Physiotherapy for Headaches

Headaches comprise one of the most common pain conditions worldwide and are a common cause for visits to medical practitioners and physiotherapists. According to clevelandclinic.org, up to 75% of adults would have experienced a headache in the last year, and headache is a major cause of absenteeism from work or school. Headaches are also common among children. Most children will have had a headache episode by the time they reach high school.

Symptoms of the most common headaches

Migraine

• Mostly located at the front of your head
• Pain is usually unilateral (on one side of your head) and may change sides
• Attacks last 4-72 hours
• Moderate to severe Throbbing pain
• Routine physical activity aggravates the pain
• Commonly associated with associated symptoms such as nausea, vomiting, dizziness, and sensitivity to light and sound
• With or without an aura (sensation or symptom prior to onset)e.g. dizziness, tinnitus. visual changes, numbness, weakness or pins & needles
• More common in women and often affects young adults younger than 30 years
• Multidisciplinary treatment is best (medication & physio)

Cluster Headache

• Attacks occur several times/year varying from short-lived episodes 1- 8x/day.
• Severe unilateral pain that may change sides.
• Begins abruptly and builds up intensity quickly.
• Autonomic symptoms are common on the affected side: drooping or teary eye, redness of the eye, sweating pale skin or nasal congestion.
• Best managed with medication, relaxation techniques, and addressing potential triggering factors.

Tension-Type Headache

• Lasts 30min- 7 days
• Bilateral (on both sides of the head)
• Pressing, tightening, non- pulsating pain
• Mild to moderate intensity
• Not associated with nausea or vomiting
• Not aggravated by routine physical activity
• May have sensitivity to light or sound
• Muscle tenderness in the head, neck and shoulders is associated with intensity and frequency
• Prevalent in teenagers and adults
• Best treated with analgesics and physiotherapy to address areas of tightness

Cervicogenic Headache

• Located at the back of the head
• Predominantly unilateral but may be bilateral, pain does not change sides
• Dysfunction in the neck (cervical spine) refers pain into the head and face
• Nagging, non-throbbing pain
• Pain triggered or aggravated by neck movement, prolonged or awkward neck postures and/or sustained pressure at the base of the skull
• Restricted neck movement and tenderness in neck muscles
• May be associated with arm/shoulder pain or discomfort, nausea, or dizziness. difficulty concentrating and visual disturbances
• Often a history of previous whiplash Injury
• Best treatment is physio- manual techniques to address joint and soft tissue dysfunction and exercises to address motor control deficits or postural dysfunction

How can physiotherapy help me with my headaches?

Headaches may be triggered by many things. Think of a glass of water. Each trigger fills your glass bit by bit. Eventually, your glass overflows and causes a massive headache. Environmental triggers like certain foods, exposure to allergens, strong odours and load noise may cause a headache. Poor or prolonged postures that place excess strain on your eyes, neck or back, as well as emotional stress, may trigger a headache.

Physiotherapy helps to empty your glass again! It is important to remember that physiotherapy treatment is not a quick fix. We recommend that you start by attending 2 sessions per week, and gradually reduce the frequency of your sessions. In this way, we prevent your glass from overflowing.

Physiotherapists are equipped with skills and knowledge to help you determine what type of headache you may be suffering from. Once you and your physiotherapist understand the origin of your headache, you can treat and manage it more effectively.

Treatment will involve identifying your specific headache triggers, and implementing strategies to avoid or manage these. Your physiotherapist will address associated joint and muscle tension in your neck, jaw, shoulders and upper back. This is done by using massage, joint mobilisation techniques, dry needling, electrotherapeutic modalities, and specific exercises and stretches. We may incorporate relaxation and breathing techniques to further assist tension release. We also teach you self-management strategies to prevent or treat future episodes.

Each patient is unique and different; therefore, a treatment program will be developed according to the specific needs of each of our patients.