Headaches

Headaches

There is effective treatment for almost every type of headache. The challenge lies in determining the type of headache, its cause, and in developing an appropriate treatment plan that will reduce both its frequency and intensity. Physical therapists can help determine the type of headache you have and are experts in managing pain from tension-type headaches.

What are Tension-type Headaches?

Headaches, like back pain, are one of the most common of all physical complaints and can be one of the most frustrating to manage.
Tension-type headaches (also called muscle-spasm headaches) are the most common types of headaches in adults. They may be the result of a neck or jaw problem, poor posture, fatigue, or stress and are customarily treated effectively with physical therapy intervention.

A problem in the neck, head, or jaw–such as an injury or arthritis–can lead to tension in the muscles at the back of the head and to increased pressure on the nerves to the face and head. Poor posture can cause these muscles to become overworked, which can trigger a headache.

How Does It Feel?

A tension-type headache typically begins at the back of the head and spreads to the top of the head and the eyes. You might feel an increase in facial pain along the cheeks near the jaw, with symptoms often described as “behind the eye” as well. People often describe tightness, a sensation of someone tugging on their hair, or a feeling of wearing a tight cap. These headaches can worsen with specific positions and may ease with rest ormoving away from prolonged positioning such as sitting at a desk or driving.

How Can a Physical Therapist Help?

Your physical therapist will conduct a thorough examination that includes a review of your health history. Your therapist will ask you questions and will perform tests to determine the most likely cause of your headaches. For example, your therapist might ask you:

• To recall any previous injuries to your neck, head, or jaw
• Describe the location, nature, and behavior of your pain and other symptoms
• To draw your areas of pain on a body diagram
• Perform tests of muscle strength and sensation
• Examine your posture when sitting, standing, and performing various activities
• Measure the range of motion of your neck, shoulders, and other relevant parts of your body
• Use manual therapy to evaluate the mobility of the joints and muscles in your neck

If it appears that you do have tension-type headaches, your physical therapist will work with you to design a plan of care to meet your goals. If the evaluation indicates that you may have a different type of headache–such as sinus, migraine, or cluster headache–your physical therapist likely will refer you to another healthcare professional for additional diagnostic tests and treatment. Your physical therapist will work with you to correct the problems that are causing your pain and will help you learn to prevent headaches through simple changes in your posture and lifestyle:

Improve your neck mobility

Physical therapists use specialized hands-on techniques, referred to as manual therapy, to increase movement and relieve pain and to stretch the muscles of the back of the neck

Improve your strength

Your physical therapist will teach you exercises to increase the strength of the muscles that help stabilize your upper back and neck to improve your posture and endurance and make it easier for you to sit or stand for longer periods of time without discomfort

Improve your posture

Physical therapists will teach you to ways to improve your posture. Whether it is simply pushing your chest out or pulling your shoulder blades backward and together, slight modifications to everyday living can make a vast improvement in posture

Modify your workstation or home office

Tips may include:
•Using a headset instead of a regular phone
•Adjusting your computer screen so that it is no lower than the level of your eyes
•Using an appropriate desk chair
•Adjusting the position of your computer mouse

Real Life Experiences
Sarah has noticed over the past two weeks that she has experienced a “pressure sensation” starting at the base of her head that travels to the front of her forehead when she is sitting at her computer for more than an hour. Her discomfort increases as the day goes on, but is less on weekends.

She decides to consult her physical therapist to see if physical therapy can help. Her therapist discusses her symptoms with her, examines her, and determines that her headache is a tension-type headache resulting from tightness in the muscles of the neck. The therapist works with Sarah to treat her pain, including manual techniques to increase her flexibility, targeted exercises to improve her strength, and improve her posture with a variety of techniques. The physical therapist also offers suggestions for making changes to her workspace. For instance, Sarah makes sure that her computer monitor is directly in front of her and at eye level; she buys a new desk chair; and she now uses a headset for her phone. She quickly notices that her headaches are much less severe and that she can work at the computer for longer periods of time. Soon, Sarah is headache-free.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat a variety of conditions or injuries. You may want to consider a physical therapist that is experienced in treating individuals with musculoskeletal problems or who is a board-certified clinical specialist. Active Lifestyles Physical Therapy of Draper, Utah consists of three physical therapists that have a combined clinical experience of over 75 years as well as board certifications in orthopedic physical therapy. We offer a combination of the most effective and contemporary treatment options available including joint mobilization techniques, instrument assisted soft tissue mobilization and dry needling.Following your initial evaluation your treatment will be tailored to your needs and may include an array of specific interventions.

Additional Resources

The American Physical Therapy Association (APTA) and physical therapy as a profession believe that consumers should have access to information that could help them make health care decisions and also prepare them for their visit with their health care provider.

APTA has determined that the following articles provide some of the best scientific evidence on how to treat cervicogenic headache. The articles report recent research and give an overview of the standards of practice for treatment both in the United States and internationally. The article titles are linked either to a PubMed* abstract of the article or to free access of the full article, so that you can read it or print out a copy to bring with you to your health care provider.

Becker WJ. Cervicogenic headache: evidence that the neck is a pain generator. Headache. 2010;50:699–705. Article Summary on PubMed.

Hall T, Briffa K, Hopper D, Robinson K. Reliability of manual examination and frequency of symptomatic cervical motion segment dysfunction in cervicogenic headache. Man Ther. 2010;15:542–546. Article Summary on PubMed.

Hall T, Briffa K, Hopper D. Clinical evaluation of cervicogenic headache: a clinical perspective. J Man Manip Ther. 2008;16:73–80. Free Article.

van Duijn J, van Duijn AJ, Nitsch W. Orthopaedic manual physical therapy including thrust manipulation and exercise in the management of a patient with cervicogenic headache: a case report. J Man Manip Ther. 2007;15:10–24. Free Article.

*PubMed is a free online resource developed by the National Center for Biotechnology

Information (NCBI). PubMed contains millions of citations to biomedical literature, including citations in the National Library of Medicine’s MEDLINE database. This information was adapted with permission from APTA MoveForwardPT Originally article authored by Eric S. Furto, PT, DPT, MTC, FAAOMPT and Reviewed by the MoveForwardPT.com editorial board. September 20, 2011

This information was adapted with permission from APTA MoveForwardPT Originally article authored by Eric S. Furto, PT, DPT, MTC, FAAOMPT and Reviewed by the MoveForwardPT.com editorial board. September 20, 2011