• 3 Ways a Physical Therapist Can Help Manage Headaches

    Headaches affect 47% of the global population and are described by the type and location of pain in the head. Many headaches are harmless and resolve gradually. However, more frequent moderate to severe headaches can impact your ability to do daily activities and quality of life. 

    Different types of headaches include:

    • Tension
    • Cervicogenic or neck muscle-related
    • Migraine
    • Secondary headaches from an underlying condition, such as fever, infectious disease, sinus disorder, or in rare cases, a tumor or more serious illness
    • Unspecified headaches

    A physical therapist will perform a clinical examination to diagnose the type of headache and develop an effective treatment plan. Physical therapy has been proven to:

    • Decrease or resolve the intensity, frequency, and duration of headache
    • Decrease medication use
    • Improve function and mobility
    • Improve ease of motion in neck
    • Improve quality of life

    A physical therapist treatment plan may include:

    1. Manual therapy: Proven hands-on techniques are designed to alleviate joint and muscle stiffness, increase mobility of the head and neck, decrease muscle tension and spasms, and improve muscle performance.
    1. Exercise: Research has shown that various types of specific exercises will decrease pain, improve endurance, decrease inflammation, and promote overall healing. In addition to individualized prescribed exercises, customized home-exercise programs are an essential part of the treatment plan.
    1. Education: Educational strategies have been found helpful at lessening severity and/or frequency of headaches. These strategies include identifying highly individualized triggers (ie, dietary, sleep, movement/postural habits, stressors, hydration). Effective strategies to alleviate symptoms also include a wide variety of relaxation techniques.

     

    Resources

    Blanpied PR, Gross AR, Elliott JM, et al. Neck pain: revision 2017. J Orthop Sports Phys Ther. 2017;47(7):A1–A83. Free Article.

    Ferracini G, Florencio LL, Dach F, et al. Myofascial trigger points and migraine-related disability in women with episodic and chronic migraine. Clin J Pain. 2017;33(2):109–115. Article Summary in PubMed.

    Bevilaqua-Grossi D, Goncalves MC, Carvalho GF, et al. Additional effects of a physical therapy protocol on headache frequency, pressure pain threshold, and improvement perception in patients with migraine and associated neck pain: a randomized clinical trial. Arch Phys Med Rehabil. 2016;97(6):866–874. Free Article.

    Fernandez-de-las-Penas C, Cuadrado ML Physical therapy for headaches. Cephalalgia. 2016;36(12):1134–1142. Article Summary in PubMed.

    Irby MB, Bond DS, Lipton RB, Nicklas B, Houle TT, Penzien DB. Aerobic exercise for reducing migraine burden: mechanisms, markers, and models of change processes. Headache. 2016;56(2):357–369. Free Article.

    Louw A, Puentedura EJ, Zimney K, Schmidt S. Know pain, know gain? A perspective on pain neuroscience education in physical therapy. J Orthop Sports Phys Ther. 2016;46(3):131–134. Free Article.

    Fernandez-de-las-Penas C, Courtney CA. Clinical reasoning for manual therapy management of tension type and cervicogenic headache. J Man Manip Ther. 2014;22(1):45–50. Free Article.

    Page P. Cervicgogenic headaches: an evidence-led approach to clinical management. Int J Sports Phys Ther. 2011;6(3):254–266. Free Article.

    Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther. 2006;11(12):118–129. Article Summary in PubMed.

    Jull G, Trott P, Potter H, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headaches. Spine (Phila Pa 1976). 2002;27(17):1835-1843. Article Summary in PubMed. 


    Authored by Denise Schneider, PT.

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