HEADACHES
CERVICOGENIC HEADACHES
TENSION HEADACHES
MIGRAINES
CERVICOGENIC HEADACHES TENSION HEADACHES MIGRAINES
It may be surprising, but physiotherapy can be an effective way to manage headaches. Seeing a physiotherapist can help you to manage ongoing symptoms arising from headaches or provide treatment to prevent future episodes. There are different types of headaches, so understanding what you are experiencing will help you obtain individualised treatment and achieve a positive outcome.
Cervicogenic Headaches
Cervicogenic Headache regions of pain
A cervicogenic headache presents as unilateral-sided pain that starts in the neck. It is a non-throbbing and non-lancinating (no piercing or stabbing sensations) pain that is usually felt in the occipital to frontoparietal and orbital regions and is triggered by neck movements or certain postures.
Diagnostic Criteria
Pain localised in the neck and back of the head which can spread, aggravated by neck movements and certain postures, pressure over C0-3, and limited range of motion.
Recommended Physio Treatment
Patients will often experience symptomatic relief from manual therapy, which may include mobilisations over the upper cervical segments and soft tissue release. Management can also involve targeted exercises to focus on range of motion, quality of movement, and strengthening the surrounding musculature to provide support and function to the cervical region.
Tension-Type Headache
Tension type headache regions of pain
A tension-type headache is a mild to moderate diffuse pain that is often described as a tight band squeezing the head and is not aggravated by neck movements. This is a common type of headache and is often triggered by:
Stress and anxiety
Fatigue
Depression or crying/being upset
Poor posture
Bright, noisy environments
Eye strain (i.e., long periods of reading, screen time).
Smoking
Caffeine dependence or withdrawal
Dehydration
Diagnostic Criteria
Bilateral location, pressing/tightening quality, mild or moderate intensity, not aggravated by routine physical activity or movement, no nausea or vomiting
Recommended Physio Treatment
Tension-type headaches can usually be self-managed, especially if there is an identifiable trigger that you can modify. Physiotherapy may also help with symptom management and headache prevention through targeted exercise, manual therapy and acupuncture.
Migraine
migraine headache regions of pain
Migraines are typically an intense throbbing or pulsing pain which can be unilateral or bilateral and are accompanied by other symptoms such as nausea, vomiting, and light sensitivity. They can be heavily debilitating and interfere with performance of daily activities.
Diagnostic Criteria
Felt in the frontal, periorbital and temporal regions, pulsating quality, moderate to severe pain, at least one of: nausea, vomiting, or photophobia/phonophobia, not aggravated by neck movements.
Recommended Physio Treatment
Treatment for migraines involves preventative measures and acute relief. Preventative measures may include lifestyle modifications such as identifying and avoiding possible triggers, stress management, diet, exercise, sleep and smoking. Acute relief from migraines can be managed with appropriate medications, with physiotherapy as an adjunct. Physiotherapy management can include manual therapy, targeted neck and shoulder exercise, relaxation techniques, education and self-management techniques.