Physio for Headaches

Author: pivotalphysio

Headaches plague many people, especially these days with the stress and changes of lifestyle that have come with COVID-19. Beyond that, headaches are common in those who work desk jobs, have suffered from a motor vehicle accident, or are prone to holding their tension in their upper body. While headaches have many different causes or triggers, they also present differently depending on what may be the source of the pain. For example, some headaches are more painful and one-sided, whereas others can be described as more dull and originating at the base of the skull. Based on your unique presentation, Physiotherapists can help to identify the cause of your headaches as well as work with you to find both short term and long term solutions to your symptoms.

Cervicogenic Headaches

In this era of technology, phones, computers, and binge-watching Netflix can play a big role in causing what are called Cervicogenic headaches. Cervicogenic headaches are caused by neck dysfunction and along with neck pain, generally are felt as pain or tension in the neck and back of the head. This can be a result of habitual slouched postures, such as your common desk job or use of technology but can also be commonly found in weight lifters or those who have suffered from whiplash and concussions. Where you feel the pain can differ slightly depending on what muscles are involved; from muscles in the shoulders, to the base of the skull.

TMJ referral

Much like necks can cause headaches, painful and tight jaws can also be a source of your pain. Whether you clench your teeth, grind at night, or have developed tightness over time, physiotherapists can once again help to assess and treat jaw dysfunction and thereby help to resolve the headaches they cause.

Tension Headaches

Stress is another common culprit that can cause headaches, specifically one classification known as tension headaches. These types of headaches, which generally begin in your early 30’s and can sometimes last multiple days, tend to be relatively less intense than other types of headaches and the pain will present at the front of the head.

Migraine Headaches

A third common headache type is the migraine. Migraines can involve a cluster of the following symptoms: nausea, vomiting, pulsating, light sensitivity. They are known to be only on one side of the head and can often make it difficult to carry on with daily life when they attack. There are a number of causes of headaches including but not limited to genetics, activity levels, stress, and diet.

Treatment and Prevention

Initially, Physiotherapists help to rule out a more serious cause of your headache such as a stroke or tumor. Once the more emergent causes have been ruled out as a cause of your headache, Physiotherapists can be beneficial in helping to prevent and alleviate some of the types of headaches mentioned above and their resulting symptoms.

Treatment Process

  1. Physiotherapists can assess your posture or movement patterns and determine if certain muscles or joints are tighter than they should be.
  2. From there, your Physiotherapist will design a personalized exercise program to help alleviate any tension and strengthen the opposing muscles or muscles that are chronically weak (note: these are usually the ones that create those muscle “knots”). Generally, the areas targeted include the neck, jaw, upper back, and shoulders.
  3. Depending on the therapist, they may offer other supplementary treatment to help facilitate the exercise program such as hands on release, dry needling/IMS, or acupuncture to name a few. 

I personally like to focus on education, posture, and therapeutic exercise in the beginning, because these will allow you to manage your symptoms independently and long term. While we wait for these exercises to take affect (habits can be hard to change right away!), I often use manual therapy and dry needling to target the muscle “knots” and create the short term release that pairs well with the exercises that should help to maintain the release.

Research suggests that increased physical activity has been proven to decrease stress levels which can precipitate both tension headaches and migraines.

Some causes and symptoms of tension headaches and migraines cannot be treated by Physiotherapists directly; however, there is evidence that aerobic exercise can decrease the number of days per month spent with migraines. Research also suggests that increased physical activity has been proven to decrease stress levels which can precipitate both tension headaches and migraines. Additionally, there is evidence that neck pain and dysfunction can be a cause and a symptom of migraines and a symptom of tension headaches.

A Physiotherapist is a professional who can not only help treat neck dysfunction but can also advise on exercises and an activity level that is appropriate for you.

When should you see a physiotherapist for headaches?

You should seek Physiotherapy for your headaches if you are looking for a long-term solution to pain, stiffness, or poor posture either before trying medication or to supplement the other types of treatment you may be using. If your Physiotherapist believes the headaches may be caused from stress or another mechanism that is beyond their scope, they can also help refer you to the appropriate medical professional.

Robyn Losch
Physiotherapist at Pivotal Physiotherapy

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