Content reviewed and contributions made by Jaqueline Davenport, PT, DPT
We’ve all had to deal with headaches throughout our lives. Whether it’s from eye strain, a bump to the head or a deeper, underlying condition, every single person has experienced a headache at some point or other. And some of us get them much more than others. Folks who are plagued by chronic headaches or migraines learn to navigate the world around their symptoms as best they can.
Here is the good news: in many cases, PT can be a great solution for some types of headaches. Of course, there are some types that this treatment won’t be able to alleviate. However, for some common types, PT is an excellent alternative to medication to alleviate and reduce symptoms.
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How Common are Headaches?
Did you know that up to 75% of adults worldwide have reported having headaches within the last year? Frequent or chronic headaches can be just as common. According to the World Health Organization, up to 1 in 20 adults has a headache nearly every day, and chronic migraines affect 1 in 7 adults worldwide. In fact, headaches are so common that there are more than 150 types of headaches. These headaches can be grouped into one of two main categories: primary and secondary.
Primary vs. Secondary Headaches
A primary headache doesn’t have an underlying cause. The headache, on its own, is the condition. A migraine or tension headache would be considered a primary headache.
A secondary headache is caused by something else. It’s a byproduct of something else, like caffeine withdrawal, spinal headaches from epidurals or even a headache from a whiplash or concussive event.
Common Types of Headaches Physical Therapy Can Help
Because headaches come in so many varieties, they often need different kinds of treatment that extend beyond physical therapy. Some more severe ones, like spinal headaches, need to be managed with other medical interventions.
There are many headache types where PT can make a difference though including concussion or whiplash, TMJ (temporomandibular joint) or jaw headaches. Physical therapy can also help relieve some of the most common headaches like tension and cervicogenic headaches and even migraines.
What Are Tension Headaches?
Tension headaches are probably the most common type of headache where the primary symptom is pain that feels like a tight band around the head. This pain feels like a dull, aching sensation and usually doesn’t throb. Often a person notices a general stiffness in the upper shoulders and the back of the neck as well.
The underlying causes of tension headaches vary, so every tension headache can present differently. Some can be triggered by stress, posture, or general weakness in the head, neck and shoulders.
What are Migraines?
Migraines are a specific type of headache. First, they often come with other symptoms such as light and noise sensitivity and neck pain. (NOTE: While it was previously thought that neck pain may be a contributing factor, recent research suggests that neck pain may be another migraine symptom for some rather than a contributing cause.) Second, these types of headaches can last for a few hours or even up to a day or two. With the combination of both factors, migraines can be debilitating for the person experiencing them.
Like tension headaches, the causes are multifactorial and vary by person. Stress, hormones or even certain foods and drinks, like chocolate or wine, can trigger a migraine. As mentioned above, for some individuals, a neck disorder may be a contributing factor while it may be simply a symptom for others. Despite varying symptoms and causes, individuals should consult their doctor to help determine their personal triggers, navigate their symptoms and find the right type of treatment.
What Are Cervicogenic Headaches?
Cervicogenic headaches are another type of secondary headache caused by issues with the upper cervical spine. The upper cervical spine is responsible for many small movements of the neck, and there are many muscles associated with that control.
Cervicogenic headaches specifically stem from issues with those top few vertebrae in the neck and how the musculature controls the movement of this part of the head. People who experience cervicogenic headaches often report a pain on one side of their head, and when the headache reoccurs, it usually stays on that same side.
Common symptoms of cervicogenic headaches include:
- Dull, non-throbbing pain in the head and neck
- Reduced flexibility in the neck
- Blurred vision in one eye
- Pain in the shoulder, arm, or shoulder blades
The pain may also extend from the back of the head toward the forehead and impact your scalp, temples and the areas around your eyes and ears.
Is Physical Therapy for Headaches Right for Me?
As was already mentioned, there are far too many types of headaches for physical therapy to be effective for all of them. But individuals who suffer from headaches that might be the result of an underlying tension in the shoulders, neck or head may benefit from physical therapy.
The best way to know if physical therapy is right for you is to talk to your doctor. They will be able to work with you to get you a more specific diagnosis, which will inform the appropriate treatment for your situation. Physicians can prescribe medication as well as provide a script for therapy for those headaches that may stem from tension in the head and the neck.
However, if you have any other symptoms in addition to your headaches, such as fever, vomiting, dizziness, a rash, and so on, make sure you share that with your doctor, as that may indicate a larger issue.
Exercises and Physical Therapy for Headaches
When it comes to headaches, your situation is as unique as you are. If your physician recommends physical therapy, your treatment plan will be completely tailored to you. However, if you are looking to relieve your pain without the use of medication before your first appointment, our headache specialist, Jaqueline Davenport, PT, DPT, has some suggestions to try at home.
Body Scanning for Tension Headaches
When we’re stressed, it’s easy for our bodies to stiffen up as a result. If we’re sitting with our shoulders bunched up, that can lead to tension. Our muscles don’t like to be “on” all the time, so it is important to check in with your body.
One way you can start to manage that is to perform body scanning every few hours – especially in stressful situations. Take a few moments and think about where your shoulders are. Are they sneaking up toward your ears? Are your shoulders rounding forward and are you slouching? Take a few minutes to practice some slow, deep breaths and focus on relaxing the top of your shoulders, the tightness around your eyes. Maybe even just change positions, do a few shoulder rolls and reset your posture.
Shoulder Strengthening for Migraines
For migraine sufferers, practicing and adopting proper posture can help support the neck and head and consequently relieve pain. One way to ensure that posture is developed and maintained is by strengthening the back of our shoulders.
One great strengthening exercise is called a “T”. Lay on the floor with your head facing down toward the ground and put your arms out to your side like your body is a “T”. Then with your thumbs up, lift your arms off the floor an inch or two, squeezing your shoulder blades and then return them to the floor. You can repeat this exercise in sets of 10, doing what your body is able to work on so you can develop that strength.
Chin Tuck for Cervicogenic Headaches
A chin tuck is one of a few great cervicogenic headache exercises because it can help correct your posture and help alleviate the headache pain that stems from your neck. Lay on the ground with your head flat on the floor. You can use a pillow if needed, but you’ll feel more stretch with your head on a firm surface.
Imagine a pencil going through your ears and rotate your chin down, looking towards your feet and feeling the back of your head sliding up along the floor. Hold the stretch for a few seconds and then release and relax.
Physical Therapy for Headaches Can Be a Powerful Treatment
If your headaches are caused by issues with your muscles or joints, physical therapy may be exactly what you need to find relief. Physical therapists are movement specialists and can provide you with the tools to manage tension headaches, migraines and cervicogenic headaches without or in addition to medication.
Contact your physician or talk to an ATI physical therapist to find out if physical therapy for headaches is right for you.