Headaches can be, well, a real headache. Almost everyone experiences one every once and a while. For some though, the headache can seriously debilitate them. They either suffer constantly or cannot function in their daily lives because of the headaches. The type of headache will determine the correct treatment: cervicogenic headache, migraines, and tension headaches all have different indications. Some of the indications that physical therapy may help resolve your pain are outlined below.
Cervicogenic Headache
Referred pain to the head happens frequently. The first three nerves of the neck can refer pain to the head. A cervicogenic headache occurs on one side
of the head: usually in the back, top-front, or eye. It can last one hour to weeks, and neck movement triggers it. People with cervicogenic headaches also report pain when a therapist moves the vertebrae in certain positions. The good news about cervicogenic headache: it resolves quickly. Most of my patients and clients with cervicogenic headache get better after one to three sessions. Other practitioners report good results as well. Often, they use different techniques from what I would use and still see improvements. This type of headache seems to respond to a variety of treatment options within the physical therapy spectrum.
Migraine Headache
One study (1) found that 86% of migraine sufferers had upper cervical dysfunction and 70% of tension headache sufferers has upper cervical dysfunction. Migraine headaches occur primarily in women. They usually occur on one side of the head but can shift side to side. Migraines usually involve the entire side of the head and can happen about one to four times per month. They can last between four to seventy-four hours. They have a variety of triggers, including light. Neck movement often does not trigger migraine pain. Many physical therapists feel that they cannot treat this type of pain. Chaibi (2), though, found physical therapy and other modalities just as effective for migraine headache management as medication. Though they also reported need for improved quality of testing. I personally have had success treating migraines with soft tissue mobilization and myofascial release. As a side note, I’ve had clients who used removal of food allergens to get rid of their migraines when manual therapy did not help.
Tension Headache
Finally, the last type of headache, the tension headache, also benefits from physical therapy. Tension headaches feel diffuse and mild to moderate in severity. People often report feeling a “tight band” around their heads. Tension headaches can last for days or weeks. They feel worse in people with “trigger points” in the neck and upper back. Some studies had found that manual therapy did not affect tension headaches. Newer studies (3), though, show improvements with physical therapy. I personally notice improvements with clients with tension headaches, though I have not treated as many people with tension headaches as with cervicogenic or migraine headaches.
Putting it all together
In conclusion, if you have had headaches, physical therapy or massage therapy can, many times, help end them. The great thing about these techniques is if they don’t work, you at least get to relax and have stress relief. Food allergens should be ruled out if therapy doesn’t work. Also, headache, in rare cases can indicate more serious health problems, such as cancer. Finally, if you haven’t seen improvements, visiting your physician can rule out these more serious concerns.
Reference:
1) Marcus, D. A., Scharff, L., Mercer, S. and Turk, D. C. (1999), Musculoskeletal Abnormalities in Chronic Headache: A Controlled Comparison of Headache Diagnostic Groups. Headache: The Journal of Head and Face Pain, 39: 21–27. doi:10.1046/j.1526-4610.1999.3901021.x
2) Chaibi A, Tuchin PJ, Russell MB. Manual therapies for migraine: a systematic review. The Journal of Headache and Pain. 2011;12(2):127-133. doi:10.1007/s10194-011-0296-6.
3) Victoria Espí-López G, Arnal-Gómez A, Arbós-Berenguer T, González ÁAL, Vicente-Herrero T. Effectiveness of Physical Therapy in Patients with Tension-type Headache: Literature Review. Journal of the Japanese Physical Therapy Association. 2014;17(1):31-38. doi:10.1298/jjpta.Vol17_005.