This is more similar to what I do for my patients in the clinic. I’ll hold this position for up to 10 minutes, really allowing the body to release and relax. 

Movement and alignment check

The last thing we’ll touch on in this section is how incorporating a variety of movements, as well as alignment of the neck and shoulders can help with pain relief for headaches during pregnancy.

I like to talk about alignment with my patients because the positions they maintain throughout the day can impact their headaches. 

But I really like to talk about it with my preggo patients because their bodies change so much in a relatively short amount of time (though I know 40 weeks can feel like forever). 

As the belly and breasts grow, the weight can lead to more rounding of the shoulders and a movement of the head forward. As this happens, the muscles in the backside of the body need to work harder to maintain an upright posture. For some women, this increased strain can lead to headaches. 

So working on moving out of this position while allowing those muscles to move in the other directions can help. 

Alignment of the shoulders 

This involves relaxing the shoulders down and back. Gently relax them down away from the ears and back like you’re trying to place them against a chair. Keep your sternum parallel to the wall, not allowing your ribs to poke out. 

Alignment of the head

Keep your chin in the same plane as your sternum and then move your head back so your ears line up with your shoulders. This is similar to the cervical retraction exercise I outlined above.

This would also impact the alignment down the rest of your spine, but we won’t get into that here. If you want to read more you can check out my e-book and get the 411 of alignment from your pelvis all the way up the spine to the head. 

A note on posture and alignment

Just to be clear, I am definitely of the camp there is no one perfect posture. I am also of the camp more movement and variety of movement is better than maintaining any one position. Even “perfect” alignment would lead to tightness if held for too long. 

The main reason I like to talk about alignment is I do think it allows for better muscle activation when we’re performing tasks requiring more “oomph.” And being pregnant can sometimes feel like you need a little more “oomph” to get through your day. 

Other Ideas 

Acupuncture

While I have not personally tried acupuncture, I have had patients who have and thought it was worth their while. Acupuncture may help downregulate the nervous system (like diaphragmatic breathing can), which in turn can help with pain signals from the brain. 

Pregnancy massage

Like acupuncture, massage can also help with the way your brain communicates with the body. When you feel more relaxed, your parasympathetic system is in the driver’s seat. And that’s what we want most of the time! 

The 1st thing I would try to treat headaches during pregnancy

So after reading all of that, you may be wondering, what would I try first?

Breathe.

Work on your breathing. During pregnancy, it’s easy to take short breaths as your baby grows up into your diaphragm. Take long, slow, deep breaths expanding the rib cage 360 degrees.

Why breathing? For one, it’s free, you don’t need any equipment, you can do it anywhere, and you already do it as part of your day-to-day (obviously). I know it sounds simple, but the pain we experience and the way we breathe are so interconnected. 

So breathe in, breathe out. And if you want more help with breathing, head over to elizacait.com/free-gift to get my e-book with the most successful tips I use with my patients to learn diaphragmatic breathing. 

 

P.S. If you feel like anxiety is part of your issue,  you can also download 5 free wallpapers with Bible verses to help you quiet your mind on the free gift page. 

Which one of these do you think will help you most?

References:

Dixit A., Bhardwaj, M., & Sharma, B. (2012) Headache in pregnancy: A Nuisance or a New Sense? Obstetrics and Gynecology International, 2012. 

Kvisvik, E. V., Stovner, L. J., Helde, G., Bovim, G., & Linde, M. (2011) Headache and Migraine during Pregnancy and Puerperium: the MIGRA-study. The Journal of Headache and Pain, 12(4), 443-451.