In the US over 37 million people suffer from migraines or chronic headaches. For many, headaches can be disabling, with chronic headache suffers being three times more likely to suffer depression as well. All too often, treatment for such headaches consists of over-the-counter pain medicine, prescription pain medicine, invasive injections or even surgery. But what if your headache was actually produced in your neck and could be treated without medicine or invasive medical procedures?

Physical therapy, including exercise, relaxation techniques and posture retraining, have been shown to be as effective as many medications in decreasing the frequency of headaches. To better understand how physical therapy can help alleviate headache pain, however, we must first look at the two main types of headaches. 

Two of the most common types of headaches are tension and cervical headaches, with tension headaches being the most prevalent in the general population. Tension headaches occur when neck and scalp muscles become tense, or contract. The muscle contractions can be a response to stress, depression, head injury, or anxiety.
They may occur at any age, but are most common in adults and older teen, and they are slightly more common in women. Common symptoms of tension headache include:
  • Constricting feeling around the head such as wearing a tight hat or tight band is common in tension headache. The pain is mild to moderate in intensity but may be severe in some cases.
  • Neck pain and trigger points are usually present in the neck, shoulder, and face muscles that induce pain upon manual pressure. 
  • Increased sensitivity to light or sound—any one symptom may be present
  • Pain does not worsen with routine physical activity in tension headache.

Cervical headache is another common headache that occurs when pain is referred from a specific source in the neck up to the head. Cervical headaches are often caused by trauma, such as fracture, dislocation, or whiplash injury, or an underlying medical condition such as rheumatoid arthritis, cancer, or infection. Common features of cervical headaches include:
  • Pain originating at the back of the neck and radiating along the forehead, area around the eye, temple, and ear
  • Pain along the shoulder and arm on the same side
  • Reduced flexibility of the neck
  • Eye swelling and blurriness of vision may occur on the affected side in some cases
  • Pain almost always affects the same side of the neck and head, but in uncommon cases both sides may be affected

How can Physical Therapy Help?
Tension and cervical headaches can be effectively treated through skilled physical therapy. Due to the fact that both of these types of headaches can often times mimic symptoms associated with migraine headaches (or even cluster headaches), a proper evaluation is of upmost importance.

The initial exam includes assessment of: range of motion of the head/neck; joint mobility, musculature tightness, tenderness, and trigger points, strength and endurance of the deep neck flexor muscles, strength and endurance of the axioscapular muscles, and posture. The physical therapist will also include other appropriate tests and measures and, once a diagnosis has been confirmed, appropriate treatment is determined.

Physical therapy can first relax the tension in the muscles with soft tissue mobilization or massage and joint mobilization, which decreases acute pain. Exercises are then given to help strengthen the neck and postural muscles to allow these muscles to withstand the tensions of day to day life. Dry needling or TENS electrotherapy may also be utilized to further relief.

The skilled physical therapists at the The Smith Clinic for Physical Therapy are highly trained in the evaluation and treatment of headaches. If you suffer from headaches, don't suffer a minute longer! Please call or come by our office today to schedule an evaluation...we’ll handle the rest. It's that easy!