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  • Tara Albright DPT

Headache Awareness Month...PT can help!

Updated: May 5, 2021

Pounding, pulsating, vice grip on your head, brain feeling ready to explode, ice pick

in your eye socket…do any of these symptoms sound familiar?

It is estimated that approximately 13% of U.S. adults suffer from chronic migraines and 80-90% of U.S. adults will suffer from tension headaches at some point in their lifetime. That is a daunting statistic, but there is good news. Several of these headaches may be helped with physical therapy. Check out the various types of headaches and how we can help:

Migraines are one of the trickier “headaches” and are often not helped much with physical therapy. Most true migraines are a centrally-mediated pain disorder; this means that the problem is in the central nervous system (the brain and spinal cord), which leads to the pain and neurologic symptoms often known as a migraine. These types of headaches need specific medical management. Occasionally PT can be helpful to manage the secondary tightness that occurs in the neck muscles, but this is not a common occurrence.

Cervicogenic headaches are recognized as a distinct headache originating in the cervical spine. Cervicogenic headaches are generally characterized as unilateral (one sided) neck pain that starts in the spine and spreads into the forehead and temporal region of that same side. Headaches usually starts as intermittent and then progress to more constant. Occasionally secondary symptoms such as nausea, dizziness, and phonophobia/photophobia can be present, making the distinction between migraine and cervicogenic headaches a little tricky. The main distinction is that migraine headaches can switch sides of the head and cervicogenic headaches do not switch sides. Cervicogenic headaches can be successfully treated using physical therapy measures such as joint mobilizations or manipulation, manual techniques, and dry needling as well as strengthening and postural education to assist with management of symptoms and prevention of returning headaches.

Tension headaches are characterized as bilateral pain in the neck and head that seems to stem from the neck muscles tightening. You will often hear people say that they “carry their stress in the neck and shoulders”. Stress is a big proponent to tension headaches and stressors can be a trigger for these headaches but other triggers for tension headaches can be poor nutrition, fatigue, insufficient sleep, hormonal changes, alcohol use, TMJ dysfunction, and weather changes. These possible triggers can be picked up by giving a good history to your doctor when being evaluated. Tension headaches can be treated with a physical therapy treatment plan focused on manual therapies, mobilizations/manipulations, massage, dry needling, education on posture and stretching techniques to eliminate the tension. As far as tension-type headaches go there are two types:

1) Episodic Tension-Type Headaches can be infrequent, occurring less than 12 days/year, or frequent, occurring more than 12 days per year, but less than 180 days per year. The frequent headaches may last longer than 1 day, but less than 10 days.

2) Chronic Tension-Type Headaches are characterized by occurring more than 180 days per year. Often they occur more than 15 days/month for 3 or more months.

Recent research has pointed to the manual skills of a physical therapist as a main component of relief from headaches. One study showed physical therapy treatment improved patient’s quality of life and reduced their headaches better than the normal medical management of medication and relaxation techniques by 30%. A more recent study showed dry needling and manipulation therapy as a very important addition to conservative physical therapy, with patient’s noting quicker improvement and longer standing results when compared to conservative management alone. Often, with headaches there are an underlying root problem, such as joint mobility issues, postural imbalances, and muscle weakness that if left unchecked and managed can cause a recurrence of headaches.

Let us help you get that throbbing, nagging, excruciating pain out of your head for good. Call us today for an appointment and see how we can help.

This information compiled from and by Tara Albright PT, DPT, Cert DN

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