Many people are surprised to learn that physical therapists can help manage headaches. While physical therapy may not be effective for all types of headaches, there are several ways in which physical therapists can help manage pain, decrease secondary effects of chronic headaches, and improve your lifestyle habits. Follow along as we share why physical therapy is the secret behind headache management. 

What is a headache?

Simply put, a headache is a pain in your head that can originate from other sources in the body. While the definition is short and sweet, there is much more involved when determining the true cause of the headache itself. 

Headaches are extremely common, and 96% of the population will experience at least one headache in a lifetime. Females tend to suffer more than males, especially when it comes to migraines. According to the American Journal of Medicine, migraines occur in 10% of the population, whereas tension-type headaches are more common and can occur in 40% of the population.

Tension-type headaches, are often caused by referred pain from the neck. The neck is filled with proprioceptors that, when irritated, can create a mismatch of information regarding our head and neck position. Additionally, tight neck muscles, slouched posture, and poor workstation set-up can contribute to abnormal pain patterns and eventually cause a headache.

female with shoulder blade pain and headaches 

Trigger points within our head, neck, and upper shoulder regions can also refer pain and mimic a headache. Recall that our joints and muscles are composed of different types of soft tissue that can be easily aggravated by injury, posture, or specific conditions. Due to close anatomical proximity, anything that affects these areas of the body has the potential to present as a headache or neck pain. 

Some research studies have also shown there to be a relationship between dizziness, balance problems, lightheadedness, and headaches. Because this can be suggestive of a serious health concern, it is always a good idea to discuss these symptoms with a healthcare professional. 

Why should I see a physical therapist for my headaches?

The International Headache Society created 14 classifications in which there are over 100 possible causes of headaches. While physical therapy may not be effective for all variants, there are certain types of headaches that would benefit from physical therapy treatment. 

Headaches that are related to the musculoskeletal or nervous systems due to muscle tension, joint problems, or posture can be treated by physical therapists, who are experts in these types of disorders. Oftentimes, pain will be referred behind the eyes or in front of the forehead, which is known as a Ram’s horn distribution. Individuals who sit at a computer workstation for long periods can suffer from headaches related to poor posture or work ergonomics. These types of headaches, while still considered to be tension-type headaches, may come and go throughout the workday. 

headaches after a motor vehicle accident or whiplash

Physical therapy may also be effective for headaches from a traumatic event, such as a motor vehicle accident, fracture, or falls. Headaches that linger after trauma may be related to cervical neck dysfunction, known as a cervicogenic headache, and can refer pain to the front part of your head, the back of the neck, the Ram’s horn distribution, or behind the eye/eyebrow. Unfortunately, issues stemming from trauma-related headaches may be more challenging to treat due to the potential involvement of the central nervous system, which is responsible for receiving information from the sensory receptors in our body. Problems affecting the central nervous system can result in blurry vision, lightheadedness, nausea, vomiting, or dizziness. These issues can complicate recovery and may lead to hypersensitivity of other headache-related symptoms. 

Other types of headaches that may be relieved with physical therapy include headaches from nerve pain/damage, stress, or concussions. Due to the heterogeneity of headaches, it is important to understand the cause of the headache in order to find the most effective treatment strategy to relieve pain and restore quality of life. Physical therapists can also help resolve secondary symptoms that may result from pain caused by vascular insufficiency, stroke, brainstem damage, medication overuse, or migraines.  

What should I expect during my first physical therapy appointment? 

physical therapy assessment of headaches

During your initial evaluation, your physical therapist will take a detailed history of your headache patterns, medical history, and daily routine. Next, during the physical examination, the therapist will attempt to reproduce your pain by touching various muscles and joints to determine if your headache originates from the musculoskeletal system. From there, your physical therapist will determine if your headache is treatable through physical therapy interventions.

Which physical therapy treatments will help my headaches? 

Thanks to the research, physical therapists can perform several effective treatment techniques to help manage your headaches. 

Hands-on technique, in conjunction with specific exercises, have shown to be most beneficial in reducing the frequency of headaches. Physical therapists can address stiff joints in the neck or spine in order to improve range of motion and mobility. Strengthening exercises for the deep neck muscles and upper back can also be helpful in alleviating secondary impairments caused by headaches. 

Headache management is most effective with a holistic approach to treatment. Your physical therapist may ask you to keep a headache diary in which you record your headache frequency, intensity, and triggers throughout the week. He or she may also provide recommendations to correct your workstation set up and sleeping position in order to reduce poor postural habits. Lastly, you may also benefit from stress management techniques, like meditation or mindfulness, to reduce muscle strain that can contribute to tension-type headaches. 

Is physical therapy effective for migraines? 

Although they are poorly understood, migraines tend to be different from standard headaches in the sense that they may be centrally-mediated and caused by changes within the brain. Common symptoms of migraines include: 

  • Blurred or double vision
  • Nausea
  • Vomiting
  • Bilateral symptoms
  • Aura/light sensitivity
  • Sound sensitivity
  • Dizziness/lightheadedness
  • Throbbing pain

While physicians can control migrainous episodes through medication and lifestyle management, physical therapists can help to address secondary effects of chronic migraines, like neck and shoulder pain, to restore movement and mobility. 

How long will it take until I see relief from my headaches? 

Relief from headaches may take some time, especially if you have been suffering from them for a while. However, you should begin to see results within four weeks of treatment, especially if you have been following the recommendations of your physical therapist. Sometimes, results can take up to eight weeks for individuals who also experience pain from the neck or jaw that may complicate and prolong recovery. 

person holding head due to headache or migraine

Takeaway points

As discussed above, there are many factors that can contribute to headaches. Determining the source of your headaches is crucial in order to determine the most effective way to manage your pain. 

If your headaches are related to problems within the musculoskeletal system, then physical therapy is your best option for treatment. Your physical therapist will evaluate your pain patterns, neck movements, posture, and daily habits in order to create an individualized treatment plan that works for you. Keep in mind that a holistic approach to headaches is highly effective and can include journaling about your headaches, workstation ergonomics, or stress management techniques. Those who suffer from migraines may be initially seen by a primary care provider or neurologist before seeing a physical therapist for secondary effects, like neck and shoulder pain. 

Recovery from headaches may not happen overnight, and seeing a qualified physical therapist who is specialized in musculoskeletal conditions is an important factor in the treatment process. If you are located near Columbus, Canal Winchester, or Blacklick, then contact Peak Physiotherapy and Performance today to begin your journey. Dr. Junak has extensive experience in treating headaches and can answer all of your questions during a free 15-minute phone consultation. Inquire here to learn more ways in which you can improve your headaches and live pain-free! 

About the Author

Dr. Andrew Junak is a Doctor of Physical Therapy and Board-Certified Orthopedic Specialist. Dr. Junak received his Doctorate of Physical Therapy from Walsh University and completed his Orthopedic Specialist training at the Cleveland Clinic. He is the owner of Peak Physiotherapy and Performance, a physical therapy clinic in Canal Winchester and Blacklick, Ohio. He serves the local communities of Lancaster, Grove City, Blacklick, Pickerington, and Columbus. Dr. Junak is passionate about helping people solve their problems in order to get them back to doing the things they love.

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