Headaches are one of the most common reasons that people see their primary care physician and they account for 20% of outpatient visits to neurologists. People with chronic or persistent headaches report disabling symptoms that interfere with daily activities. Many have sought numerous different headache treatment approaches, only to accept these headaches as a fact of life, and becoming dependent on medications to relieve their symptoms.
The International Headache Society has classified hundreds of different types of headaches into two categories: primary headaches and secondary headaches. Primary headaches include migraine, tension-type, and cluster headaches. They are the most common type of headache and stem from a single cause.
Secondary headaches are classified according to their causes, including temporomandibular joint (TMJ) disorders, vertigo, myofascial pain, and cervicogenic headaches, which are attributed to mechanical disorders of the neck. Both types of headaches can be treated with physical therapy.
What Causes Headaches?
Headaches are often a combination of factors, including musculoskeletal, psychological, neurovascular, nutritional, and chemical imbalances in the brain. Some headaches relate to or are indicative of a disease process; some are life-threatening and others benign. Thus, a thorough medical evaluation is necessary with any onset of a new or ongoing headache.
A thorough physical therapy examination attempts to determine the type of headache and to define the neuromusculoskeletal factors contributing to it. Muscle tension, joint dysfunction of the neck and jaw, poor posture and stress are factors that can be addressed and treated by a skilled physical therapist trained in manual therapy.
How Can Physical Therapy Provide Headache Treatment?
Treatment may include use of heat or ice, soft tissue mobilization, shoulder blade, mid back, rib, and neck mobilizations, neck stretches, dry needling, neck and mid back strengthening, and posture education. In addition, we’ll provide you with best practices to manage or decrease your pain the next time you feel a headache coming on.
Each patient is treated differently, as each headache is unique!
Physical therapy treatment for headaches can be extremely effective – some patients may notice immediate relief, though some may require a few weeks of physical therapy to address strength issues. Not only can PT reduce pain for those suffering from headaches and migraines, it can also prevent future occurrences.
If I’m Suffering From a Headache, Why Does My PT Want to Focus on My Muscles or Joints?
Fairly frequently, headaches can actually stem from musculoskeletal problems involving the neck, jaw, and shoulder, and there are two ways the muscles and joints in these areas can cause pain.
The first is called referred pain. Most people know that pains in the chest, left shoulder, and left arm frequently signal a heart attack. When the heart muscle is stressed, the pain experienced can be felt in the arm, likely because of the way the nerves from the arm and the heart travel together to the brain. That’s referred pain. Similarly, the neck’s muscles and joints can refer pain to the head.
For example, if you’re someone who works a desk job or is frequently bent over a computer, you’re likely to develop myofascial trigger points, or knots. These knots can refer pain up the neck and into the temple.
The second way musculoskeletal issues can cause headaches is when the muscles in the neck trigger a migraine. For some, muscle tightness and dysfunction in the neck can lead to pain and discomfort that triggers a migraine headache.
If you suffer from headaches and are looking for a way to manage them beyond medication, e-mail us at LetsTalk@PTCentral.org and a Board Certified Orthopedic Specialist will answer any questions you may have related to treatment options.